Baltimore’s guaranteed income pilot among first to focus on health influence | GUEST COMMENTARY

Baltimore Mayor Brandon Scott, right, shakes hand with Joe Jones Jr., founder of Center for Urban Families, before announcing the guaranteed income pilot program during a news conference at the War Memorial Building.  The pilot program will provide 200  randomized lottery selected young parents unconditional cash payment of $1,000 per month for two years. April 20, 2022. (Kenneth K. Lam/Baltimore Sun Staff)

When mayor Brandon Scott announced an unprecedented direct investment into Baltimore residents, a guaranteed income pilot program that will give 200 randomly selected young adult parents in the city $1,000 a month for 24 months, with no strings attached, he joined a wave of mayors across the country who are investing in people who need it most.

Baltimore’s pilot is critical to the nation, as it will be among the first to focus on how guaranteed income influences the health of family and family members. While these initiatives have often focused on improving people’s financial standing, there has been a missed opportunity to understand the full power of guaranteed income initiatives on other parts of people’s lives.


While ideas of guaranteed income have been in the U.S. since at least the 1960s, and were even championed by people like Dr. Martin Luther King Jr. as part of racial and economic equity, the US has yet to see a widespread national implementation of a guaranteed income for families who have been struggling. There have been other types of guaranteed income, such as the oil reserves that Alaskan residents receive, and the supplemental income that some Indigenous peoples receive when casinos are placed on their reservations, but nothing national and widespread that can help U.S. families meet their needs and build wealth.

Baltimore is not new to interventions that reduce poverty, as one of the sites of the Moving to Opportunity project that had positive impacts on mental and physical health. In Baltimore, specifically, we saw lower crime linked to lower poverty.


With an unique emphasis on family and child health and well-being, Baltimore’s guaranteed income program will be relatively different from how other cities approached this idea. Participants will be surveyed on questions on stress, sleep, time spent with family, and how their health care needs are met — data that researchers might not otherwise be able to obtain. Reports from recent studies in other cities show that after just one year, guaranteed income has led to better mental and physical health, and improved people’s ability to pay for emergency health care and copays.

Baltimore’s two-year pilot gives an even greater opportunity to look at how guaranteed income might influence short-term and long-term health outcomes by examining health closely and potential community health effects, like reducing community violence. We also hope it is a reminder that poverty is a policy choice, requiring policy solutions.

For full disclosure, we must admit that, like most people in this country, we are directly connected to people who would benefit from guaranteed income. A few years ago, Dr. Dean used her tax return refund to help a family member purchase a car. At the time, the family member was living in a rural area and relying on other family members for rides to work. If their ride was late, slept in or was having car trouble, they couldn’t show up at work, which led to repeated job loss.

That one-time infusion of cash changed the entire trajectory of their family. Getting a car enabled them to apply for a better job, reduced their commute (which gave them time to take their special-needs child to health care visits), and travel to better grocery stores or family members’ homes for child care or much-needed joy and rejuvenation.

Similarly, Mx. Snguon used their tax return refund from last year to purchase a van for their father. Mx. Snguon’s father needed a van that could transport his grandchildren from day care or school as well as needing a car himself to get to work.

These are examples of one-time cash support from our personal experiences that we can use in projecting how sustained help over two years can change the entire course of a family’s opportunity — including, potentially, their health. Both Dr. Dean and Mx. Snguon come from communities that experience social and economic deprivation and guaranteed income is a significant step to give people the support they need.

In a country as rich as the US, we have all the resources that we need to ensure that not one family experiences poverty. We applaud Baltimore’s step at investing directly in those families and giving the nation an opportunity to see how guaranteed income influences a family’s ability to escape poverty, as well as set them on a path for better health and well-being. The rest of the nation needs it.

Lorraine T. Dean ( is a member of the Baltimore Guaranteed Income Steering Committee and an associate professor in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health, where Sevly Snguon is a doctoral student.