ORCID Profile
0000-0002-0937-6894
Current Organisations
Cardiff University
,
Northumbria University
,
Independent
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Publisher: Bristol University Press
Date: 08-2022
DOI: 10.1332/174426420X15820274674068
Abstract: In the context of the UK Government’s ‘prevention agenda’, Laura Webber and colleagues have called for a ‘health in all policies’ approach. Universal Basic Income (UBI) is a system of cash transfers to citizens. Recent research suggests it could significantly benefit population health, including via reducing stress. However, a Finnish trial of a policy with similarities to UBI has influenced debate. This was reported as a failure due to a policy objective of reducing unemployment, despite demonstrating significant benefits to well-being. In this piece, we seek to advance the debate about the cost-benefit of UBI by identifying knowledge gaps and proposing a means of designing effective trials. We review UBI trial design and findings in comparison with social gradient in health literature and biopsychosocial theory to identify knowledge gaps. We highlight a need to refocus UBI trials on improved health, including via reduced stress, to provide policy makers the means of producing accurate cost-benefit analysis. Previous trials have either not reflected likely UBI policy or failed to measure impacts that enable accurate analysis. We contend that interdisciplinary work is required to establish trials that observe factors known to drive the social health gradient. Finally, we argue that statistical modelling is needed to extrapolate shorter-term findings to long-term population-level outcomes. Resource allocation by Government and/or major funders is required to produce evidence that enables accurate analysis of UBI. Such trials would provide a platform for interdisciplinary work resulting in joined-up evidence and policy.
Publisher: Informa UK Limited
Date: 14-07-2023
Publisher: Springer Science and Business Media LLC
Date: 11-04-2021
DOI: 10.1007/S10742-021-00246-8
Abstract: Opposition to Universal Basic Income (UBI) is encapsulated by Martinelli’s claim that ‘an affordable basic income would be inadequate, and an adequate basic income would be unaffordable’. In this article, we present a model of health impact that transforms that assumption. We argue that UBI can affect higher level social determinants of health down to in idual determinants of health and on to improvements in public health that lead to a number of economic returns on investment. Given that no trial has been designed and deployed with that impact in mind, we present a methodological framework for assessing prospective costs and returns on investment through modelling to make the case for that trial. We begin by outlining the pathways to health in our model of change in order to present criteria for establishing the size of transfer capable of promoting health. We then consider approaches to calculating cost in a UK context to estimate budgetary burdens that need to be met by the state. Next, we suggest means of modelling the prospective impact of UBI on health before asserting means of costing that impact, using a microsimulation approach. We then outline a set of fiscal options for funding any shortfall in returns. Finally, we suggest that fiscal strategy can be designed specifically with health impact in mind by modelling the impact of reform on health and feeding that data cyclically back into tax transfer module of the microsimulation.
Publisher: BMJ
Date: 18-01-2021
DOI: 10.1136/MEDETHICS-2020-106477
Abstract: At a time of COVID-19 pandemic, universal basic income (UBI) has been presented as a potential public health ‘upstream intervention’. Research indicates a possible impact on health by reducing poverty, fostering health-promoting behaviour and ameliorating biopsychosocial pathways to health. This novel case for UBI as a public health measure is starting to receive attention from a range of political positions and organisations. However, discussion of the ethical underpinnings of UBI as a public health policy is sparse. This is depriving policymakers of clear perspectives about the reasons for, restrictions to and potential for the policy’s design and implementation. In this article, we note prospective pathways to impact on health in order to assess fit with Rawlsian, capabilities and perfectionist approaches to public health policy. We suggest that Raz’ pluralist perfectionist approach may fit most comfortably with the prospective pathways to impact, which has implications for allocation of resources.
Publisher: Springer Science and Business Media LLC
Date: 20-06-2018
Publisher: BMJ Publishing Group Ltd
Date: 08-2023
Publisher: SAGE Publications
Date: 30-07-2023
Publisher: Center for Open Science
Date: 02-06-2020
Abstract: The onset of the 2020 global COVID-19 pandemic led to a marked increase in positive discussion of Universal Basic Income (UBI) in political and media circles. However, we do not know whether there was a corresponding increase in support for the policy in the public at large, or why. Here, we present three studies carried out during 2020 in UK and US s les. In study 1 (n=802, April 2020), people expressed much stronger support for a UBI policy for the times of the pandemic and its aftermath than for normal times. This was largely explained by the increased importance they attached, in the pandemic context, to a system that is simple and efficient to administer, and that reduces stress and anxiety in society. In study 2 (n=400, May 2020), we pitted UBI against a conditional targeted social transfer system. Preferences for UBI were stronger for pandemic times than for normal times. This was partially explained by a number of perceived advantages, such as simplicity of administration and suitability for a changing world. In study 3 (n= 397, September 2020), we found that the headline results of studies 1 and 2 persisted six months after the onset of the pandemic, albeit with attenuated effect sizes. Our results illustrate how a changing social and economic situation can bring about markedly different policy preferences, through changes in citizens’ perceptions of what is currently important.
Publisher: Springer Science and Business Media LLC
Date: 18-10-2022
Publisher: Research Square Platform LLC
Date: 12-05-2022
DOI: 10.21203/RS.3.RS-1561814/V1
Abstract: 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. Methods We outline two types of prospective intervention based on 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. Results We find that, in general, self-reported measures alongside routinely collected linked respondent data may provide 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. 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.
