At the height of the Covid pandemic in 2020 and 2021, the city operated the Chelsea Eats program, which provided financial resources for some of the city’s most vulnerable residents.
A recent study in JAMA, the Journal of the American Medical Association, showed that the monthly $400 cash benefits in the city had a number of positive benefits for residents, including improvements in health and increased access to emergency care.
The study, authored by Sumit D. Agarwal, MD, MPH, PhD; Benjamin Lê Cook, PhD; and Jeffrey B. Liebman, PhD; linked and
analyzed the medical records of the 2,880 participants who applied for the cash benefits. Chelsea Eats randomly assigned individuals by
lottery to receive cash benefits via debit card of up to $400 per month for nine months, Increasing the baseline income of those who participated by 23 percent per month.
That monthly payment was not restricted, and could be used for food, shelter, utility payments, or other necessities.
The results of the study published in JAMA showed that the cash benefits led to 27 percent fewer emergency department visits, including 62 percent fewer emergency department visits for behavioral health reasons, and 42 percent fewer admissions to the hospital from the emergency department.
The cash benefits also led to 87 percent fewer emergency department visits related to substance use, offering evidence against the often-heard concern that cash transfers increase use of drugs and alcohol, the studies authors stated.
The study also found that benefits increased outpatient visits to subspecialists by 21%, especially to clinics further away and for those without a car.
The study’s authors stated that reductions in health care spending could offset as much as half the costs of the program by decreasing expensive visits to the hospital.
“The Chelsea Eats was a very innovative program, really spearheaded by the previous city manager, Thomas Ambrosino,” said City Manager Fidel Maltez. “It was a fantastic team effort; it involved a lot of our employees, a lot of our staff, and it could not have happened without the support of our city council.”
Ambrosino was able to leverage some federal funds along with some local funds, as well as some private funds through philanthropic organizations, for the nine-month trial program.
“It was meant to provide a financial benefit to folks who really needed it, following the pandemic and the recovery,” said Maltez. “It really transformed the lives of all the participants. From conversations I’ve had with residents who participated, it just provided a relief, a safety net that was able to provide families with needed income to pay their rent, to pay their utility bills, to pay for their emergencies that came up.”
Maltez said Ambrosino partnered with the Harvard Kennedy School of Government to assess the impact of Chelsea Eats and other similar programs.
The study tracked the 1,700 people who took part in Chelsea Eats and compared them to people who were not in the program as well as the outcomes of the participants from before they took part in the program, Maltez said.
“They were really trying to assess, did we get the bang for our buck,” said Maltez. “They tracked a lot of different, scientific parameters, and the one that I think is most exciting is … the major reduction in emergency department visits related to behavioral health and substance abuse. The connection is that we believe when folks are strapped for cash, they all suffer – whether it is mental health, whether it is not being able to prioritize their wellbeing, and no previous study was able to quantify that.”