A closer look at the meaning of “wellbeing”: what role can cash assistance play?

From the Healthy Gorge Inititative:

By Judy Bankman

When a member of Celilo Village lost her husband to Covid-19, she was grieving and also dealing with a sudden loss of income. She received a hardship card from The Next Door, which provided no-strings-attached cash to help support her and her family.

Another community member wasn’t sure how she would buy gas and groceries.

The hardship card helped.

Research has long demonstrated that health and income are directly related: the higher one’s income, the better one’s health. Covid-19 has shown us how closely public health is connected to economics. When the pandemic hit, the economy took a hit, too.

Many of us were and continue to be directly affected: restaurant and retail workers were laid off, businesses closed, and healthcare providers worked round the clock. Because they generally don’t receive paid time off, many essential agricultural workers lost income if they became sick or had to quarantine.

As providers of healthcare and social services, economics is generally beyond our purview. Our work is centered on eliminating barriers to resources and services, especially for our most underserved communities. Oftentimes, we cannot do much about the economic hardships our clients and patients experience. Covid has begun to change that.

During Covid, the recognition of the relationship between economics and health led to a variety of efforts to provide direct cash assistance to those who most needed it. The federal government issued economic stimulus checks that were eligible to all Americans making under $75,000 a year (or $150,000 for a couple filing joint taxes).

Perhaps for all of us, this was the first time we had received a check directly from the president. At a state level, the Oregon Worker Relief Fund provided $60 million cash assistance to immigrant communities whose work was impacted by the pandemic.

Here in the Gorge, several local organizations had their own version of cash assistance for community members economically impacted by Covid-19.  The Next Door Inc . (TNDI) distributed hardship cards, initially through a community donation campaign called Supporting Your Next Door Neighbor, and later through funding from the Oregon Housing Development Corporation and the Oregon Health Authority.

Like the state and federal programs, TNDI based their efforts on local data. First, staff reached out to their clients with a questionnaire to understand the extent of hardship individuals and families were experiencing. Then, the organization distributed VISA gift cards through Key Bank in amounts ranging from $75 to $300, depending on need.

The nonprofit CultureSeed , which provides year-round connection to nature, self, and others for underserved youth, set up its own Covid Emergency Relief Fund that collected donations from the community to directly support families of youth members during the pandemic. Washington Gorge Action Programs also ran a donation-funded Covid Relief Fund, which assisted households with rent and mortgage payments, car payments, medical bills, and internet installation.

To be sure, many existing programs have long offered support that equates to money, such as SNAP (food stamps), WIC (Women, Infants & Children), and the Housing Choice Voucher program. But these programs have strict guidelines for usage - one cannot use SNAP benefits to purchase diapers or pay a utility bill for example, or use WIC benefits to purchase many types of foods. TANF (Temporary Assistance for Needy Families) is the one form of government assistance without stipulations on how to spend it, but it only reaches 23% of eligible Americans .

Oregon is actually one of a handful of states with the greatest number of eligible residents receiving TANF.

One form of cash assistance, universal basic income (UBI), has been discussed for decades; in 1972, former President Nixon supported UBI that would have provided $1,600 annually to all American families, regardless of income. Now, UBI is having a resurgence.

Andrew Yang

In 2020, Democratic presidential candidate Andrew Yang ran his campaign on a platform of a UBI of $1000 per month.

Today, the Compton Pledge is the country’s largest cash assistance pilot program, which currently provides 800 individuals in Compton, CA with $7,200 a year while studying how a “minimum income floor” could potentially help life families out of poverty.

Several other cash assistance pilot programs around the country have already shown positive outcomes. In June 2020, Mayor Michael D. Tubbs of Stockton, CA founded Mayors for a Guaranteed Income, a program rooted in Martin Luther King Jr.’s legacy and vision of UBI as a means to reach economic equality.

Tubbs’ local program, the Stockton Economic Empowerment Demonstration (SEED), gave Stockton residents $500/month for two years: this resulted in lower levels of depression and anxiety and higher levels of employment among participants.

In 2018, a program called Magnolia’s Mother’s Trust in Jackson, Mississippi provided $1,000 to mothers with low-income for one year with no strings attached. Research showed that 27% of mothers were more likely to see a doctor when necessary, and 40% avoided borrowing money . And yet, as you might expect, this increase in income meant a decrease in eligibility for some services. Rent went up and food stamps disappeared.

The $1000 for one year was not quite enough to bring these mothers out of poverty. What do these examples show us? That UBI, or perhaps any form of cash assistance, will certainly have a positive impact on the wellbeing of those who receive it, from improved mental health to decreased poverty. But, receiving cash is not quite enough to eliminate poverty entirely.

Cash assistance needs to work in conjunction with services, like support for housing, healthcare, and food. Even if cash support is enough to cover all basic needs, it does not replace the value of connections with Community Health Workers or job training programs. Cash assistance has been shown to be a critical part of the solution, but it is not a replacement for valuable, community-based programs.

So far, local jurisdictions and programs targeting specific individuals (e.g. single mothers) have shown success with cash assistance. Even though rolling out cash assistance at the national level was unimaginable for many of us a few short months ago, the fact is it has already happened and it kept millions out of poverty.

Now is the time for more cities and states to extend and expand cash support programs. We can’t deny that economics is a part of well-being. If we want to achieve a Culture of Health and promote wellbeing for all, financial support needs to be part of the equation.

To learn more about the Healthy Gorge Initiative, click here.