Effects of guaranteed basic income interventions on poverty-related outcomes in high-income countries: A systematic review and meta-analysis.

Background: High-income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly conditional and stringent in recent decades based on the premise that transitioning people from government support to paid work will improve their circumstances. However, many people end up with low-paying and precarious jobs that may cause more poverty because they lose benefits such as housing subsidies and health and dental insurance, while incurring job-related expenses. Conditional assistance programs are also expensive to administer and cause stigma. A guaranteed basic income (GBI) has been proposed as a more effective approach for alleviating poverty, and several experiments have been conducted in high-income countries to investigate whether GBI leads to improved outcomes compared to existing social programs. Objectives: The aim of this review was to conduct a synthesis of quantitative evidence on GBI interventions in high-income countries, to compare the effectiveness of various types of GBI versus "usual care" (including existing social assistance programs) in improving poverty-related outcomes. Search Methods: Searches of 16 academic databases were conducted in May 2022, using both keywords and database-specific controlled vocabulary, without limits or restrictions on language or date. Sources of gray literature (conference, governmental, and institutional websites) were searched in September 2022. We also searched reference lists of review articles, citations of included articles, and tables of contents of relevant journals in September 2022. Hand searching for recent publications was conducted until December 2022. Selection Criteria: We included all quantitative study designs except cross-sectional (at one timepoint), with or without control groups. We included studies in high income countries with any population and with interventions meeting our criteria for GBI: unconditional, with regular payments in cash (not in-kind) that were fixed or predictable in amount. Although two primary outcomes of interest were selected a priori (food insecurity, and poverty level assessed using official, national, or international measures), we did not screen studies on the basis of reported outcomes because it was not possible to define all potentially relevant poverty-related outcomes in advance. Data Collection and Analysis: We followed the Campbell Collaboration conduct and reporting guidelines to ensure a rigorous methodology. The risk of bias was assessed across seven domains: confounding, selection, attrition, motivation, implementation, measurement, and analysis/reporting. We conducted meta-analyses where results could be combined; otherwise, we presented the results in tables. We reported effect estimates as standard mean differences (SMDs) if the included studies reported them or provided sufficient data for us to calculate them. To compare the effects of different types of interventions, we developed a GBI typology based on the characteristics of experimental interventions as well as theoretical conceptualizations of GBI. Eligible poverty-related outcomes were classified into categories and sub-categories, to facilitate the synthesis of the individual findings. Because most of the included studies analyzed experiments conducted by other researchers, it was necessary to divide our analysis according to the "experiment" stage (i.e., design, recruitment, intervention, data collection) and the "study" stage (data analysis and reporting of results). Main Results: Our searches yielded 24,476 records from databases and 80 from other sources. After screening by title and abstract, the full texts of 294 potentially eligible articles were retrieved and screened, resulting in 27 included studies on 10 experiments. Eight of the experiments were RCTs, one included both an RCT site and a "saturation" site, and one used a repeated cross-sectional design. The duration ranged from one to 5 years. The control groups in all 10 experiments received "usual care" (i.e., no GBI intervention). The total number of participants was unknown because some of the studies did not report exact sample sizes. Of the studies that did, the smallest had 138 participants and the largest had 8019. The risk of bias assessments found "some concerns" for at least one domain in all 27 studies and "high risk" for at least one domain in 25 studies. The risk of bias was assessed as high in 21 studies due to attrition and in 22 studies due to analysis and reporting bias. To compare the interventions, we developed a classification framework of five GBI types, four of which were implemented in the experiments, and one that is used in new experiments now underway. The included studies reported 176 poverty-related outcomes, including one pre-defined primary outcome: food insecurity. The second primary outcome (poverty level assessed using official, national, or international measures) was not reported in any of the included studies. We classified the reported outcomes into seven categories: food insecurity (as a category), economic/material, physical health, psychological/mental health, social, educational, and individual choice/agency. Food insecurity was reported in two studies, both showing improvements (SMD = -0.57, 95% CI: -0.65 to -0.49, and SMD = -0.41, 95% CI: -0.57 to -0.26) which were not pooled because of different study designs. We conducted meta-analyses on four secondary outcomes that were reported in more than one study: subjective financial well-being, self-rated overall physical health, self-rated life satisfaction, and self-rated mental distress. Improvements were reported, except for overall physical health or if the intervention was similar to existing social assistance. The results for the remaining 170 outcomes, each reported in only one study, were summarized in tables by category and subcategory. Adverse effects were reported in some studies, but only for specific subgroups of participants, and not consistently, so these results may have been due to chance. Authors' Conclusions: The results of the included studies were difficult to synthesize because of the heterogeneity in the reported outcomes. This was due in part to poverty being multidimensional, so outcomes covered various aspects of life (economic, social, psychological, educational, agency, mental and physical health). Evidence from future studies would be easier to assess if outcomes were measured using more common, validated instruments. Based on our analysis of the included studies, a supplemental type of GBI (provided along with existing programs) may be effective in alleviating poverty-related outcomes. This approach may also be safer than a wholesale reform of existing social assistance approaches, which could have unintended consequences.

