Academic journal article Canadian Journal of Public Health

Impact of a Guaranteed Annual Income Program on Canadian Seniors' Physical, Mental and Functional Health

Academic journal article Canadian Journal of Public Health

Impact of a Guaranteed Annual Income Program on Canadian Seniors' Physical, Mental and Functional Health

Article excerpt

Four million Canadians (12.9%) live in poverty.1 There is a persistent negative correlation between low income and self-reported health, increased risk of chronic diseases (coronary heart disease, type 2 diabetes), respiratory disease, lung cancer and decreased life expectancy.2 Poverty is also related to adverse impacts on mental health3 and is associated with conditions such as major depression.4

Over the last decade, Canadian governments have implemented a variety of targeted anti-poverty measures, such as increased minimum wage, housing programs, services for low-income individuals and those with disabilities, and programs directed at families with children.2 Despite these efforts, poverty rates remain high, possibly because such measures fail to mitigate lack of sufficient income to cover the basic costs of living.2 An alternative anti-poverty strategy that has been gaining public policy consideration and media attention in recent years is a guaranteed annual income (GAI).5,6 Conceptually, GAI is regular income provided by the state to citizens below a pre-determined economic threshold, regardless of work status.7 The Canada Child Tax Benefit/National Child Benefit Supplement available to Canadian households with age-eligible children could be construed as a form of GAI.8,9 Because GAI has few restrictions, it differs from the current income assistance programs, in which means-testing and stigma might limit access. In essence, GAI provides people with a sense of financial security, as it is a guaranteed payment ensuring that citizens can afford the basic necessities, such as food, clothing and shelter, needed to sustain life.10 Other than the Manitoba-based MINCOME study of the 1970s10 and a public policy study that reported simple descriptive statistics on food insecurity, health and mental health among Canadian seniors and near seniors,11 the evaluation of GAI as a poverty reduction strategy for improved health outcomes has not occurred in this country.

In Canada, seniors 65 years and older are eligible for public pension benefits, delivered through the federal tax system, which collectively function like a GAI (see Appendix A for details). The objective of this study was to determine the impact of seniors' benefits/GAI on self-reported health, self-reported mental health and functional health in Canada using unattached, low-income seniors who are and are not age-eligible for seniors' benefits/GAI. This study is timely in light of the recent call by Ontario physicians and the Special Senate Committee on Aging for implementation of a GAI to address poverty-related illnesses and to provide income security for all Canadians.12,13

METHODS

Data source

The data for this study were obtained from the Canadian Community Health Survey Cycle 5.1 (2009-2010), accessed as microdata through the Prairie Regional Data Research Centre following disclosure rules. The Canadian Community Health Survey is a cross-sectional survey that collects health and sociodemographic data from a large representative sample of the Canadian population.14 Analyses were restricted to respondents in four age groups - two groups that are ineligible for seniors' benefits, as a GAI exemplar (55-59 and 60-64 years), and two that are eligible (65-69 and 70-74 years). We restricted our analysis to single, low-income individuals, as this demographic group is most vulnerable to experiencing food insecurity, a metric of both poverty and health risk.15-17 To identify these individuals, we included only those respondents who a) had an annual household income of CAD $20,000 or less, b) had a personal income of $20,000 or less, so that personal and household were likely equivalent, and c) were not married or attached (e.g., were single, divorced, separated or widowed).

The Canadian Community Health Survey categorizes annual income in $10,000 increments. We used a maximum annual income of $20,000 in this study as the income cut-off for economic vulnerability; this best matched the seniors' benefits/GAI income amount and also remained less than the low-income cut-off (LICO) for a single person living in Canada at the time. …

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