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The international evidence base and income management

Minister Jenny Macklin insists that her plan to extend income management is evidence-based but, as Eva Cox recently pointed out at The Stump, it all depends what you mean by evidence.

Given that the Health in All Policies conference is starting in Adelaide today (program available here), Croakey thought it timely to revisit income management as a health issue.

My first stop in search of some systematic evidence about income management was the Campbell Collaboration, an international research network that produces systematic reviews of the effects of social interventions, and “helps people make well-informed decisions by preparing, maintaining and disseminating systematic reviews in education, crime and justice, and social welfare”.

You could call it a sibling of the Cochrane Collaboration.

Second stop was Associate Professor Aron Shlonsky, a child welfare expert at the University of Toronto, who co-chairs the Collaboration’s Social Welfare Coordinating Group.

Asked if there is any evidence to support income management, he said the closest review that might be relevant is titled “Financial benefits for child health and well-being in low income or socially disadvantaged families in developed world countries”.

This review (which can be freely downloaded by searching the Collaboration’s website) notes that a strong and consistent relationship has been observed between relative poverty and poor child health and wellbeing even among rich nations.

The review set out to examine evidence that additional monies provided to poor or disadvantaged families may benefit children by reducing relative poverty and thereby improving children’s health, well-being and educational attainment.

The reviewers did not find significant benefits associated with low-value, strictly conditional welfare reform, but concluded that increasing family income remains a promising intervention. It also noted “tentative but important evidence” that sanctions and work requirements involved in income interventions may place additional stresses on families with young children and have the potential to increase family breakdown and child abuse.

So while the review didn’t directly address the impact of income management, it tends to suggest such a policy is more likely to produce harmful outcomes than benefits for child welfare.

Prof Shlonsky agrees with this assessment and told Croakey by email:  “The argument is that making already meager payments even more meager and constricted doesn’t work. There is an old saying, ‘poor programs for poor people’, and this surely applies here. The review shows that poor programs don’t work, so why make them even worse?”

Interestingly, the review also said that the UK, USA, Australia and New Zealand constitute the small group of OECD countries where inequalities have increased since the 1960s.

All of which tends to suggest that if Minister Macklin and her Government were really wanting to improve child health and wellbeing, there are plenty of other things they should be doing rather than extending income management.

For example, Sir Michael Marmot’s recent report making recommendations for how to reduce health inequalities, called Fair Society, Healthy Lives, emphasised the need to empower and work with disadvantaged communities rather than hitting them with punitive policies. It also emphasised the need for a broad-based investment in early childhood.

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