Baltimore community resident and collaborator perspectives on the influence of guaranteed income on health: a formative qualitative study

Given increased interest and investment in guaranteed income initiatives across North America, it is critical to understand the impact of guaranteed income on health, an understudied outcome. As part of Baltimore, Maryland’s guaranteed income pilot, we conducted formative research to understand the influence of increased income on health and develop concrete recommendations for implementation and evaluation of the pilot.

We conducted semi-structured in-depth interviews with Baltimore community residents (n = 8) and community collaborators (n = 8), probing on familiarity with guaranteed income; effect of guaranteed income on overall health and specific health outcomes (e.g., mental health, nutrition); and recommendations for program structure (e.g., eligibility, target population). Data were analyzed thematically using a framework analysis approach.

Respondents agreed that guaranteed income could have beneficial effects on health though some were unsure of specific mechanisms. Respondents emphasized pathways through which guaranteed income could improve health: (1) reduced financial-related stress; (2) improved nutrition through purchase of healthier foods; (3) improved family well-being including child health and parent-child relationships; (4) increased utilization of health services; (5) improved community health through increased community cohesion and decreased violence. Respondents described decreased feelings of time scarcity as a social determinant of health. Most respondents reported that Baltimore’s guaranteed income program should prioritize young, low-income families with $1,000/month or more for at least one year.

This formative research on the potential health impacts of guaranteed income in Baltimore highlights important health outcomes and pathways, such as social cohesion and decreased feelings of time scarcity, to prioritize for evaluation.