Miracle friends and miracle money in California: a mixed-methods experiment of social support and guaranteed income for people experiencing homelessness.

BACKGROUND: This paper describes the protocols for a randomized controlled trial using a parallel-group trial design that includes an intervention designed to address social isolation and loneliness among people experiencing homelessness known as Miracle Friends and an intervention that combines Miracles Friends with an economic poverty-reduction intervention known as Miracle Money. Miracle Friends pairs an unhoused person with a volunteer "phone buddy." Miracle Money provides guaranteed basic income of $750 per month for 1 year to Miracle Friends participants. The study will examine whether either intervention reduces social isolation or homelessness compared to a waitlist control group. METHODS: Unhoused individuals who expressed interest in the Miracle Friends program were randomized to either receive the intervention or be placed on a waitlist for Miracle Friends. Among those randomized to receive the Miracle Friends intervention, randomization also determined whether they would be offered Miracle Money. The possibility of receiving basic income was only disclosed to study participants if they were randomly selected and participated in the Miracle Friends program. All study participants, regardless of assignment, were surveyed every 3 months for 15 months. RESULTS: Of 760 unhoused individuals enrolled in the study, 256 were randomized to receive Miracle Friends, 267 were randomized to receive Miracle Money, and 237 were randomized to the waitlist control group. In the two intervention groups, 360 of 523 unhoused individuals were initially matched to a phone buddy. Of the 191 study participants in the Miracle Money group who had been initially matched to a volunteer phone buddy, 103 were deemed to be participating in the program and began receiving monthly income. DISCUSSION: This randomized controlled trial will determine whether innovative interventions involving volunteer phone support and basic income reduce social isolation and improve housing outcomes for people experiencing homelessness. Although we enrolled unhoused individuals who initially expressed interest in the Miracle Friends program, the study team could not reach approximately 30% of individuals referred to the study. This may reflect the general lack of stability in the lives of people who are unhoused or limitations in the appeal of such a program to some portion of the unhoused population. TRIAL REGISTRATION: ClinicalTrials.gov NCT05408884 (first submitted on May 26, 2022).

How, why and for whom does a basic income contribute to health and wellbeing: a systematic review.

Ensuring that people have a sufficient income to meet their basic needs and that it keeps pace with costs of living are important when considering ways to reduce health inequities. Many have argued that providing a basic income is one way to do this. The aim of this review is to provide an overview of the existing peer reviewed evidence on the health and wellbeing impacts of basic income interventions. A systematic search of ten electronic databases was conducted in June 2022. Eligible publications examined any effect on health and wellbeing from unconditional cash transfers. All study designs were included, and no limitations were placed on duration of cash transfer trials, location of study, study population or on amount of money provided through the cash transfer. Ten studies were included in this review. Studies employed a range of methods. All studies reported on a trial of Universal Basic Income in either a region or a town. Studies explored a range of health and wellbeing related outcomes including crime, quality of life, employment, subjective wellbeing, tuberculosis and hospitalization. Basic income programs can mitigate poverty in a time of economic upheaval and have the potential to become a powerful policy tool to act upon the determinants of health and reduce health inequality. This review found a small number of trials indicating a positive impact on health and wellbeing. More trials which track recipients over a longer period are needed to provide more robust evidence for the impact of basic income programs.

