the town with no poverty evelyn l. forget community health sciences university of manitoba

THE TOWN WITH NO POVERTY

Evelyn L. ForgetCommunity Health Sciences

University of Manitoba

PROJECT TEAM

• Evelyn Forget• Noralou Roos• Derek Hum• Ron Hikel

• Wayne Simpson• Richard Lobdell• Hugh Grant• Charles Burchill• Pat Nichol

We gratefully acknowledgeFinancial support: Canadian Institutes for Health Research MOP2005Data Access: Manitoba Health

1974

1974

1979

IN MANITOBA

• Ed Schreyer (age 39) was premier

• Roland Penner, subsequently Attorney General, was banned from travel to the US because of his communist sympathies

• The “RED Committee” of Cabinet [resources and economic development] sought social justice

In Winnipeg

DAUPHIN MANITOBA

DAUPHIN MANITOBA1974

DAUPHIN MANITOBA2005

DAUPHIN MANITOBA1954 and 1974 and 2005

Map: River CityNW NECourt house

High School

Communitycentre

Ukrainian OrthodoxChurch

Ukrainian CatholicChurch

Hospital

RR Station

Grain elevators

Arts Centre

“LittleChicago”

River

Railroad Tracks

MainStreet

Darla Rhyne,1979

WHERE DID THE RED COMMITTEE LOOK FOR

INSPIRATION?

A GUARANTEED ANNUAL INCOME

• Would save money because it would eliminate the duplicated bureaucracies of all the different social agencies

• Would be “just” because all people would be treated equally no matter what social programme they fell under– Horizontal equity– Vertical equity

A GUARANTEED ANNUAL INCOME

• Would let people get beyond just “making ends meet”

• Would lengthen time horizon– Should a potentially useful adolescent son stay in

high school?– Can I afford adequate child care rather than expose

my kids to dangerous farm equipment?

BUT

• If you pay them anyway, would people stop working?

• Between 1965 and 1980, the US government funded 4 GAI social experiments

• The Canadian government funded one

THE CANADIAN EXPERIMENT

• 2 sites

– A dispersed sample in Winnipeg– A saturation site in Dauphin MB

• The Dauphin site was the only saturation site in any of the 5 experiments

A Dispersed Sample

• Allows you to get precise estimates of the impact of changes in the payout and tax-back rates without confounding

• Your subject is the only one who knows s/he is receiving payments and probably no one else of her acquaintance is in the experiment

BUT

• If a social programme were to be implemented universally, the results of a dispersed sample might be highly misleading

• Subjects are in a highly artificial setting. They are receiving support, but not their friends and relatives

A Saturation Site

• By definition has all kinds of confounding, because everyone is enrolled in the experiment, and knows that their friends and neighbours are also participating

• Social attitudes and behaviours are likely to change, which will affect the subjects’ behaviour independently of the support received

How were MINCOME support levels determined?

• In 1972, average income per taxpayer in Parklands was $3,820

• 69.6% of the provincial average

• $17,576 in today’s dollars

MINCOME SUPPORT LEVELS RELATIVE TO CANADIAN INDICATORS OF LOW INCOME (2004 dollars)1

MINCOME MINCOME StatCan Family Size Median Income2 minimum3 breakeven4 LICO5 1 15089 5685 11370 9558 2 37246 10623 21246 15927 3 46491 13164 26328 19112 4 50890 14954 29908 222976 5 53481 17980 35960 25486

1 All financial figures were converted from their original levels to 2004 dollars using the Consumer Price Index. 2 See Income Distribution by Size in Canada: Preliminary Estimates, 1972. Statistics Canada Cat. No. 13-206, p. 9 3 These MINCOME support levels represent the minimum annual income a family would get under the MINCOME scheme. They represent the guarantee; if any member of the family earned any income from employment, self-employment or other sources, their actual family income would be higher because the “tax-back rate” is only 50%. For example, a family of 4 with $10,000 of earned income would actually have an annual income of $19,954 under MINCOME. That is, they would receive $9,954 under the scheme to supplement their labour market earnings. 4 This is the 2004 equivalent income at which no further benefits would be received. Families earning less than this limit would still receive supplemental payments from the scheme. 5 These limits were established by JR Podoluk (see Incomes of Canadians, Queen’s Printer, 1968, p. 185) and were used as low-income cut-offs by Statistics Canada in its Consumer Finance Survey Reports. That is, this is the period-specific LICO inflated by the Consumer Price Index to 2004 dollars. 6 For comparison purposes, the Year 2000 Market Basket Measure of Poverty for Rural Manitoba sets the unofficial poverty line at $22,932 for a family of 2 adults and 2 children.

OUR INTERESTS

• Did the participants suffer less poverty under the GAI experiment?

• What would be the effects of less poverty?

• How long would the effects last after the intervention ended?

In Particular,

• We know that health is a positive function of socio-economic status– Middle income people are healthier than poor people– High income people are healthier than middle income

people

• We know that overall health status is higher in a more equal society than in a less equal society

• But we don’t really know WHY or HOW income affects health

HOW CAN WE DESIGN A PROJECT TO ANSWER OUR

QUESTIONS?

CHALLENGE 1

• The data were never compiled and cleaned for analysis

• The health and social data were collected by survey from a subset of participants– Small samples

• The Federal Records Centre (on Inkster) has “1800 cubic feet of unspecified files” – and no finding guide

SOLUTION

BUT

CHALLENGE 2

• We don’t know which of the people resident in Dauphin and its rural municipality during MINCOME actually received money

SOLUTION

• Re-conceptualize the nature of a guaranteed annual income

• Income INSURANCE rather than income SUPPORT

• Hypothesis: Behaviour and health outcomes will be affected by the PROMISE that no one will have an income of less than the guaranteed rate

SOLUTION

• EVERYONE in the saturation site received the treatment

• Some lives will be affected more than others

CHALLENGE 3

• Many things happened since 1974

• How do we know that changes we find are the result of MINCOME?

SOLUTION

• Create a contemporaneous control group

• Choose 3 or 4 Manitobans who do not live in Dauphin in 1974, and match them to people who do live in Dauphin

• Compare differences

PROPENSITY MATCHING

• Individual: age, sex• Family: age of mother at birth of first child,

number of children, single parent female led

• Community: rural/small town; Socio-economic Status (income, education); geography

• Geography

CHALLENGE 4

• Maybe Dauphin is just different

• Perhaps differences have nothing to do with MINCOME

SOLUTION

• Create a second control

• Use “Dauphin” as a control for itself

• Match each experimental subject to 2 sex-matched Dauphin residents a few years older – town to town; rural municipality to rural municipality

• Compare age-specific outcomes

SOLUTION

• Can we use sibling controls?

– 2 sex-matched siblings from Dauphin, so the older serves as a control for the younger

– A matched pair from out-of-Dauphin, so that the pair serves as a community control for the Dauphin pair

CHALLENGE 5

• How do we convince a funding committee that we are likely to find something?– No one has used “income security” as we

have– MINCOME only distributed money for 3 years– No one has used administrative data the way

we propose

SOLUTION

• A file survey done in Winnipeg during the winter of 1972-3 found:– 17% were on welfare less than 3 months, – 18.7% for 4-12 months,– 26.1% for 13-24 months, – 15.4% for 25-36 months, – 5% for 37-48 months,– 17.8% for more than 48 months

• That is: 3 years may be “long enough”

SOLUTION

Grade 12 Enrolment as % Previous Year Grade 11 Enrolment

0.0

20.0

40.0

60.0

80.0

100.0

120.0

Dauphin

Winnipeg

Non-Winnipeg

SOLUTION

• We acknowledge that, for most people, the effects of MINCOME will not persist for long after the payments stop

• But for those who receive support during vulnerable periods, the effect may be life-long (and may even affect their children)

CHALLENGE 6

• How will we analyze the data?– Registry data from 1970 to present– Hospital files from 1970 to present– Physician files from 1970 to present– Birth outcomes from mid-70s– Pharmaceutical files from 1996 to present– School data from 1991 to present– Social services data from 1991 to present