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Perspective Open Access August 14, 2024

Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns

Shervin Assari 1, 2, 3, 4,* and Hossein Zare 5, 6
1
Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
2
Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
3
Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
4
Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
5
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
6
School of Business, University of Maryland Global Campus (UMGC), College Park, United States
Publihed in: Global Journal of Epidemiology and Infectious Disease (Volume 4, Issue 1, 2024)
Page(s): 34-43
DOI: 10.31586/gjeid.2024.1026
Received
May 12, 2024
Revised
July 30, 2024
Accepted
August 12, 2024
Published
August 14, 2024
Keywords
Marginalization; Poverty; Cash Transfer; Income
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright: Copyright © The Author(s), 2024. Published by Scientific Publications

Abstract

Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.

 

For many years, cash assistance has been targeted as a primary tool for poverty elimination. The underlying premise of this approach is that providing direct financial support will enable individuals and families to secure better employment, manage their finances more effectively, and ultimately improve their overall health and well-being. Proponents argue that with financial barriers reduced, recipients will have the resources needed to pursue educational opportunities, invest in healthier lifestyles, and escape the cycle of poverty.

However, the existing literature presents a more nuanced picture, often showing that the results of such interventions are not as promising as initially hoped. Studies have indicated that while cash assistance can provide temporary relief and modest improvements in some areas, it often fails to produce substantial and lasting changes in the lives of the recipients. This suggests that cash assistance alone may not be sufficient to address the multifaceted nature of poverty and its underlying causes.

Several factors may contribute to the limited effectiveness of cash assistance programs. Structural barriers, such as limited access to quality education and healthcare, persistent discrimination, and a lack of supportive social services, can impede the long-term benefits of financial aid. Additionally, economic instability and fluctuating labor markets may undermine the stability that cash assistance aims to provide.

In this perspective article, we first provide a comprehensive overview of the concept of cash assistance and guaranteed income. We then summarize recent literature that has examined the effects of these interventions, highlighting both the successes and limitations observed. Following this, we delve into potential explanations for the observed weak effects, considering the broader socioeconomic context and structural challenges that may hinder the effectiveness of cash-based interventions. Finally, we discuss the policy implications of our findings, suggesting additional measures that could complement cash assistance to create more sustainable and impactful change. By addressing these additional needs, we hope to offer a more holistic approach to poverty alleviation that acknowledges the complexity of the issue and the necessity for multifaceted solutions. It is crucial to approach these findings with caution and avoid oversimplifying the effects when recommending policies to address economic, behavioral, and health disparities.

Mincome, the "Manitoba Basic Annual Income Experiment," was a Canadian guaranteed annual income (GAI) social experiment conducted in Manitoba during the 1970s [1]. Funded jointly by the Manitoba provincial government and the Canadian federal government under Prime Minister Pierre Trudeau, the experiment included a randomized controlled trial in the City of Winnipeg and rural Manitoba. Additionally, a "saturation site" pilot project was launched in the town of Dauphin, Manitoba, in 1973. No final report on Mincome was issued and there are no strong evidence suggesting influence of such a Basic Annual Income program on major wellbeing of the population [2].

B-MINCOME, conducted between 2017 and 2019 in Barcelona, was one of the first European implementations of guaranteed income. This intervention implemented a basic income experiment, to reduce poverty and social exclusion in a low-income area of the city. A new cash grant was designed along with a package of active policies. Four modalities of participation were then established depending on two criteria: whether attending these policies was mandatory or not, and whether participants’ additional income altered the amount of the grant or was instead net added on top. The intervention failed to improve these outcomes: Using social services, Undertake training, Engaging in social leisure activities, Spending more time on household chores, health (self-rated), mental health (self-rated), New diagnostics of anxiety or depression, perceived social support, social volunteering, engaging in social participation, or educational involvement [3].

Troller-Renfree et al. published the first results of the Baby’s First Years [4] intervention on babies. The detailed information on the design of the intervention is available here [4]. In summary, this innovative study randomly assigned 1,000 low-income mother–newborn dyads into two intervention arms: a large nominal unconditional monthly cash transfer and a nominal unconditional monthly cash transfer. The results reveal changes in the brain function at 1 y, using resting electroencephalography, among the infants in the larger cash transfer group [5, 6]. However, the study did not show any impact on

Gennetian et al. paper in Nature Human Behaviour reported another aspects of the results of their Baby’s First Years [4] intervention. They tested the impact of unconditional cash transfers on family investments among parents in low-income families [7]. They enrolled and randomized low-income mothers from four US metropolitan areas into two groups. One group received a monthly unconditional cash transfer of $333 per month (high) and one group received a monthly unconditional cash transfer of $20 per month (low) for the first several years after childbirth. The findings suggest that families receiving a higher cash transfer spend more on child-specific goods and engage more in early learning activities. These results are promising and highlight the potential benefits of public and economic interventions that provide financial support for new mothers living in poverty [8, 9, 10, 11].

Vivalt et al. [12] conducted a study to examine the causal effects of income on a wide range of employment outcomes through an experiment involving 1,000 low-income participants. Participants were randomly assigned to receive $1,000 per month unconditionally for three years, while a control group of 2,000 participants received $50 per month. The study collected detailed survey data, administrative records, and data from a custom mobile phone app. Results showed that the cash transfer group experienced a reduction in total individual income by about $1,500 per year relative to the control group, excluding the transfers. Additionally, the program led to a 2.0 percentage point decrease in labor market participation and a reduction in labor hours by 1.3-1.4 hours per week. Participants' partners also reduced their working hours by a comparable amount. The primary effect of the cash transfer was an increase in time spent on leisure activities. The project did not impact the quality of employment, and statistical analysis ruled out even small positive effects. In addition, there were no significant effect of the intervention on investments in human capital, although younger participants might pursue more formal education [17].

While cash assistance as a tool for poverty elimination has positive effects, policymakers may have a tendency to overestimate the effects of their policies and interventions [13, 14, 15]. They should be humble and expect more attenuated results in real-life settings due to the voltage drop of any intervention once it is implemented outside of controlled experimental settings [16]. Another reason for humility is that the impact of poverty on health and behavior is not uniform across different racial and ethnic groups [17]. Research has consistently shown that the presence or absence of poverty is a more consequential determinant of health for Whites than for marginalized social groups such as Black populations [18]. The disparities in health and behavioral outcomes between Black and White populations cannot be fully explained by socioeconomic status (SES) alone [19].

There have been various anti-poverty interventions implemented in developing countries, but the evaluations of these programs have rarely been conducted using randomized trials. Without randomization, there is always the possibility of bias, which could lead to an overestimation of the effects of these programs. These examples do demonstrate the potential for cash transfer programs to improve public health indicators, reduce poverty, and enhance social outcomes, particularly when they are well-targeted and accompanied by complementary interventions. However, while some of these interventions have been associated with improvements in outcomes, the lack of randomized evaluations means we cannot definitively attribute these effects to the programs themselves. Table 1 lists some of these programs, but it should be noted that this list is not exhaustive.

In their influential paper, “The Miracle of Microfinance? Evidence from a Randomized Evaluation,” [20] Nobel laureates Abhijit Banerjee and Esther Duflo presented findings from a randomized evaluation of a group lending microcredit program in Hyderabad, India. In this study, a microfinance lender operated in 52 randomly chosen neighborhoods, resulting in an 8.4 percentage point increase in the uptake of microcredit. The study observed an increase in both small business investments and profits for pre-existing businesses, but it found no significant rise in overall consumption. While spending on durable goods did increase, expenditures on "temptation goods" declined. The evaluation also revealed no significant impacts on health, education, or women's empowerment. After two years, when control areas had also gained access to microcredit and households in the treatment areas had borrowed more and for longer periods, few significant differences between the groups remained [20]. Therefore, while some minor positive effects of microcredit may be evident, the benefits of such programs have often been overestimated by researchers, with the actual gains being null or at most very modest [13].

Table 1
Some notable examples of cash transfer programs in developing countries that have not been evaluation using randomized trial design

Another illustrative example is provided by a study conducted by Lantz et al. [21], who performed a population-based telephone survey involving 2,346 rural Wisconsin women aged 40 years and older. The study revealed that the most significant barriers to cancer screening in this rural population were nonfinancial impediments to access. The removal of economic barriers alone did not lead to substantial increases in screening rates when other types of barriers were present. The researchers concluded that policies and interventions focused solely on the visible disparities among rural women of different socioeconomic levels—such as the ability to afford healthcare services—are insufficient if they do not also address barriers related to knowledge, attitudes, and healthcare access. This study provides empirical evidence that eliminating financial barriers alone is unlikely to significantly reduce socioeconomic disparities in cancer screening. The findings underscore the importance of considering a broader range of factors, including whether women understand the purpose of the tests and whether they are recommended for their age or risk profile. Importantly, the study's simulation exercises suggest that nonfinancial barriers, such as recent contact with a healthcare provider and having a regular physician—especially one who has previously recommended cancer screening—are critical determinants of screening behavior. These factors strongly influence a woman’s adherence to screening guidelines, irrespective of her financial situation or her knowledge and attitudes toward the tests. The study suggests that policies and programs offering free or reduced-cost screenings will have limited impact in subpopulations that lack consistent healthcare or recent interaction with a healthcare provider. However, designing policies and interventions that effectively address these nonfinancial barriers presents a significant challenge [21].

