Title: Understanding the prospective public health impact and social feasibility of Universal Basic Income schemes in the UK: Developing microsimulation of impact on self-rated health and QALYs and public engagement with ‘left behind’ communities to understand ‘willingness to pay’
Funder: Department of Health and Social Care

Abstract: Universal Basic Income (UBI) describes systems in which every citizen receives a secure, guaranteed and regular payment to pay for basic needs like food and housing. UBI has been proposed for such reasons as: ? providing people with security against unemployment and poverty ? promoting people’s training, education and unpaid caring ? encouraging business development in areas of the country that have low rates of employment and income We have discovered evidence that suggests UBI may improve people’s health and national health overall. Studies of systems elsewhere and of relationships between people’s income and their health in this country shows that increasing income and making it more secure improves health. Although there is no UK UBI system, we have used computer programmes to predict the impact that UBI could have on mental health among 14-24-year-olds. We have also worked with young people in Bradford and all ages in England and Wales that might gain most from UBI to understand why and how the amount of money people receive affects their health. Our results suggest those systems could prevent 29-46,000 cases of anxiety and depression every year among young people. People who make health policy need to understand how UBI might affect people’s health and produce savings to society. We will analyse how changes in income affect people’s assessment of their own health over the course of 10 years’ of surveys from Understanding Society: The UK Household Longitudinal Study. We will use our existing estimates of the impact of UBI systems on people’s income to calculate how those systems would influence people’s self-rated health. We will then calculate how many ‘quality-adjusted life-years’ (QALY) are gained and put a recognised financial value to society to those years. This will develop a new ‘health module’ of our microsimulation computer model to enable us to understand how changes to welfare affect the health of UK adults. Policymakers across the four nations also need to know whether people affected by the introduction of UBI think that money should be used to improve health and whether there are socially acceptable ways of funding UBI. In online surveys, we will show people a range of options about how much people should be paid and how this should be funded and ask them to choose their favoured options. This will create a ‘public acceptability model’ to enable us to understand whether UBI can be used to promote public health. We will create a tool that can be used online to predict how popular a given policy would be among different groups. We will work with people in a Northern English community with high unemployment levels, low wages and health problems to understand concerns about how UBI might be implemented. This is important for politicians and health professionals who need to know about sensitivities within communities targeted for ‘Levelling Up’ funding. Community members will explain concerns about the system and develop proposals for making systems socially acceptable. Our project team and advisory board includes members with lived experience of disability, poverty and the benefits system. This proposal and the UBI systems we examine have been co-developed with non-academics. We will write four academic journal articles and an end of project report for policymakers and members of the public. Our similarly costed existing 12 month project’s publications (8 articles; 4 reports) demonstrates this is possible.

Lay abstract: Research questions What are the estimated impacts of three costed UBI schemes on self-rated health and QALYs and what are the attendant economic implications? How do ‘left-behind’ communities evaluate designs and means of funding UBI for public health? Background This work develops long-term, multidisciplinary analysis of UBI and health in combining two leading research teams. Systematic reviews have found cross-sectional and longitudinal associations between income/income disparities and health (Pickett & Wilkinson 2015) and significant health impacts from schemes that resemble UBI (Gibson et al. 2020). Our logic model indicates that UBI may improve health by reducing poverty, increasing security of income/reducing stress and promoting long-term health behaviour (Johnson et al. 2022). We have: modelled tax-welfare distributional effects of three costed UBI schemes for public health impact against comparator policies; asserted income as a primary driver in the association with mental health; modelled UBI impacts on mental health – estimated 29,000-46,000 cases of adolescent anxiety and depression avoided annually depending on scheme; examined public preferences. Aims and objectives Aim: develop capacity to provide policymakers with comprehensive evidence of UBI health impact Objectives: 1) develop Landman health module to microsimulate schemes’ impact on SF-12 self-rated health and cost via QALYs 2) conduct conjoint experimental surveys on public assessment of design, costs and means of funding UBI 3) conduct participatory citizen engagement workshops to explore community-level concerns over implementation Methods 1) Microsimulation We will use a model that examines changes 'within-between' individuals to analyse relationships between incomes and SF-12 Mental and Physical Component Scores across 10 waves of Understanding Society. We will develop a Landman TTM health module to microsimulate whole adult UK population impacts of income changes produced by our modelled schemes on self-rated health and project impacts on QALYs. 2) Conjoint experiment We will conduct conjoint experiments with UK-wide representative samples where participants choose between schemes with different attributes: level of health impact, targeting, overall cost and means of funding. This will allow creation of a ‘public acceptability model’ to examine policy proposals and framings. We will create an online tool to predict acceptability of schemes among groups. 3) Citizen Engagement We will examine implication and implementation concerns through qualitative workshops co-designed with community co-researchers from Jarrow, England, which has high health inequalities and vulnerability to welfare reform. We will explore and categorise concerns, use them to refine our ‘public acceptability model’ and evaluate health policy framings. Impact and Dissemination Impact: Team: development of microsimulation and qualitative research capacity; Knowledge: enhanced understanding of relationships between income, health and public budgets; Policy: increased capacity to assess health, economic and social impact of UBI versus existing welfare schemes. Northumbria University will own any IP. ? 4 Articles analysing: relationship between income, self-rated security and SF-12 scores in Understanding Society; microsimulation of impact on QALYs; ‘public acceptability model’; citizen engagement workshops ? Online public acceptability tool ? Compass project report and launch event

Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE