A long-running cash distribution program in Alaska is challenging widely held assumptions about the potential harms of direct cash payments, according to a modern study published in the American Journal of Epidemiology. Researchers found no evidence that the annual payments increase rates of traumatic injury or death.
The study, conducted by researchers at New York University, the University of California San Francisco (UCSF) School of Medicine, and led in part by Alaska’s former chief medical officer, examined eleven years of data, from 2009 to 2019. It focused on Alaska’s Permanent Fund Dividend (PFD), a program established in 1982 that provides annual payments to state residents. The amount varies yearly, typically ranging from $1,000 to $2,000 per person, and is funded by oil revenues, according to the Alaska Permanent Fund Corporation.
“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,” said Sarah Cowan, a sociologist at NYU and founder and executive director of the university’s Cash Transfer Lab. “Those fears are unfounded. Our long-term study of a state’s population shows no connection between cash transfers and serious injury or death.”
The researchers analyzed records of all traumatic injuries treated in Alaska hospitals using the state’s trauma registry, as well as all reported deaths documented in vital records. They found no statistically significant increase in serious traumatic injuries or deaths from unnatural causes in the weeks or months following the distribution of PFD payments, which typically occur in the fall.
Anne Zink, who served as Alaska’s chief medical officer from 2019 to 2024 and is now a senior fellow at the Yale School of Public Health, emphasized the importance of data-driven evaluation. “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,” Zink said. “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.”
The study’s lead author, Ruby Steedle, is a researcher at the Cash Transfer Lab. Other members of the research team included Tasce Bongiovanni, an associate professor of surgery at UCSF’s School of Medicine, and NYU Cash Transfer Lab researchers Robert Pickett, Hailie Dono, Erica Hobby, and Byungkyu Lee.
The findings contrast with some earlier research on cash transfers, which yielded mixed results. The authors attribute the strength of their study to its comprehensive scope – reviewing all traumatic injuries and deaths statewide – its extended timeframe, and the fact that it assessed a program reaching an entire state’s population, offering a broader representation than most guaranteed income studies.
The Alaska Permanent Fund was created by an amendment to the Alaska Constitution in 1976, designed to set aside at least 25% of oil revenues for future generations. Whereas primarily funded by oil revenue, the fund’s income is also derived from mining revenues.