Basic Income in Belgium survey: experimental data on citizens' attitudes toward a variety of basic income policies.

This article presents the BAsic income in BELgium (BABEL) dataset on public opinion on the introduction of a universal basic income (UBI) in Belgium, collected through an online panel among a sample of 3000 respondents in spring 2021. The BABEL survey implements an innovative vignette experiment in which both the policy design (i.e., the benefit level, the universality) and the potential policy outcomes (i.e., effect on poverty, unemployment) of a UBI are set to vary randomly. This full factorial experimental design is appropriate to analyze the complex of process of opinion formation about a UBI which entails multiple considerations. Accordingly, the data enables researchers to assess the net effect of the different design characteristics and hypothetical outcomes, as well as the trade-offs people are (not) willing to make to support basic income. Additionally, the survey includes items about benefit recipiency, COVID-19, demographic characteristics, general welfare attitudes, behavioral intentions, and political opinion. These data are thus appropriate for examining which design or outcome factors are relevant in shaping support for a UBI as well as extensive subgroup analysis.

Reconsidering economic interventions to reduce oral health inequalities.

Despite the general recognition of economic factors as fundamental upstream social determinants of health inequalities, interventions to improve health and reduce inequalities tend to focus on proximal health determinants. However, recent socioeconomic crises have increased the focus on economic factors. Health-related approaches to address economic factors can be divided into two categories: (1) indirect approaches, such as financial support for obtaining dental care and fiscal policies targeting unhealthy commodities and (2) direct approaches, such as cash transfers or provision of a universal basic income. For indirect approaches, policies reducing out-of-pocket payments for dental care appear to improve access to services and reduce oral health inequalities. Price policies targeting tobacco and sugar through taxation are associated with declines in periodontal disease and caries, and sugar taxation appears to reduce oral health inequalities. As regards direct approaches, studies on cash transfers to low-income individuals have found no positive impact on dental visits, while results in relation to caries prevention were inconclusive. No dental studies examined the effect of a population approach to income security, such as basic income. Research on economic interventions for oral health inequalities is scarce, and studies using causal inference methods and natural experiments are urgently needed.

Transformative community projects in East Germany's rural spaces: exploring more sustainable forms of learning, working, and living.

Increasingly people experience alienation in educational institutions, in work life, and fragmentation in their personal life. This study explores more self-determined, healthy, and sustainable forms of working, learning, and living through a dynamic process that began in 2020 with the purchase of an old homestead in Eastern Germany. Through the remodeling of the buildings and grounds, the first social and cultural references emerged. Along with practical uses, the farm project sees itself as a future workshop or think tank. The resulting consideration includes ideas of compulsory schooling woven into a self-designed format and the introduction of an unconditional basic income. These components could lead to thousands of such projects in rural and urban areas. Drawing from communitarianism, the belief is that an active civil society must take on social, economic, and educational responsibilities and offer children and young people improved conditions in which to grow up. Theory development on the individual components exists, such as entrepreneurship, transformation, community-building, basic income, or self-directed learning but not on the interaction of these variables in the overall context. We tentatively call this integrated design a transformative community project.

Universal cash transfers and prescription utilization: Evidence from the Alaska permanent fund dividend.

We investigate the impact of a large cash transfer on prescription utilization. Our identification strategy leverages the Alaksa Permanent Fund Dividend (PFD), which is distributed annually in October and comprises 6% of the average household's annual income. We study the impact of the PFD on the use of prescription medications using a within-Alaska comparison group and difference-in-differences design. Using the IBM MarketScan Commercial Claims and Encounters Prescription Drug Database, we observe prescriptions for 50,866 commercially-insured individuals who filled prescriptions between 2013 and 2019. We find no changes in prescription use overall and are able to rule out changes larger than 0.5% in the week of the PFD and 1.4% the week after. Subgroup analyses find no changes by patient characteristics, degree of cost sharing, or prescription type. We also conduct a synthetic control analysis using a non-Alaska comparison group and find no effects of the PFD on prescriptions. These findings are useful for understanding liquidity sensitivity for prescription medication and the effects of cash distributions among individuals with employer-based health insurance.