All the studies discussed above have predominantly focused on marginalized and impoverished populations. These studies have primarily utilized cash assistance programs and have not included multi-sector interventions. Additionally, they have failed to address the stigma and other barriers faced by individuals in these populations. The results of these studies have shown less than expected effects, with no major hypothesized outcomes being achieved. Both physical and mental health outcomes have remained largely unchanged, and some unintended negative effects, such as low participation in the labor market, have also been observed.

We explain these findings through the lens of the Diminished Returns (MDRs) theory [22, 23, 24, 25, 26, 27, 28, 29, 30]. According to MDRs, resources and assets tend to have weaker effects on health, behaviors, and economic outcomes for marginalized populations compared to their more advantaged counterparts [31, 32, 33, 34, 35, 36, 37, 38]. This phenomenon highlights the structural and systemic barriers that limit the effectiveness of interventions aimed at improving the well-being of marginalized groups [39, 40, 41, 42, 43, 44, 45, 46, 47, 48]. Consequently, the anticipated benefits of cash assistance programs and similar interventions are often not fully realized, underscoring the need for more comprehensive, multi-sector approaches that address the underlying causes of health and economic disparities.

As shown by the Marginalization – related Diminished Returns (MDRs) literature [49, 50], the same level of resources and SES yields fewer health benefits for marginalized groups compared to their White counterparts. This theory underscores the role of structural factors, such as racism and segregation, which limit access to essential resources like healthy food, quality education, and public transportation for marginalized families. These structural barriers diminish the positive returns of parental resources and SES on youth from marginalized communities.

Here are some examples of Minorities' Diminished Returns (MDRs) documented in the literature: An increase in income among Black individuals is not consistently associated with a reduction in the risk of discrimination [51], stress [52], distress [53], school dropout, depression [54], externalizing behaviors [55], internalizing behaviors [55], suicide [56], substance use [57], asthma [58], obesity [59, 60], chronic disease [61], and high blood pressure [62]. In Black children, increase in income does not predict increase in some aspects of cognitive functioning such as attention [63] and matrix reasoning [38]. These patterns are evident across various life stages, including birth [64], childhood [58], pre-adolescence [38], adolescence [54], emerging adulthood [65], mid-adulthood [66], and older adulthood [67, 68, 69, 70]. Similarly, other resources such as family structure, education, parental education, and employment often do not yield the same protective effects for Black individuals as they do for their White counterparts. These patterns of diminished returns are not exclusive to Black people and have also been observed among other marginalized groups, including Asian [71], Latino [57, 72, 73], Native American [24, 74, 75], immigrant [31, 40, 76, 77, 78, 79], Lesbian, gay, bisexual, and transgender (LGBT) [30, 34, 80], and even certain marginalized White populations.

It is unexpected but true that under social stratification, racism, and segregation, higher financial resources in Black families often come with increased exposure to discrimination and higher rates of depression. High income protects against diseases for Whites more effectively than for Blacks, partly because resources are more likely to translate into savings and long-term benefits for privileged groups. For marginalized families, systemic inequalities hinder the conversion of financial resources into health and behavioral improvements [49, 50].

Public policies that increase availability of cash and reduce financial distress or even add income security for families living in poverty would not be highly effective unless we see a reform the systems of education, housing, food, healthcare, and policing that can help that added income or cash can bring for families. This is particularly the case for families with multiple marginalizing identities [17].

This opinion piece is not intended to discourage investments in poverty elimination or marginalization reduction. On the contrary, we advocate for continued and increased investments in these areas. However, it is a myth to believe that closing the SES gap will automatically eliminate health and behavioral disparities. Policymakers must consider the broader social context and address the structural determinants of health to achieve true equity [17]. There is always a need for multisectoral interventions [81, 82, 83].

In conclusion, it is essential to recognize the limitations of SES-focused interventions and the need for comprehensive strategies that tackle structural inequalities that cause unemployment and poverty. Only by addressing the root causes of disparities can we hope to close the economic, behavioral, and health gaps in our society. Such interventions should be multi-sector, multi-level, and upstream. Giving cash to people is helpful, but none of that.

Funding: Hossein Zare received funding from the National Institute of Health (NIMHD) grant U54MD000214.

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  60. Assari S, Bazargan M, Chalian M. The Unequal Effect of Income on Risk of Overweight/Obesity of Whites and Blacks with Knee Osteoarthritis: the Osteoarthritis Initiative. J Racial Ethn Health Disparities. Aug 2020;7(4):776-784. doi:10.1007/s40615-020-00719-5[CrossRef] [PubMed]
  61. Assari S. The Benefits of Higher Income in Protecting against Chronic Medical Conditions Are Smaller for African Americans than Whites. Healthcare (Basel). Jan 9 2018;6(1)doi:10.3390/healthcare6010002[CrossRef] [PubMed]
  62. Assari S, Najand B, Khatami SM. High Systolic Blood Pressure of High-Income African American Children. J Racial Ethn Health Disparities. Jul 7 2023;doi:10.1007/s40615-023-01668-5[CrossRef] [PubMed]
  63. Assari S, Boyce S, Bazargan M. Subjective Family Socioeconomic Status and Adolescents’ Attention: Blacks’ Diminished Returns. Children. 2020;7(8):80.[CrossRef] [PubMed]
  64. Assari S. Protective Effects of Maternal Education against Low Birth Weight Deliveries: Blacks' Diminished Returns. Res Health Sci. 2020;5(4):1-17. doi:10.22158/rhs.v5n4p1[CrossRef] [PubMed]
  65. Assari S, Zare H. Household Income and Offspring Education Explain Blacks' Diminished Returns of Parental Education. Open J Psychol. 2024;4(1):18-29. doi:10.31586/ojp.2024.986[CrossRef] [PubMed]
  66. Assari S, Preiser B, Kelly M. Education and Income Predict Future Emotional Well-Being of Whites but Not Blacks: A Ten-Year Cohort. Brain Sci. Jun 29 2018;8(7)doi:10.3390/brainsci8070122[CrossRef] [PubMed]
  67. Assari S. Black Americans' Diminished Health Returns of Professional Occupations: A Thirty-Year Follow-Up Study of Middle-Aged and Older Adults. J Racial Ethn Health Disparities. May 28 2024;doi:10.1007/s40615-024-02034-9[CrossRef]
  68. Assari S. Combined Effects of Race and Educational Attainment on Physician Visits Over 24 Years in a National Sample of Middle-Aged and Older Americans. Hosp Pract Res. Winter 2020;5(1):17-23. doi:10.34172/hpr.2020.04[CrossRef] [PubMed]
  69. Assari S, Cobb S, Najand B, Zare H, Sonnega A. Race, Educational Attainment, and Sustained High Body Mass Index over 24 Years of Follow-up in Middle-Aged and Older Adults. J Racial Ethn Health Disparities. May 2 2023;doi:10.1007/s40615-023-01589-3[CrossRef] [PubMed]
  70. Assari S, Zare H, Sonnega A. Racial Disparities in Occupational Distribution Among Black and White Adults with Similar Educational Levels: Analysis of Middle-Aged and Older Individuals in the Health and Retirement Study. J Rehabil Ther. 2024;6(1):1-11. doi:10.29245/2767-5122/2024/1.1141[CrossRef]
  71. Assari S. Diminished Returns of Income Against Cigarette Smoking Among Chinese Americans. Journal of health economics and development. 2019;1(2):1.
  72. Assari S. Minorities' Diminished Returns of Educational Attainment on Life Satisfaction among Black and Latino Adults in the United States. Journal of Medicine, Surgery, and Public Health. 2024/03/20/ 2024:100091. doi:https://doi.org/10.1016/j.glmedi.2024.100091[CrossRef]
