The health case for basic income

Can a universal benefit address poverty, reduce inequality and promote public health?

The health case for basic income
The health case for basic income

By Elliott Johnson, Matthew Johnson, Daniel Nettle, Howard Reed, and Graham Stark

See original post here.

The idea of a universal basic income has had some prominence in recent years – with the Greens committed to phasing it in in their 2019 manifesto, and Labour pledging to trial it in their manifesto that year. It gained prominence again in 2020 when Covid started, with many MPs calling for it in response to the crisis. There is now a briefing on the idea in the House of Lords library.

Can it work? We run Basic Income Health, a long-term interdisciplinary project based at Northumbria University to find out whether the policy is politically and financially feasible, looking at the link between health and income, and assessing Basic Income’s possible health, social and economic benefits.

What is ‘basic income’?

Basic Income would be a system of regular, secure, predictable payments to all the UK’s adult permanent residents to support their basic needs. Unlike most existing welfare systems, it would be largely unconditional – not ‘means-tested’ (dependent on low income), based on additional needs (such as those related to being disabled), or dependent on particular behaviour (such as being unemployed and looking for work).

Health policy has often focused on improving healthy behaviour and increasing the efficiency of health services, but there is a lot of evidence now to show that health is socially determined. In other words, many conditions are strongly affected by factors such as income, wealth, education, social capital and opportunity. With a lot of emphasis now on prevention, some GPs have called for cash prescriptions, and a range of organisations, health bodies, community groups and politicians have called for trials of basic income.

What we know

Awareness of the social determinants of health has been increasing ever since the publication of the Black report in 1980 – with more recent publications including Fair Society, Healthy Lives (the ‘Marmot Review’) of 2010, and the Equality and Human Rights Commission’s evidence review of the impact of welfare reform and welfare-to-work programmes in 2018.

There have also been systematic reviews of evidence on household income and children’s developmental outcomesincome changes and the mental health of working-age adults, and money and health. These have produced some widely differing findings, suggesting that income has little direct impact on health, that both influence the other almost equally, and that income is highly important in determining health – so there is clearly a need for further research.

This project

Our aim is to give policymakers evidence to use in developing and implementing pilots, trials and basic income schemes – and analysing large longitudinal datasets such as Understanding Society is a crucial part of that. The work includes examining relationships between income, financial security and a range of health measures, as well as microsimulation of distributional and health impacts on the basis of trends identified in the data.

Findings so far

Some of the key findings emerging from examination of UK datasets include:

Using Understanding Society, we examined the relationship between socioeconomic status and mental health among 16- to 24-year-olds, and, using the Millennium Cohort Study and Next Steps, we have looked at the relationship between socioeconomic status and mental health among 14- and 17-year-olds and 25-year-olds. Together, these papers showed that being in a higher income group is linked to a lower likelihood of clinically significant depressive symptoms, while those living in the poorest households have a greater probability of mental health problems than the richest. Also, increases in income over the course of childhood and adolescence are associated with reduced symptoms of depression and anxiety.

We have used the Family Resources Survey to microsimulate the distributional effects of Basic Income cash payments at different levels, and found that the policy would be affordable. Even a fiscally neutral starter scheme would take poverty levels for children and pensioners below their post-1961 low points. More generous schemes would achieve more, at greater cost – but, either way, it could all be done in the timeframe of one parliament.

We then combined this analysis with the estimates from the Understanding Society analysis to microsimulate the impact of the distributional changes on anxiety and depression among 14-to-24-year-olds. This suggests that Basic income would have a significant impact as a preventive health measure. For example, based on depressive disorders, NHS and personal social service costs, the savings could be between £125 million and £1.03 billion if 50% of cases are diagnosed and treated.

We have also found that Basic Income would be popular, using crowd-sourced data from ‘red wall’ constituencies.

Finally, we’ve reviewed data sources including the Census, Understanding Survey, and the Crime Survey for England and Wales (and possible linkage between them) to show that any trials of Basic Income could be evaluated much more effectively in order to understand the health impact.


We have used these findings to create a unique tool: the Public Policy Preference Calculator, which allows policymakers, stakeholders and the public to understand the implications of welfare policies.

Users choose a number of policy features – such as payment amounts, income tax rates, employment status, and means-testing – and see estimates of the effects on income distribution, life expectancy, and mental health. It also provides an estimate of the policy’s likely popularity, either for the whole population, or for population subgroups based on voting behaviour, gender, age, or financial situation.

Policy recommendations

We have written reports for CompassAutonomy and the Royal Society of Arts which together set out a series of recommendations for policymakers including:

  • committing to trials of Basic Income
  • explaining the health and economic benefits to voters using narratives tailored to their circumstances
  • comprehensive and consistent evaluation of trials of Basic Income using measures that allow for comparison with longitudinal data
  • more microsimulation modelling to cover all age groups and major health conditions
  • working with researchers and stakeholders to formulate schemes and work out ways of funding Basic Income
  • bringing copyrighted evaluation measures into the public domain.

Our research and reports have had endorsements from politicians such as Mark Drakeford, outgoing First Minister of Wales, and Andy Burnham, Mayor of Greater Manchester – and we hope that a trial will start soon in Jarrow, in north-east England, and East Finchley, in north London.

Research is ongoing, and we are now using Understanding Society data to model the impact of Basic Income schemes on the whole adult population. We’re submitting papers soon, and I hope I can return to this platform with more news of the health case for Basic Income.

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