Impact of Guaranteed Income on Health, Finances, and Agency: Findings from the Stockton Randomized Controlled Trial.

The purpose of this experiment was to test the effects of a $500 per month guaranteed income for 2 years on health and financial outcomes. A mixed-methods randomized controlled trial in Stockton, CA, USA enrolled 131 individuals to the treatment condition and 200 to control to receive a guaranteed income from February 2019 to January 2021. Quantitative data collection began 3 months prior to allocation at 6-month intervals concluding 6 months after withdrawal of the intervention. Qualitative data collection included 105 interviews across 3 stages. The primary outcomes were income volatility, physical and mental health, agency, and financial wellbeing. The treatment condition reported lower rates of income volatility than control, lower mental distress, better energy and physical functioning, greater agency to explore new opportunities related to employment and caregiving, and better ability to weather pandemic-related financial volatility. Thus, this study provides causal evidence of positive health and financial outcomes for recipients of guaranteed income. As income volatility is related to poor health outcomes, provision of a guaranteed income is a potentially powerful public health intervention.

Are 'red wall' constituencies really opposed to progressive policy? Examining the impact of materialist narratives for Universal Basic Income.

Universal Basic Income (UBI) is often presented as desirable in theory, but unsaleable electorally. Policymakers fear intuitive, 'values'-based opposition from socially conservative voters, whom the policy would benefit materially, but who might regard it as 'giving others something for nothing'. We provide evidence from 'red wall' constituencies in Wales and the Midlands and North of England that indicates this presumption of voters is wrong. In Study 1, we find high levels of support for the policy, with different narrative framings more effective for different groups based on their material interests. In Study 2, we used a novel 'adversarial collaboration' method to show that simple narratives can strongly increase support for UBI even among respondents who initially see themselves as fundamentally opposed. The generated narratives stressed positive, material consequences of introducing UBI, rather than conformity with abstract values. This indicates that policymakers should exercise caution over 'values'-based explanations for preferences. Supplementary Information: The online version contains supplementary material available at 10.1057/s41293-022-00220-z.

Designing a generic, adaptive protocol resource for the measurement of health impact in cash transfer pilot and feasibility studies and trials in high-income countries.

INTRODUCTION: In the context of the COVID-19 pandemic, upstream interventions that tackle social determinants of health inequalities have never been more important. Evaluations of upstream cash transfer trials have failed to capture comprehensively the impacts that such systems might have on population health through inadequate design of the interventions themselves and failure to implement consistent, thorough research measures that can be used in microsimulations to model long-term impact. In this article, we describe the process of developing a generic, adaptive protocol resource to address this issue and the challenges involved in that process. The resource is designed for use in high-income countries (HIC) but draws on examples from a UK context to illustrate means of development and deployment. The resource is capable of further adaptation for use in low- and middle-income countries (LMIC). It has particular application for trials of Universal Basic Income but can be adapted to those covering other kinds of cash transfer and welfare system changes. METHODS: We outline two types of prospective intervention based on pilots and trials currently under discussion. In developing the remainder of the resource, we establish six key principles, implement a modular approach based on types of measure and their prospective resource intensity, and source (validated where possible) measures and baseline data primarily from routine collection and large, longitudinal cohort studies. Through these measures, we seek to cover all areas of health impact identified in our theoretical model for use in pilot and feasibility studies. RESULTS: We find that, in general, self-reported measures alongside routinely collected linked respondent data may provide a feasible means of producing data capable of demonstrating comprehensive health impact. However, we also suggest that, where possible, physiological measures should be included to elucidate underlying biological effects that may not be accurately captured through self-reporting alone and can enable modelling of long-term health outcomes. In addition, accurate self-reported objective income data remains a challenge and requires further development and testing. A process of development and implementation of the resource in pilot and feasibility studies will support assessment of whether or not our proposed health outcome measures are acceptable, feasible and can be used with validity and reliability in the target population. DISCUSSION: We suggest that while Open Access evaluation instruments are available and usable to measure most constructs of interest, there remain some areas for which further development is necessary. This includes self-reported wellbeing measures that require paid licences but are used in a range of nationally important longitudinal studies instead of Open Access alternatives.