  73. Assari S, Bazargan M, Caldwell C. Parental Educational Attainment and Chronic Medical Conditions among American Youth; Minorities' Diminished Returns. Children (Basel). Aug 26 2019;6(9)doi:10.3390/children6090096[CrossRef] [PubMed]
  74. Sabetnejad Z, Assarian F, Omidi A, Najarzadegan MR. Effectiveness of cognitive behavioral therapy and fluoxetine on sexual function of women with obsessive compulsive disorder: A double-blind randomized controlled trial. Electron Physician. Nov 2016;8(11):3156-3163. doi:10.19082/3156[CrossRef] [PubMed]
  75. Assari S, Bazargan M. Protective Effects of Educational Attainment Against Cigarette Smoking; Diminished Returns of American Indians and Alaska Natives in the National Health Interview Survey. International Journal of Travel Medicine and Global Health. 2019;[CrossRef] [PubMed]
  76. Assari S, Cobb S, Cuevas AG, Bazargan M. Diminished Health Returns of Educational Attainment Among Immigrant Adults in the United States. Front Psychiatry. 2020;11:535624. doi:10.3389/fpsyt.2020.535624[CrossRef] [PubMed]
  77. Assari S. Household Income and Children's Depressive Symptoms: Immigrants' Diminished Returns. Int J Travel Med Glob Health. Fall 2020;8(4):157-164. doi:10.34172/ijtmgh.2020.27[CrossRef] [PubMed]
  78. Assari SA, G., Boyce, S., Bazargan, M., Caldwell, C.,. Parental Human Capital and Adolescents’ Executive Function: Immigrants’ Diminished Returns. . Medical Research Archives. 2020;8(10):1-20. doi:10.18103/mra.v8i10.2235[CrossRef] [PubMed]
  79. Assari S. Socioeconomic Status and Current Cigarette Smoking Status: Immigrants' Diminished Returns. Int J Travel Med Glob Health. Spring 2020;8(2):66-72. doi:10.34172/IJTMGH.2020.11[CrossRef] [PubMed]
  80. Assari S. Education Attainment and ObesityDifferential Returns Based on Sexual Orientation. Behav Sci (Basel). Jan 29 2019;9(2)doi:10.3390/bs9020016[CrossRef] [PubMed]
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APA Style
Assari, S. , & Zare, H. (2024). Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns. Global Journal of Epidemiology and Infectious Disease, 4(1), 34-43. https://doi.org/10.31586/gjeid.2024.1026
ACS Style
Assari, S. ; Zare, H. Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns. Global Journal of Epidemiology and Infectious Disease 2024 4(1), 34-43. https://doi.org/10.31586/gjeid.2024.1026
Chicago/Turabian Style
Assari, Shervin, and Hossein Zare. 2024. "Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns". Global Journal of Epidemiology and Infectious Disease 4, no. 1: 34-43. https://doi.org/10.31586/gjeid.2024.1026
AMA Style
Assari S, Zare H. Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns. Global Journal of Epidemiology and Infectious Disease. 2024; 4(1):34-43. https://doi.org/10.31586/gjeid.2024.1026 
@Article{gjeid1026,
AUTHOR = {Assari, Shervin and Zare, Hossein},
TITLE = {Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns},
JOURNAL = {Global Journal of Epidemiology and Infectious Disease},
VOLUME = {4},
YEAR = {2024},
NUMBER = {1},
PAGES = {34-43},
URL = {https://www.scipublications.com/journal/index.php/GJEID/article/view/1026},
ISSN = {2770-8675},
DOI = {10.31586/gjeid.2024.1026},
ABSTRACT = {Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.},
}
%0 Journal Article
%A Assari, Shervin
%A Zare, Hossein
%D 2024
%J Global Journal of Epidemiology and Infectious Disease

