Canadian Journal of Public Health

, Volume 107, Issue 2, pp e176–e182 | Cite as

Impact of a guaranteed annual income program on Canadian seniors’ physical, mental and functional health

  • Lynn McIntyre
  • Cynthia Kwok
  • J. C. Herbert Emery
  • Daniel J. Dutton
Quantitative Research


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 


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 


  1. 1.
    Statistics Canada. Income of Canadians, 2011. Ottawa, ON: Statistics Canada, 2013. Available at: (Accessed July 14, 2015).Google Scholar
  2. 2.
    Raphael D. Poverty in Canada: Implications for Health and Quality of Life. Toronto, ON: Canadian Scholars’ Press Inc., 2011.Google Scholar
  3. 3.
    Auger N, Alix C. Income, income distribution, and health in Canada. In: Raphael D (Ed.), Social Determinants of Health. Toronto, ON: Canadian Scholars’ Press, 2009;61–74.Google Scholar
  4. 4.
    Patel V, Lund C, Hatherill S, Plagerson S, Corrigall J, Fund M, Flisher AJ. Mental disorders: Equity and social determinants. In: Blas E, Kurup AS (Eds.), Equity, Social Determinants and Public Health Programmes. Geneva: WHO Press, 2010;115–44.Google Scholar
  5. 5.
    Coyne A. Guarantee a Minimum Income, not a Minimum Wage. National Post 2015 June 10. Available at: (Accessed October 28, 2015).Google Scholar
  6. 6.
    Segal H. Guaranteed annual income: Why Milton Friedman and Bob Stanfield were right. Policy Options 2008;29(4):45–51.Google Scholar
  7. 7.
    Young M, Mulvale JP. Possibilities and Prospects: The Debate Over a Guaranteed Income. Ottawa, ON: Canadian Centre for Policy Alternatives, 2009. Available at: (Accessed July 14, 2015).Google Scholar
  8. 8.
    Simpson W. Basic Income, Guaranteed Income and Tax Credits: What’s the Difference? Calgary, AB: The School of Public Policy, 2015. Available at: (Accessed January 18, 2016).Google Scholar
  9. 9.
    Jones LE, Millligan KS, Stabile M. Child cash benefits and family expenditures: Evidence from the National Child Benefit. NBER Working Paper Series No. 21101, 2015. Available at: (Accessed January 18, 2016).Google Scholar
  10. 10.
    Forget E. The town with no poverty: The health effects of a Canadian guaranteed annual income field experiment. Can Public Policy 2011;37(3):283–305. doi: 10.3138/cpp.37.3.283.CrossRefGoogle Scholar
  11. 11.
    Emery JCH, Fleisch VC, McIntyre L. How a Guaranteed Annual Income could put food banks out of business. School Public Policy Res Papers 2013;37(6):1–20.Google Scholar
  12. 12.
    Martin D, Meili R. Basic income: Just what the doctor ordered. Toronto Star 2015 August 26. Available at: (Accessed October 22, 2015).Google Scholar
  13. 13.
    Carstairs S, Keon WJ. Special Senate Committee on Aging. Canada’s Aging Population: Seizing the Opportunity. Ottawa, ON: Senate Canada, 2009. Available at: (Accessed January 18, 2016).Google Scholar
  14. 14.
    Statistics Canada. Canadian Community Health Survey (CCHS)–Annual Component, 2011. Available at: (Accessed June 24, 2014).Google Scholar
  15. 15.
    Bazel P, Mintz J. Income adequacy among Canadian seniors: Helping singles most. School Public Policy Res Papers 2014;7(4):1–17.Google Scholar
  16. 16.
    Brzozowski M, Crossley TF. Measuring the well-being of the poor with income or consumption: A Canadian perspective. Can J Econ 2011;44(1):88–106. doi: 10.1111/caje.2011.44.issue-1.CrossRefGoogle Scholar
  17. 17.
    Tarasuk V, Cheng J, de Oliveira C, Dachner N, Gundersen C, Kurdyak P. Association between household food insecurity and annual health care costs. Can Med Assoc J 2015;187(14):e429–36. doi: 10.1503/cmaj.150234.CrossRefGoogle Scholar
  18. 18.
    Statistics Canada. Low Income Lines, 2009–2010. Ottawa: Statistics Canada, 2014. Available at: (Accessed October 27, 2015).Google Scholar
  19. 19.
    Council of Canadian Academies. Aboriginal Food Security in Northern Canada: An Assessment of the State of Knowledge. Expert Panel on the State of Knowledge of Food Security in Northern Canada. Ottawa, ON: Council of Canadian Academies, 2014.Google Scholar
