PolicyLab

Poverty is prevalent in the United States, with nearly 1 in 6 children growing up in households with incomes below the federal poverty line. Children who experience poverty, particularly during the earliest years, are at risk of various adverse health and developmental outcomes during childhood and throughout their lives. As the connection between poverty and poor health outcomes is well-described, there is now an urgent need to move beyond merely outlining health disparities for low-income children and toward developing interventions that improve health outcomes.

Preterm infants and their families are one pediatric population for which exposure to poverty may be particularly detrimental. Among preterm infants, evidence suggests that low income is associated with poorer long-term health. Additionally, caregivers of preterm infants experience added economic strain due to the out-of-pocket costs of having a baby in the Neonatal Intensive Care Unit (NICU), such as transportation and lost wages, and the costs of their infant’s care after discharge. Because poverty-associated poor outcomes are disproportionately experienced by racial and ethnic minority populations, addressing the root cause of these disparities is crucial for advancing health equity. 

A growing body of literature suggests that recurring unconditional cash transfers (UCTs)—or no strings attached cash payments—to families with low incomes may be an effective intervention to reduce financial strain, improve caregiver psychological health and improve children’s health. However, only a single pilot randomized controlled trial to date has measured the impact of UCTS in the preterm population, and we know very little about the feasibility of delivering monthly UCTs in the NICU setting.