1. THE TOWN WITH NO POVERTY Evelyn L. Forget Community Health Sciences University of Manitoba

2. PROJECT TEAM Evelyn Forget Noralou Roos Derek Hum Ron Hikel Wayne Simpson Richard Lobdell Hugh Grant Charles Burchill Pat Nichol We gratefully acknowledge Financial support: Canadian Institutes for Health Research MOP2005 Data Access: Manitoba Health

4. 1974

6. 1979

8. 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

9. In Winnipeg

10. DAUPHIN MANITOBA

11. DAUPHIN MANITOBA 1974

12. DAUPHIN MANITOBA 2005

13. DAUPHIN MANITOBA 1954 and 1974 and 2005

14. Map: River City NW NE Court house High School Community centre Ukrainian Orthodox Church Ukrainian Catholic Church Hospital RR Station Grain elevators Arts Centre “Little Chicago” River Railroad Tracks Main Street Darla Rhyne,1979

15. WHERE DID THE RED COMMITTEE LOOK FOR INSPIRATION?

16. 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

17. 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?

18. BUT If you pay them anyway, would people stop working?

19. Between 1965 and 1980, the US government funded 4 GAI social experiments The Canadian government funded one

20. 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

21. 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

22. 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

23. 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

24. How were MINCOME support levels determined?

25. In 1972, average income per taxpayer in Parklands was $3,820 69.6% of the provincial average $17,576 in today’s dollars

27. 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?

28. 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

29. HOW CAN WE DESIGN A PROJECT TO ANSWER OUR QUESTIONS?

30. 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

31. SOLUTION

32. BUT

33. CHALLENGE 2 We don’t know which of the people resident in Dauphin and its rural municipality during MINCOME actually received money

34. 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

35. SOLUTION EVERYONE in the saturation site received the treatment Some lives will be affected more than others

36. CHALLENGE 3 Many things happened since 1974 How do we know that changes we find are the result of MINCOME?

37. 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

38. 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

40. CHALLENGE 4 Maybe Dauphin is just different Perhaps differences have nothing to do with MINCOME

41. 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

42. 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

43. 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

44. 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”

45. SOLUTION

46. 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)

47. 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