Publisher: Springer International Publishing
Date: 2023
Publisher: Public Library of Science (PLoS)
Date: 28-02-2023
DOI: 10.1371/JOURNAL.PONE.0279845
Abstract: A substantial body of evidence suggests that young people, including those at the crucial transition points between 16 and 24, now face severe mental health challenges. In this article, we analyse data from 10 waves of a major UK longitudinal household cohort study, Understanding Society, to examine the relationship between income and anxiety and depression among 16- to 24-year-olds. Using random effects logistic regression (Model 1) allowing for whether the in idual was depressed in the previous period as well as sex, age, ethnicity, whether the in idual was born in the UK, region, rurality, highest qualification, marital status, employment status and attrition, we find a significant and inversely monotonic adjusted association between average net equivalised household income quintiles and clinical threshold levels of depressive symptoms SF-12 Mental Component Summary (MCS score ≤45.6). This means that being in a higher income group is associated with a reduced likelihood of clinically significant depressive symptoms, allowing for observable confounding variables. Using a ‘within-between’ model (Model 2), we find that apart from among those with the very highest incomes, increases in average net equivalised household income over the course of childhood and adolescence are significantly associated with reduced symptoms of anxiety and depression as measured by a higher SF-12 MCS score. Compared with previous reviews, the data presented here provides an estimate of the magnitude of effect that helps facilitate microsimulation modelling of impact on anxiety and depression from changes in socioeconomic circumstances. This enables a more detailed and complete understanding of the types of socioeconomic intervention that might begin to address some of the causes of youth mental health problems.
Publisher: Bristol University Press
Date: 23-10-2023
Publisher: Center for Open Science
Date: 21-09-2023
Publisher: American Psychological Association (APA)
Date: 08-2020
DOI: 10.1037/TRA0000739
Publisher: SAGE Publications
Date: 10-01-2023
DOI: 10.1177/13691481221146886
Abstract: If policy preferences follow material interests, the experience of socioeconomic disadvantage ought to increase support for redistributive policies. However, experiencing disadvantage might also reduce faith in government’s ability to make things better, indirectly reducing support for redistributive action, and leading to a spiral of widening disadvantage and increasing political disengagement. Indeed, disadvantaged communities sometimes favour right-wing platforms over those offering redistribution, as in the taking of ‘red wall’ constituencies in the North and Midlands of England by the UK Conservative party in 2019. This article uses quantitative data from a survey of ‘red wall’ voters (n = 805) to examine the bases of people’s perceptions of redistributive policies. We find that even a radical redistributive policy, Universal Basic Income (UBI), receives consistently high levels of support (69.45 SD 27.24). Lower socioeconomic status, greater financial distress and greater risk of destitution all increase support. These effects are partly mediated by mental distress, which is markedly higher among the less well off. However, the same socioeconomic factors also reduce faith in government, which in turn is associated with lower support. Thus, those who stand to benefit most from redistribution are aware of their material interests, but are also the least confident in the ability of government to improve their lives. As such, there is a clear political challenge for progressive politicians: those whose support they depend upon require a significant redistributive offer, but also need to be persuaded of the viability of reform to support progressive change.
Publisher: Bristol University Press
Date: 02-2023
DOI: 10.1332/175982721X16702368352393
Abstract: Critics of Universal Basic Income (UBI) have claimed that it would be either unaffordable or inadequate. This discussion paper tests this claim by examining the distributional impacts of three UBI schemes broadly designed to provide pathways to attainment of the Minimum Income Standard (MIS). We use microsimulation of data from the Family Resources Survey to outline the static distributional impacts and costs of the schemes. Our key finding is that even the fiscally neutral starter scheme would reduce child poverty to the lowest level achieved since 1961 and achieve more than the anti-poverty interventions of the New Labour Governments from 2000. The more generous schemes would make further inroads into the UK’s high levels of poverty and inequality, but at greater cost. We conclude by assessing fiscal strategies to reduce the up-front deficit of higher schemes, providing a more positive assessment of affordability and impact than critics have assumed.
Publisher: Informa UK Limited
Date: 08-09-2023
Publisher: Informa UK Limited
Date: 11-10-2023
Publisher: Human Kinetics
Date: 10-2018
Publisher: BMJ Publishing Group Ltd
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 17-03-2021
DOI: 10.1057/S41599-021-00760-7
Abstract: The onset of the 2020 global COVID-19 pandemic led to a marked increase in positive discussion of Universal Basic Income (UBI) in political and media circles. However, we do not know whether there was a corresponding increase in support for the policy in the public at large, or why. Here, we present three studies carried out during 2020 in UK and US s les. In study 1 ( n = 802, April 2020), people expressed much stronger support for a UBI policy for the times of the pandemic and its aftermath than for normal times. This was largely explained by the increased importance they attached, in the pandemic context, to a system that is simple and efficient to administer, and that reduces stress and anxiety in society. In study 2 ( n = 400, May 2020), we pitted UBI against a conditional targeted social transfer system. Preferences for UBI were stronger for pandemic times than for normal times. This was partially explained by a number of perceived advantages, such as simplicity of administration and suitability for a changing world. In study 3 ( n = 397, September 2020), we found that the headline results of studies 1 and 2 persisted six months after the onset of the pandemic, albeit with attenuated effect sizes. Our results illustrate how a changing social and economic situation can bring about markedly different policy preferences, through changes in citizens’ perceptions of what is currently important.
Publisher: Springer Science and Business Media LLC
Date: 23-03-2023
DOI: 10.1186/S40814-023-01276-4
Abstract: 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 ex les 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. 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. 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. 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.
Publisher: Oxford University Press (OUP)
Date: 14-01-2022
Abstract: 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. 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. 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. These results set, for the first time, a set of research activities required in order to maximize health impact in UBI programmes.
Publisher: Bristol University Press
Date: 02-2023
Publisher: BMJ
Date: 10-2023
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2021
End Date: 2022
Funder: Wellcome Trust
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