Basic Income and the Status of Women in an Established Gender-Equal Welfare State: Results from the Finnish Basic Income Experiment.

Debates on the gendered effects of universal basic income (UBI) tend to bifurcate into two opposing views. On the one hand, UBI is seen as a strong incentive for women to stay at home and be permanently locked into their care responsibilities. On the other hand, UBI is seen as a tool for empowerment, increasing women's autonomy, fortifying their capacity to act, and guaranteeing their individual income and income security. This paper contributes to these debates by asking if UBI enhances women's empowerment or not. Using the survey data compiled in the context of the Finnish basic income experiment (2017-2018), we compare survey responses from the UBI treatment group (n = 586) and the control group (n = 1047). Our results based on χ2 statistics and regression analyses show that, while UBI did not affect employment, it was positively associated with individual capacities and confidence in various aspects of life. However, these empowering effects were universal and did not differ between women and men. Our results indicate that UBI is not a gender equality-related issue in established gender-equal Nordic welfare states. On the basis of our findings, we also argue that the previous academic discussion on UBI and on results from various experiments is too universalising. It does not pay sufficient attention to the national social policy contexts where experiments have been carried out.

The work disability trap: manifestations, causes and consequences of a policy paradox.

PURPOSE: This article focuses on the risk that work disability policies lock people into work disability rather than promote durable health and return to work. We outline the concept of a work disability trap as a heuristic device to explore this policy paradox inherent in the design of most social insurance systems. MATERIALS AND METHODS: This is a conceptual paper drawing on examples from existing research. RESULTS: We identify three manifestations of the disability trap: not overcoming disability; underperforming; and returning to work prematurely. The causes of these manifestations are identified as structural rather than based on malingering clients, while negative consequences are identified both on client and system levels. CONCLUSION: We emphasize the need for systems built on trust and reasonable expectations, and the need for providing rehabilitation support independently of economic compensation. Universal basic income is introduced as a potential tool to ameliorate some of the consequences of the disability trap.Implications for rehabilitationCompensation systems focusing too prominently on early return to work may have counter-productive effects on rehabilitation.Overly suspicious assessment systems nurture a view of people as malingerers.Rehabilitation professionals need to be attentive to system-generated effects which may prevent overcoming work disability.

From industrial to digital citizenship: rethinking social rights in cyberspace.

Growing social inequalities represent a major concern associated with the Digital Revolution. The article tackles this issue by exploring how welfare regulations and redistribution policies can be rethought in the age of digital capitalism. It focuses on the history and enduring crisis of social citizenship rights in their connection with technological changes, in order to draw a comparison between the industrial and the digital scenario. The first section addresses the link between the Industrial Revolution and the genesis of social rights. It describes the latter as a legal 'machine' designed to offset the imbalances produced by the technological movement of industrialization. The second and third sections introduce the notion of 'industrial citizenship' to describe the architecture of social rights in mature industrial societies and to contend that European systems of welfare are still largely modeled on an industrial standard. The fourth part investigates the impact of the Digital Revolution on this model of social citizenship. It identifies debates on basic income as a major trajectory for redesigning welfare regulations in a post-industrial era, and the digital user as a crucial emerging subject of rights. The final part explores how digital users could be entitled to social rights as data suppliers. To this end, it introduces the idea of 'digital-social rights' resulting from the incorporation of welfare and redistribution principles into emerging digital rights. Hence, it proposes a legal-political framework for the redistribution of the revenues generated by data in the form of a 'digital basic income' for citizens of cyberspace.

Can Conservatives Be Persuaded? Framing Effects on Support for Universal Basic Income in the US.

Universal basic income (UBI) has been proposed as a policy response to technological advances and structural inequality. Yet, recent data show that most conservatives in Europe and the US are strongly opposed to the welfare proposal. Can framing UBI as a policy that conforms to their ideological predispositions overcome such opposition? Exploiting the compatibility of UBI with core conservative ideals such as individualism and laissez-faire government, I design an original survey experiment that randomly exposes respondents to one of two frames: (1) an equalizing-opportunity frame which emphasizes that UBI creates a level playing field and promotes self-responsibility, or (2) a limiting-government frame which highlights UBI as a policy that limits government and reduces bureaucracy. I find that American conservatives-identified by using 10 policy statements-remained strongly opposed to UBI even after they were presented with such frames. Analyses of open-ended responses, which show that how conservatives explained their opposition to UBI remained unchanged regardless of framing, reinforce this conclusion. Conservatives' opposition to UBI remained rigid, even after the key components of UBI that fit the conservative ideology were accentuated. These results shed light on the political feasibility of framing UBI, and the rigidity of welfare attitudes among American conservatives. Supplementary Information: The online version contains supplementary material available at 10.1007/s11109-022-09824-z.

A Policy Review of the SEED (Stockton Economic Empowerment Demonstration) Project: Is the Devil in the Details?

This review examines the Stockton Economic Empowerment Demonstration (SEED) project, a guaranteed income (GI) project that was undertaken in Stockton, California from 2019- 2021. SEED is a collaborative initiative by the Mayor's Office of Stockton, the Reinvent Stockton Foundation (RSF), and the Economic Security Project (ESF). The purpose of the SEED project was to ascertain the effects of guaranteed income on the well-being of the project recipients, with a focus on the effects of a UBI on participants' financial and psychological health. This review will study the potential benefits and challenges involved in implementing such a project, from political, social and economic perspectives. The review will also examine a UBI project's long- and short-term viability, and its impact on a city, and the project's beneficiaries. The review will aim to provide a balanced understanding of guaranteed income projects, and the means by which they affect recipients as well as other stakeholders, and the possibilities of implementing guaranteed income on a larger scale.

Decolonising money: learning from collective struggles for self-determination.

As a reflection of our politically engaged research, this paper addresses the multiple challenges of transforming money for the emergence of the Pluriverse, arguing that practical efforts of emancipation and autonomy need to dismantle the colonial nature of our current monetary system: the flip side of the colonial state. On the one hand, we look into Chiloé, a territory marked by long-term relations of colonialism, dependency and extraction, where the arrival of monetised forms of work in extractive industries has meant the destruction of former ways of inhabiting the territory. On the other, we explore the emergence of the Circles project, in Berlin, that aims at creating a basic income from the bottom-up, whereby people in different communities issue money equally and exchange with each other without the need for state cash. More than assuming that money in itself is 'bad', we suggest that a recovery of the social and ecological fabric of life could be done through local money systems, designed and managed by the communities themselves, delivered and redistributed as a basic income. Moving to a plural monetary system based on relations of care would lead to a recovery of history as a project of collective self-determination.

The Role of UBI in Mitigating the Effects of Psychosocial Stressors: A Review and Proposal.

Psychosocial stressors and social disadvantages contribute to inequalities in opportunities and outcomes. In the current paper, we use an epidemiological perspective and highlight the role stress plays on individuals by reviewing the outcomes of major stressors such as poverty and unemployment. We further analyzed the psychological and physical cost of these stressors and their long-term impact. We examined the role of universal basic income and closely looked at income experiments that were implemented in the past, in terms of their effectiveness in enhancing the community as well as individual outcomes and propose the UBI as a tool for alleviating the impact of these stressors. At a time when a major pandemic (e.g., COVID-19) threatens economic stability and health globally, we believe the UBI is relevant now, more than ever.

Designing trials of Universal Basic Income for health impact: identifying interdisciplinary questions to address.