%@ 2770-8675
%V 4
%N 1
%P 34-43

%T Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns
%M doi:10.31586/gjeid.2024.1026
%U https://www.scipublications.com/journal/index.php/GJEID/article/view/1026

TY  - JOUR
AU  - Assari, Shervin
AU  - Zare, Hossein
TI  - Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns
T2  - Global Journal of Epidemiology and Infectious Disease
PY  - 2024
VL  - 4
IS  - 1
SN  - 2770-8675
SP  - 34
EP  - 43
UR  - https://www.scipublications.com/journal/index.php/GJEID/article/view/1026
AB  - Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.
DO  - Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns
TI  - 10.31586/gjeid.2024.1026
ER  -
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  22. Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. African American Children’s Diminished Returns of Subjective Family Socioeconomic Status on Fun Seeking. Children. 2020;7(7):75.[CrossRef] [PubMed]
  23. Assari S, Boyce S, Bazargan M, Caldwell CH. African Americans’ diminished returns of parental education on adolescents’ depression and suicide in the Adolescent Brain Cognitive Development (ABCD) study. European journal of investigation in health, psychology and education. 2020;10(2):656-668.[CrossRef] [PubMed]
  24. Assari S. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander Children's Body Mass Index: Diminished Returns of Parental Education and Family Income. Res Health Sci. 2020;5(1):64-84. doi:10.22158/rhs.v5n1p64[CrossRef] [PubMed]
  25. Assari S. College Graduation and Wealth Accumulation: Blacks' Diminished Returns. World J Educ Res. 2020;7(3):1-18. doi:10.22158/wjer.v7n3p1[CrossRef] [PubMed]
  26. Assari S. Dimensional Change Card Sorting of American Children: Marginalization-Related Diminished Returns of Age. Child Teenagers. 2020;3(2):72-92. doi:10.22158/ct.v3n2p72[CrossRef] [PubMed]
  27. Assari S, Cobb S, Saqib M, Bazargan M. Diminished returns of educational attainment on heart disease among Black Americans. The open cardiovascular medicine journal. 2020;14:5.[CrossRef] [PubMed]
  28. Assari S. Diminished returns of educational attainment on life satisfaction among Black and Latino older adults transitioning into retirement. Journal of Medicine, Surgery, and Public Health. 2024/04/01/ 2024;2:100091. doi:https://doi.org/10.1016/j.glmedi.2024.100091[CrossRef]
  29. Assari S BM, Caldwell CH, Zimmerman MA. Diminished Returns of Parental Educational Attainment on School Achievement of Non-Hispanic Black High School Students. Under review. 2020;[CrossRef] [PubMed]
  30. Assari S, Bazargan M. Education Level and Cigarette Smoking: Diminished Returns of Lesbian, Gay and Bisexual Individuals. Behav Sci (Basel). Sep 24 2019;9(10)doi:10.3390/bs9100103[CrossRef] [PubMed]
  31. Assari S, Perez MU, Johnson N, et al. Education Level and Self-rated Health in the United States: Immigrants' Diminished Returns. Int J Travel Med Glob Health. Summer 2020;8(3):116-123. doi:10.34172/ijtmgh.2020.20[CrossRef] [PubMed]
  32. Assari S. Educational Attainment and Exercise Frequency in American Women; Blacks’ Diminished Returns. Women’s Health Bulletin. 2019;6(3):e87413.[CrossRef] [PubMed]
  33. Assari S, Bazargan M. Educational Attainment and Self-Rated Oral Health among American Older Adults: Hispanics’ Diminished Returns. Dentistry Journal. 2019;7(4):97.[CrossRef] [PubMed]
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  39. Assari S, Najand B, Sheikhattari P. Household income and subsequent youth tobacco initiation: Minorities’ Diminished Returns. Journal of Medicine, Surgery, and Public Health. 2024/04/01/ 2024;2:100063. doi:https://doi.org/10.1016/j.glmedi.2024.100063[CrossRef] [PubMed]
  40. Assari S. Income and Mental Well-Being of Middle-Aged and Older Americans: Immigrants’ Diminished Returns. International Journal of Travel Medicine and Global Health. 2020;8(1):37-43. doi:10.34172/ijtmgh.2020.06[CrossRef] [PubMed]
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  62. Assari S, Najand B, Khatami SM. High Systolic Blood Pressure of High-Income African American Children. J Racial Ethn Health Disparities. Jul 7 2023;doi:10.1007/s40615-023-01668-5[CrossRef] [PubMed]
  63. Assari S, Boyce S, Bazargan M. Subjective Family Socioeconomic Status and Adolescents’ Attention: Blacks’ Diminished Returns. Children. 2020;7(8):80.[CrossRef] [PubMed]
  64. Assari S. Protective Effects of Maternal Education against Low Birth Weight Deliveries: Blacks' Diminished Returns. Res Health Sci. 2020;5(4):1-17. doi:10.22158/rhs.v5n4p1[CrossRef] [PubMed]
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  67. Assari S. Black Americans' Diminished Health Returns of Professional Occupations: A Thirty-Year Follow-Up Study of Middle-Aged and Older Adults. J Racial Ethn Health Disparities. May 28 2024;doi:10.1007/s40615-024-02034-9[CrossRef]
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  76. Assari S, Cobb S, Cuevas AG, Bazargan M. Diminished Health Returns of Educational Attainment Among Immigrant Adults in the United States. Front Psychiatry. 2020;11:535624. doi:10.3389/fpsyt.2020.535624[CrossRef] [PubMed]
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