P3.192: Wealth and Health: Connecting the Dots Between Perinatal Cash Transfers and Child Health

Background: The United States continues to have stark health inequities, with both maternal and infant mortality rates highest among Black families. Studies show state-level earned income tax credits result in significant reductions in preterm births and low birth weight births, the largest contributors to infant mortality, with the most notable gains among Black families. Despite such evidence supporting cash transfers as a means to address both health and wealth disparities, US policymakers do not yet view unconditional cash transfers as an effective health policy intervention. The objective of this project was to identify opportunities for targeted advocacy campaigns that support implementation and expansion of cash transfers during the perinatal period.

Project Description: This project was developed in partnership with several pregnancy-focused guaranteed income programs that are part of a national collaborative advocating for a federal maternal and infant cash program. In conversations with policymakers, we heard a desire for an improved understanding of how perinatal cash transfers impact child and family well-being. To address this need and strengthen advocacy efforts, we distilled findings from U.S.-based, peer-reviewed research on perinatal cash transfers into conceptual frameworks to more explicitly link cash transfers with demonstrated maternal and child health outcomes. By identifying several hypothetical causal pathways, we can articulate both the human and financial impact of cash transfers. Our conceptual framework also supports narrative change, combating stigma and harmful stereotypes associated with giving cash directly to families. For example, our mechanistic framework (Figure 1) illustrates how cash reduces health harming behaviors such as tobacco use. This finding may dispel myths and false narratives that cash given directly to families may be used for substance use.

Discussion: This project distills a large body of academic work into informative visuals that can be used to engage policymakers and influence policy change (Fig. 1 and 2). Modeling how and why cash transfers improve health across the maternal and infant continuum helps translate the evidence into potential cost savings and equity advances for policymakers and other key stakeholders. This work is already informing and guiding conversations with policymakers and advocates to lay the groundwork for a national perinatal cash policy agenda. In addition, our work identifies gaps in the literature that support more targeted research efforts to advance evidence-based cash transfer policy.

Conclusion: Our visual frameworks simply and effectively convey the health impacts of perinatal cash transfers. With clearer messaging around how cash improves maternal, infant, and early childhood health, we can better advocate for cash transfers as a targeted intervention to reduce the persistent racial disparities in maternal and infant mortality.