A new 11-year study of Alaska's long-running cash transfer program challenges those concerns. Researchers found no evidence that direct cash payments increase the likelihood of traumatic injury or death.

The study was conducted by researchers from New York University, the University of California San Francisco (UCSF) School of Medicine, and Alaska's former chief medical officer. The findings were published in theAmerican Journal of Epidemiology.

"Past research has shown that cash transfers are an effective tool for reducing poverty, but their implementation is often limited by critics who worry about irresponsible spending that can lead to tragedy," says NYU sociologist Sarah Cowan, founder and executive director of the university's Cash Transfer Lab, which conducted the study. "Those fears are unfounded. Our long-term study of a state's population shows no connection between cash transfers and serious injury or death."

Alaska Permanent Fund Dividend as a Real World Test

The analysis centered on Alaska's Permanent Fund Dividend (PFD), a statewide program that provides annual payments to residents.

"As a practicing emergency physician I worried about yearly PFD leading to immediate harm, but as Alaska's chief medical officer and public health official, I know how important it is to review the data objectively," adds Anne Zink, chief medical officer for the State of Alaska from 2019 to 2024 and now a senior fellow at the Yale School of Public Health. "This study provides the kind of population-level evidence that public health officials and policymakers need when evaluating guaranteed income programs. When looking across the entire state's population over 11 years, there was no evidence of increased trauma or mortality temporally associated with the PFD cash transfer."

Earlier research on cash transfers has produced mixed findings. Some studies reported no connection to injury or death, while others suggested there could be a link. According to the authors, this new study stands out because it reviewed every traumatic injury and death recorded statewide and covered a longer time frame than previous work. It also assessed a program that reaches an entire state, reflecting a broader and more diverse population than most guaranteed income studies.

The research team also included Ruby Steedle, a researcher at the Cash Transfer Lab and the paper's lead author, and Tasce Bongiovanni, an associate professor of surgery at UCSF's School of Medicine.

Decades of Annual Cash Payments in Alaska

Since 1982, Alaska has sent a yearly payment to all residents. The amount changes annually but typically ranges from $1,000 to $2,000 per person. Because the program has operated for decades and includes the full state population, it provides a rare opportunity to evaluate how a universal basic income and other cash transfer programs function in practice.

For this study, researchers reviewed data from 2009 through 2019. They analyzed records of all traumatic injuries treated in Alaska hospitals using the state's trauma registry, along with all reported deaths documented in vital records.

Across the state, the annual cash payments were not associated with an increase in serious traumatic injuries or deaths from unnatural causes in the short term. The findings held up under multiple robustness checks. Injury and death rates did not rise during the week to month after payments were distributed, which usually occurs in the fall.

The same pattern was observed in Alaska's urban regions, which resemble small and medium sized cities in the continental US. This suggests the results may apply beyond a single state.

"Together, these findings provide strong evidence that narratives about short-term harm from cash payments are unfounded," the authors conclude.

The paper's other authors were NYU Cash Transfer Lab researchers Robert Pickett, Hailie Dono, and Erica Hobby and Byungkyu Lee, an assistant professor in NYU's Department of Sociology.

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