America is dying: Two birds, one stone

Imagine this: America reducing poverty and increasing positive health outcomes at the same time. Federally organized conditional cash transfer (CCT) programs might be the answer we have all been awaiting. According to the World Health Organization, “Conditional cash transfer programs give money to households on the condition that they comply with certain pre-defined requirements.” Meaning, the government would give a set amount of money to a family living under a designated income if they agree to completely vaccinate their children, send their kids to school regularly and visit a primary care physician for well-visits, among other things.

While this may seem like a novel idea, it has actually been around for decades. In the 1990s, countries like Brazil and Mexico piloted CCT programs which had significantly positive results. What has been called “social policy diplomacy” by a minister who assisted with the Bolsa Familia Program in Brazil presents a new side to the global debate on social welfare. For years, Brazil faced the problem of severe income inequality, a problem that similarly pervades America. Now, the Bolsa Familia Program is the largest of its kind, and we can analyze its effects and consider the implementation of a similar cash transfer scheme in America.

This program gives relatively small cash transfers of $35 to families in extreme poverty if, and only if, the family is compliant with its child’s education (attendance is tracked) and preventative health care visits.Prior to the Bolsa Familia Program, only 4 percent of the national income was concentrated in the bottom 60 percent of Brazilians. Almost immediately, poverty fell. Ten years after its implementation, the extreme poverty rate halved from 9.7 percent to 4.3 percent. Additionally,attendance rates in schools increased, indirectly helping increase rates of health literacy and vaccine compliance. The effects of the Bolsa Familia Program are undeniable and surprising.

How can a country like Brazil, which lacks the expansive network of resources that exists in America and is teeming with corruption, carry out such a program? To ensure access to basic needs, the government of Brazil gives money to 14 million households every single month. The level of technicality and leadership required to systematically dole out this much money, track children’s attendance in school and check that families are attending preventative appointments is mind-boggling to say the least.

New York followed the example of the Bolsa Familia Program by implementing a CCT scheme as well. This program had positive effects on its population. It reduced poverty and poverty-related struggles such as food insecurity. It also increased the usage of preventative dental care among participating families. Although it may be politically impractical to implement a national CCT program due to pushback and the general fragmentation of our government system between state and federal bureaucracies, we should consider the positive effects it may have on American families, especially those that live well below the federal poverty line. CCT programs are not a cop-out method to pump money into the poor — they are evidence-based practices that reconcile the vicious cycle of poverty and promote healthy behaviors.