Basic Income An Upstream Solution to Food Insecurity
Basic Income: An Upstream Solution to Food Insecurity Dr. Lisa Simon, Associate Medical Officer of Health June 20, 2017
Outline • SDOH and the Roots of Food Insecurity • Basic Income and Health • Ontario’s Basic Income Pilot • SMDHU Campaign on Food Insecurity
What determines our health? (CDC. Based on Tarlov, Annals of the NY Academy of Sciences, 1999. )
Health inequities
1 in 8 households are food insecure
Cost of food is out of reach
Relationship between food insecurity and household income 60% Food insecurity captures material deprivation. 50% Percent food insecure 40% 30% 20% 10% 9 $7 9, 99 9 $7 0, 00 0 - $6 9, 99 9 $6 0, 00 0 - $5 9, 99 9 $5 0, 00 0 - $4 9, 99 9 000 0, $4 0, 00 0 - $3 9, 99 9, $2 $3 0, 00 0 - $1 $2 $1 0, 00 < 0 - $1 0, 9, 00 99 0 9 0% the product of • income - stability, security, and adequacy relative to expenses (e. g. , shelter, food, medications, debt) • assets / home ownership Income adjusted for household size (Tarasuk, Mitchell & Dachner, Household Food Insecurity in Canada, 2014. 2016) Slide courtesy of: Dr. Valerie Tarasuk
Food insecurity crosses income sources (Tarasuk, Mitchell & Dachner, Household Food Insecurity in Canada, 2014. 2016)
Moving Upstream (National Collaborating Centre for Determinants of Health, 2014)
Basic Income as a response to food insecurity
Basic Income (BI) • Regular, reliable distribution of money from government to people to help ensure total income sufficient to meet basic needs, regardless of work status • Can be distributed: • On a universal basis (demogrant) • Conditional on income, so that the benefit is reduced as income increases (negative income tax)
BI is not the same as income assistance • It is an entitlement, conditional only on income and family size, therefore guarantees universal income security • No requirement for job search or employment availability • No detailed application and monitoring – payment is automatic • Proposals often more generous than income assistance • May better support transition to employment • Covers those already employed but in poverty
BI is not a replacement for all social programs • Generally seen as a replacement for adult benefits • E. g. Ontario Works (OW) and Ontario Disability Support Program (ODSP) • EI, CPP, universal health coverage, and most else should stay in place
BI is one prong of a comprehensive social security framework Must be complemented by: • Affordable housing • High quality, affordable child care • Labour law reform • Education and training • Health benefits • Etc.
Key public health rationale for BI Basic income has a role as part of a comprehensive approach to addressing key SDOH: § Poverty and food insecurity: Effective, dignified, and efficient part of a comprehensive poverty reduction strategy. § Income inequality: Help close the gap in income. § Precarious employment: Increase social security given substantial labour market changes and uncertainty.
BI also has potential to: • Enhance autonomy and dignity • Support opportunities for education and unpaid work at home/community • Support creativity and entrepreneurship • Strengthen local/regional economies • Simplify and lessen costs of administering welfare
Manitoba Mincome Experiment 1974 -1979 • Canadian GAI field experiment • 8. 5% decrease in hospitalization rates for participants vs. controls, and decline in physician contact • Increased high school completion • Minimal work disincentive (Forget, Canadian Public Policy, 2011)
Impact of Child Benefits Expanded Canada Child Tax Benefit and National Child Benefit: • low-income families used the additional income for basic needs, education and health (Jones, Milligan, and Stabile, National Bureau of Economic Research, 2015)
Impact of Seniors’ Benefits Old Age Security & Guaranteed Income Supplement • • Canada has one of lowest rates of seniors poverty in world Single low-income adults over age 65 have: • half the prevalence of food insecurity of those under 65 • better health outcomes than recipients of conditional income assistance programs under 65 (Mc. Intyre et al, Canadian Public Policy, 2016; Mc. Intyre et al, CJPH, 2016)
Probability of moderate and severe food insecurity by age among low-income unattached adults (CCHS 2007 -13) Slide courtesy of: Dr. Valerie Tarasuk
Support for BI Support for the concept of BI has come from: • Economists and social policy experts • Politicians at all levels, across the political spectrum: • Federal: Minister Duclos interest, Political party resolutions • Provincial: ON pilot, QC gov’t examining, others interested • Municipal: Many Council motions, Mayoral support • Civil society: BICN, and local BI support groups • Health, food insecurity, and social work sectors • International: e. g. Finnish and Dutch pilots
Health Sector Support for BI • SMDHU Board of Health endorsed the concept in 2015, and called for federal-provincial investigation into BI • Followed by similar endorsement by: • Association of Local Public Health Agencies (Ontario) • Multiple other local Boards of Health • Ontario Public Health Association • Ontario Society of Nutrition Professionals in Public Health • Registered Nurses Association of Ontario • Canadian Public Health Association • Canadian Medical Association • ~200 Ontario physicians signed letter to ON Minister of Health
Ontario’s Basic Income Pilot: Background • Feb 2016: Pilot announced • June 2016: Hon. Hugh Segal appointed Special Advisor on BI • Summer 2016: Segal led informal consultations to inform submission to government • Several health organizations made in-person and written contributions • Nov 2016: Hugh Segal’s discussion paper and ON gov’t consultation guide released • Consultations until Jan, 2017
Ontario’s Basic Income Pilot: Plans • 3 yr RCT in 3 communities (n=4000) starting 2017: Hamilton/Brantford/Brant, Thunder Bay & area, and Lindsay • Participants: 18 - 64 yrs, low income • Planning a separate, parallel First Nations BI Pilot
Ontario’s Basic Income Pilot: Plans • Benefit amount: up to $16, 989/yr (single) or $24, 027 (couple), less 50% of earned income. Up to + $6, 000/yr if disability. • Measuring outcomes in: • mental health, stress/anxiety, food security, health & health care usage, housing stability, ed & training, employment & labour market participation • Evaluation by third-party research consortium
Cent$less …. what is it? A communication campaign to create public support & advocacy for income solutions to household food insecurity
Public Awareness http: //www. smdhu. org/centsless https: //www. facebook. com/simcoe. muskoka Campaign Componen ts Media Awareness http: //www. simcoemuskokahealth. org/JFY/Newsroo m/topical/food-and-income-press-kit Community Engagement
Cent$less …. where are we headed? Community advocacy for policies that ensure everyone has enough money to feed themselves & their families today, next week & years from now.
�� Takk Gracias Thank you Mahalo Merci Miigwetch Spacibo Dankie Dziękuję
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