BACKGROUND: A large body of evidence indicates the importance of upstream determinants to health. Universal Basic Income (UBI) has been suggested as an upstream intervention capable of promoting health by affecting material, biopsychosocial and behavioural determinants. Calls are emerging across the political spectrum to introduce an emergency UBI to address socioeconomic insecurity. However, although existing studies indicate effects on health through cash transfers, UBI schemes have not previously been designed specifically to promote health. METHODS: In this article, we scope the existing literature to set out a set of interdisciplinary research challenges to address in designing a trial of the effectiveness of UBI as a population health measure. RESULTS: We present a theoretical model of impact that identifies three pathways to health impact, before identifying open questions related to regularity, size of payment, needs-based supplements, personality and behaviour, conditionality and duration. CONCLUSIONS: These results set, for the first time, a set of research activities required in order to maximize health impact in UBI programmes.

Predictors of Depression among Individuals Receiving the Basic Livelihood Security Program Benefits in Korea: A Study Based on the Sixth and Seventh Korea National Health and Nutrition Examination Survey (2013-2018).

The purpose of this study is to verify the relationship between oral health behaviors and depression and influencing factors on depression to establish strategies that can contribute to improvement of mental health problems such as depression in vulnerable social class recipients. This study is a descriptive correlation study conducted on basic livelihood recipients over the age of 19 who responded to the 6th~7th (2013~2018) National Health and Nutrition Examination Survey. In this study, a total of 2749 people who met the criteria for subject selection were included in final analysis after requesting and downloading their raw data from the National Health and Nutrition Examination Survey through the consent process mandated by the Korea Centers for Disease Control and Prevention. Of the 2749 subjects, 279 were diagnosed with depression, accounting for 10.1% of the total. The collected data were analyzed using t-tests and chi-squared tests, and factors affecting depression were analyzed by logistic regression analysis. Our results showed that the factors affecting depression were 1.74 times for men (95% CI = 1.29-2.24), 1.37 times for older people (95% CI = 1.01-1.87), and 1.66 times for low education (95% CI = 1.21-2.27). Subjects with impairment in daily activities had 1.89 times (95% CI = 1.43-2.52) higher risk. Subjects with moderate physical activity and subjects with economic activity showed a lower risk (95% CI = 0.30-0.73) and 0.52 times (95% CI = 0.30-0.72), respectively, than subjects who did not. We confirmed that the probability of being diagnosed with depression decreased, and the perceived health status was 0.36 times lower (95% CI = 0.22-0.61) than those with good status. Therefore, it is necessary to prepare countermeasures that reflect various aspects in consideration of not only age and gender, but also daily life and emotional state when establishing policies for vulnerable classes such as recipients of basic livelihood.

BARRIERS TO GOVERNMENTAL INCOME SUPPORTS FOR SEX WORKERS DURING COVID-19: RESULTS OF A COMMUNITY-BASED COHORT IN METRO VANCOUVER.

The COVID-19 pandemic has brought into stark focus the economic inequities faced by precarious, criminalized and racialized workers. Sex workers have been historically excluded from structural supports due to criminalization and occupational stigma. Given emerging concerns regarding sex workers' inequitable access to COVID-19 income supports in Canada and elsewhere, our objective was to identify prevalence and correlates of accessing emergency income supports among women sex workers in Vancouver, Canada. Data were drawn from a longstanding community-based open cohort (AESHA) of cis and trans women sex workers in Metro Vancouver from April 2020-April 2021 (n = 208). We used logistic regression to model correlates of access to COVID-19 income supports. Among 208 participants, 52.9% were Indigenous, 6.3% Women of Colour (Asian, Southeast Asian, or Black), and 40.9% white. Overall, 48.6% reported accessing income supports during the pandemic. In adjusted multivariable analysis, non-injection drug use was associated with higher odds of accessing COVID-19 income supports (aOR: 2.58, 95% CI: 1.31-5.07), whereas Indigenous women faced reduced odds (aOR 0.55, 95% CI 0.30-1.01). In comparison with other service workers, access to income supports among sex workers was low overall, particularly for Indigenous sex workers, demonstrating the compounding impacts of colonization and disproportionate criminalization of Indigenous sex workers. Results highlight the need for structural supports that are low-barrier and culturally-safe to support sex workers' health, safety and dignity.