Designing Universal Basic Income for Socially Just Health Outcomes

Background and Purpose: The Ontario Basic Income Pilot was one of the largest basic income projects to date anywhere. When the pilot program and accompanying government research were prematurely cancelled in 2018 with a change of provincial government, academics worked to fill the gap and collect quantitative and qualitative data from pilot participants. The original team produced well-received findings on the quantitative data (Ferdosi et al., 2020). This presentation draws on a follow up study that analyzed the qualitative data and triangulated them with the quantitative findings. The study aimed to establish whether basic income could be an effective alternative to current income support programs. In this presentation we center physical and mental health outcomes to explore the potential for basic income as a socially just policy response.

Methods: Participants were based in Hamilton-Brantford, Ontario, Canada. Findings draw on qualitative interview data from 40 participants, which was then triangulated with the previously completed descriptive analysis of 217 survey responses. We employed an iterative approach to thematic analysis in NVivo, inductively developing themes first from the data, then deductively reflecting on the experiences using an intersectional and systems perspective (Hankivsky et al., 2014; Mertens, 2007). The research project was carried out in partnership with an advocacy organization and community knowledge dissemination was an important component of the project.

Results: While analysis showed that basic income had positive effects on a range of well-being indicators, in this presentation we will build on previous work on the effects of basic income for physical and mental health (Forget, 2015). Indirectly, basic income improved health through, for example, better housing, food security and community participation. Participation in the pilot program also worked directly to increase use of preventative methods for both physical and mental health, improve access to long-term healthcare supports and decrease the need for urgent care. However, participants identified important limitations in the design of this program compared with alternate social policy responses. For example, those previously on the Ontario Disability Support Program lost certain healthcare benefits under the pilot program. Moreover, the sudden cancellation of the pilot caused significant damage to the physical and mental health of multiple participants.

Conclusions and Implications: Basic income programs, if done properly, could play an important role in improving the physical and mental health of participants. However, poor design of temporary pilot programs, or sudden cancellation due to changing political landscapes, can have serious negative consequences for health. This research has important implications for those who advocate for equitable alternatives to current income support programs and those who work to improve public health. This is particularly relevant in the context of the current health crisis, which has been exacerbated in Ontario by the precarity of low-wage workers. As we advocate for improved social policies and public health, it is essential to call not for band-aid solutions, nor yet another precarious pilot project, but for well-designed programs that will have long-lasting positive effects. Finally, we discuss the limitations of this project as a replacement for government research.