  20. 20.
    Feng Y, Bernier J, Mcintosh C, Orpana H. Validation of disability categories derived from Health Utilities Index Mark 3 scores. Health Rep 2009;20(2):1–8.Google Scholar
  21. 21.
    Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav 1997;38(1):21–37. doi: 10.2307/2955359.CrossRefGoogle Scholar
  22. 22.
    Horseman J, Furlong W, Feeny D, Torrance G. The Health Utilities Index (HUI®): Concepts, measurement properties and applications. Health Qual Life Outcomes 2003;1:54–67.CrossRefGoogle Scholar
  23. 23.
    Kaplan MS, Berthelot JM, Feeny D, McFarland BH, Khan S, Orphana H. The predictive validity of health-related quality of life measures: Mortality in a longitudinal population-based study. Qual Life Res 2007;16(9):1539–46. PMID: 17899447. doi: 10.1007/s11136-007-9256-7.CrossRefGoogle Scholar
  24. 24.
    Mawani FN, Gilmour H. Validation of self-rated mental health. Health Rep 2010;21(3):61–75.PubMedGoogle Scholar
  25. 25.
    Anderson SA. Core indicators of nutritional state for difficult-to-sample populations. J Nutr 1990;120:1559–600.Google Scholar
  26. 26.
    Health Canada. Income Related Household Food Insecurity in Canada. Ottawa: Health Canada, 2007. Available at: (Accessed October 28, 2015).Google Scholar
  27. 27.
    Raphael D. Social determinants of health: An overview of key issues and themes. In: Raphael D (Ed.), Social Determinants of Health, 2nd ed. Toronto, ON: Canadian Scholars’ Press Inc., 2009.Google Scholar
  28. 28.
    Emery JCH, Fleisch VC, Mclntyre L. Legislated changes to federal pension income in Canada will adversely affect low income seniors’ health. Prev Med 2013;57(6):963–66. PMID: 24055151. doi: 10.1016/j.ypmed.2013.09.004.CrossRefGoogle Scholar
  29. 29.
    Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: The challenges ahead. Lancet 2009;374(9696):1196–208. doi: 10.1016/S0140-6736(09)61460-4.CrossRefGoogle Scholar
  30. 30.
    Nelson K, Fritzell J. Welfare states and population health: The role of minimum income benefits for mortality. Soc Sci Med 2014;112:63–71.CrossRefGoogle Scholar
  31. 31.
    Agid O, Kohn Y, Lerer B. Environmental stress and psychiatric illness. Biomed Pharmacother 2000;54:135–41.CrossRefGoogle Scholar
  32. 32.
    Neysmith S, Bezanson K, O’Connell A. Telling Tales. Living the Effects of Public Policy. Halifax, NS: Fernwood Publishing, 2000.Google Scholar
  33. 33.
    Canadian Institute for Health Information (CIHI). National Health Expenditure Trends, 1975 to 2015. Ottawa: CIHI, 2015. Available at: (Accessed October 22, 2015).Google Scholar
  34. 34.
    Public Health Agency of Canada (PHAC). The Chief Public Health Officer’s Report on the State of Public Health in Canada, 2014: Public Health in the Future. Ottawa: PHAC, 2014. Available at: (Accessed November 21, 2014).Google Scholar
  35. 35.
    Fitzpatrick T, Rosella LC, Calzavara A, Petch J, Pinto AD, Manson H, Goel V, Wodchis WP. Looking beyond income and education. Am J Prev Med 2015;49(2):161–71. doi: 10.1016/j.amepre.2015.02.018.CrossRefGoogle Scholar
  36. 36.
    Lammam C, MacIntyre H. The Practical Challenges of Creating a Guaranteed Annual Income in Canada. Vancouver, BC: Fraser Institute, 2015. Available at: (Accessed July 21, 2015).Google Scholar
  37. 37.
    Government of Canada. Public Pensions 2016. Available at: (Accessed July 5, 2016).

Copyright information

© The Canadian Public Health Association 1996

Authors and Affiliations

  • Lynn McIntyre
    • 1
  • Cynthia Kwok
    • 1
  • J. C. Herbert Emery
    • 2
    • 3
  • Daniel J. Dutton
    • 4
  1. 1.Department of Community Health Sciences, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
  2. 2.The School of Public PolicyUniversity of CalgaryCalgaryCanada
  3. 3.Department of EconomicsUniversity of CalgaryCalgaryCanada
  4. 4.The Prentice Institute for Global Population and EconomyUniversity of LethbridgeLethbridgeCanada

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