If you found yourself facing poverty, would you know where to find assistance? You might be aware of traditional safety net programs, like the Supplemental Nutrition Assistance Program (SNAP) to help buy groceries or Temporary Assistance for Needy Families (TANF) to provide income support. Guaranteed income initiatives might be less familiar to you.

Federal and state-run safety net programs were created to support residents experiencing substantial financial hardship. Unfortunately, they have strict limitations: recipients can only use SNAP for certain items, and TANF requires recipients to work a certain number of hours to qualify.

In contrast, guaranteed income is an unconditional, direct cash payment sent to recipients. No strings attached, no work requirements, no restrictions. This cash provides recipients flexibility to use funds on whatever they need – maybe school supplies one month or a medical emergency the next. The foundation of this program rests on trusting people to use funds in a way that makes the most sense for them.

It seems like a radical idea, but before his assassination, Dr. Martin Luther King, Jr. explored guaranteed income as a way to eradicate poverty. Seeing guaranteed income as a tool for racial and economic equity and wanting to test a bold solution to end poverty, then mayor Michael Tubbs, launched the first guaranteed income pilot in Stockton, California in 2017.

Through the Stockton Economic Empowerment Demonstration (SEED), more than 100 Stockton residents received direct cash payments monthly, for 2 years. An analysis found that the income had a positive impact on recipients’ employment status, health, and financial stability. As a result, Tubbs founded Mayors for a Guaranteed Income (MGI) with the goal of creating a network of mayors to advocate for guaranteed income in their communities. Today, more than 100 communities across the U.S. have run programs with their residents.

Sukhi Samra, director of SEED and MGI, joined Public Health Post in a discussion of how the programs were started, how recipients responded, and how policymakers continue to construct initiatives that fit the needs of communities.

Public Health Post: You worked with the Stockton Economic Empowerment Demonstration (SEED). What were some key lessons you learned from the original Stockton program?

Sukhi Samra: Mayor Tubbs was motivated by the work of Dr. King, who wrote that the single most effective solution to poverty was giving direct cash to folks. So, in Stockton we finally decided it was time to get to the root cause of poverty: a lack of cash. But the hardest thing was getting folks to trust that the government would give them something for nothing. Stockton is comprised of historically disinvested communities with hard histories of the government being exploitative and not working in their favor. Folks weren’t used to having the government trust them, so turning around and providing cash without strings attached switched that paradigm.

SEED and MGI were founded and based in California, but you have projects in communities across the country, including here in Boston. When you implement this program in different areas, how do you adapt it to fit the community’s needs?

Our role is to provide funding and technical assistance to mayors. Mayors are on the front lines, the first responders – when constituents are facing problems, the first place they want to go to is their local officials. Mayors see the impacts of economic insecurity in a way that federal policymakers do not. So we leave it to the cities, the mayoral staff, the local nonprofit staff, and local communities to decide what form of a guaranteed income pilot makes the most sense for them. We’re here to guide by providing best practices, and sharing about what worked in Stockton, what didn’t, and some considerations that might be important for them.

The hardest thing in Stockton was getting people to trust that the guaranteed income program was real, and other cities have experienced that, as well. But otherwise, challenges and individual implementations are going to vary city by city.

What do you consider the most important outcomes of this program?

In Stockton, folks were healthier, both physically and mentally. There were significant improvements on mental health outcomes, as measured by the Kessler 10 (assessing psychological distress) and SF 36 (assessing quality of life). There was a significant decrease in the physical pain folks reported. We saw employment numbers go up, and we saw income volatility come down.

Those are the key metrics that we use across all of our pilots, but especially as we try to make a bipartisan argument, employment numbers are really important. We know that this is a country that views “productivity” and the labor market as metrics of success. Right or wrong, that’s the dialogue we continue to use because we know it’s what will move public sentiment forward.

What advice do you have for public health professionals who want to work with policymakers and implement innovative programs like this one?

Guaranteed income very much fits into a framework of public health that recognizes poverty as a public health issue, as the predecessor for so many diseases. But oftentimes, policies move at the speed of trust – it’s vital for public health officials to have that trust with city officials and their residents.

It’s also important to have fundraising and support to test out pilot programs before you scale them into larger policies. And no one wants to reinvent the wheel. Even with innovative policies, being able to point to a community of peers and show that something has been tested elsewhere – I think that is helpful in making government work.

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