Abstract
OBJECTIVE: Although there is widespread recognition that poverty is a key determinant of health, there has been less research on the impact of poverty reduction on health. Recent calls for a guaranteed annual income (GAI), defined as regular income provided to citizens by the state regardless of work status, raise questions about the impact, relative to the costs, of such a population health intervention. The objective of this study was to determine the impact of Canadian seniors’ benefits (Old Age Security/Guaranteed Income Supplement, analogous to a GAI program) on the self-reported health, self-reported mental health and functional health of age-eligible, low-income seniors.
METHODS: We used the 2009–2010 Canadian Community Health Survey to examine unattached adult respondents with an annual income of $20,000 or less, stratified by seniors’ benefits/GAI eligibility (55–64 years: ineligible; 65–74 years: eligible). Using regression, we assessed self-reported health, self-reported mental health and functional health as measured by the Health Utilities Index, as outcomes for seniors’ benefits/GAI-eligible and -ineligible groups.
RESULTS: We found that individuals age-eligible for seniors’ benefits/GAI had better health outcomes than recipients of conditional income assistance programs. Eligibility for seniors’ benefits/GAI after age 64 was associated with better self-reported health, functional health and self-reported mental health outcomes, and these effects were observed until age 74.
CONCLUSION: Using seniors’ benefits as an example, a GAI leads to significantly better mental health and improved health overall. These improvements are likely to yield reduced health care costs, which may offset the costs associated with program expansion.
Key words: Health, mental health, HUI, Canada, poverty, Guaranteed Annual Income, seniors
Résumé
OBJECTIF: On reconnaît en général que la pauvreté est l’un des grands déterminants de la santé, mais on a moins étudié l’impact de la réduction de la pauvreté sur la santé. Les demandes récentes en faveur d’un revenu annuel garanti (RAG), défini comme étant un revenu régulier offert aux citoyens par l’État peu importe leur statut d’emploi, soulèvent des questions à propos de l’impact d’une telle intervention en santé des populations par rapport à ses coûts. Notre étude visait à déterminer l’impact des prestations aux Canadiens âgés (la Sécurité de la vieillesse/le Supplément de revenu garanti, semblables à un programme de RAG) sur la santé autodéclarée, la santé mentale autodéclarée et la santé fonctionnelle des personnes âgées à faible revenu ayant l’âge d’admissibilité.
MÉTHODE: Nous avons utilisé l’Enquête sur la santé dans les collectivités canadiennes de 2009–2010 pour examiner les répondants adultes sans attaches ayant un revenu annuel de 20 000 $ ou moins, stratifiés selon leur admissibilité aux prestations aux aînés/au RAG (55–64 ans: inadmissibles; 65–74 ans: admissibles). Au moyen d’une régression, nous avons évalué la santé autodéclarée, la santé mentale autodéclarée et la santé fonctionnelle, mesurées par le Health Utilities Index, en tant qu’effets dans les groupes admissibles et inadmissibles aux prestations aux aînés/au RAG.
RÉSULTATS: Nous avons constaté que les personnes ayant l’âge d’admissibilité aux prestations aux aînés/au RAG avaient de meilleurs résultats sanitaires que les bénéficiaires des programmes d’aide au revenu assortis de conditions. L’admissibilité aux prestations aux aînés/au RAG après l’âge de 64 ans était associée à de meilleurs résultats de santé autodéclarée, de santé fonctionnelle et de santé mentale autodéclarée, et ces effets étaient observés jusqu’à l’âge de 74 ans.
CONCLUSION: En ce qui concerne les prestations aux aînés, un RAG mène à une amélioration significative de la santé mentale et à une amélioration globale de la santé. Ces améliorations sont susceptibles d’entraîner des baisses des coûts des soins de santé, ce qui pourrait compenser les coûts associés à l’expansion des programmes.
Mots clés: santé, santé mentale, HUI, Canada, pauvreté, revenu annuel garanti, personne âgée
Footnotes
Acknowledgements: This study was funded by a Programmatic Grant in Health and Health Equity, Canadian Institutes of Health Research (FRN 115208). We thank Valerie C. Fleisch for her early contributions to this manuscript.
Conflict of Interest: None to declare.
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