A program that gave women in Flint, Mich., money during pregnancy and after childbirth significantly improved their health and that of their newborns, according to a new study published Wednesday.
The program, called Rx Kids, gave women a lump sum of $1,500 midway through their pregnancies and $500 a month through the first year of the child’s life, with no restrictions on how they could use the money. After it was established in 2024, rates of premature birth declined, and fewer babies were born underweight or in need of neonatal intensive care. The study, published in The Lancet Public Health, also found that more pregnant women received prenatal care, and fewer smoked.
“Moms told us, ‘Because of these dollars, I can take a day off work and pay for gas to go to my prenatal appointment,’” said Dr. Mona Hanna, director of Rx Kids and the senior author of the new paper.
The new report offered one of the most optimistic recent assessments of cash transfer programs. Results from other similar programs across the country have been mixed. But the Flint initiative is one of several that target pregnancy and the first year of a baby’s life, when income often dips just as expenses increase. This critical period influences a child’s development and long-term health trajectory, said Dr. Hanna, who is also associate dean of public health at Michigan State University College of Human Medicine.
The study evaluated the outcomes of some 4,500 births in Flint between 2021 and 2025, and compared them with those in similar, matched cities in Michigan. Before the program’s implementation, rates of premature birth and low birth weight had been increasing in Flint.
Researchers would have expected those rates “to increase even more, because the rates were rising year after year and rising in the matched cities, but instead, Flint’s rates went lower,” said Dr. Sumit Agarwal, a physician and economist at the University of Michigan and the paper’s first author. He and the study’s other authors concluded that the program effectively reduced Flint’s preterm birth rate by 2.7 percent and low birth weight rate by 4.2 percent.
Previous studies have found that Rx Kids was also associated with fewer evictions, better maternal health and a drop in welfare investigations of child maltreatment. The program has now expanded to 42 communities in Michigan.
The results contrast starkly with the disappointing conclusions last year from a rigorous study called “Baby’s First Years” that had a control group for comparison. It found that children whose families were given $333 a month did not perform better on tests of cognitive skills after four years than children in a comparison group whose families got a nominal $20 a month. Their health and their mothers’ stress levels were also no better.
Kevin Corinth, an economist who studies poverty and safety net programs at the conservative American Enterprise Institute, said he was skeptical that the small amounts of cash given to mothers in Flint could bring about such significant improvements. He added that the gold standard for assessing this type of intervention is to randomly give some mothers cash and not others, and then compare the outcomes.
But Hilary Hoynes, a professor of economics and public policy at the University of California, Berkeley, said the report was consistent with previous studies, including her own research, which has shown that women who received larger income tax credits were less likely to have low birth weight babies.
Cash transfer programs in other countries have also shown positive results, including cutting child mortality rates in Kenya, and improving school attendance, nutrition and use of health services in other low- and middle-income nations.
Dr. Hoynes said that one possible explanation for the benefits seen in the Flint study was that the money enabled low-income women to access prenatal care earlier and act on advice to stop smoking, which is closely correlated with poor birth outcomes.
It’s also possible that the money reduced stress among mothers, which may play a role in preterm birth, said Dr. Nigel Paneth, an emeritus professor of epidemiology and pediatrics and human development at Michigan State University.
While the cash-transfer sums were relatively modest, more than half of mothers in Flint earn under $10,000 a year.
“A $1,500 check for a poor person is a pretty good stress reliever,” Dr. Paneth said.
Dozens of cash transfer programs have been put in place across the country in recent years. Advocates say that while government programs like the Supplemental Nutrition Assistance Program, or SNAP, can provide specific benefits, cash helps families purchase what they need when they need it.
“If you qualify for SNAP, you probably need help with your car, too,” said Michael Tubbs, the former mayor of Stockton, Calif., and the chairman of Mayors for Guaranteed Income, a network of over 150 mayors who support such initiatives.
Kinea ‘Kandi’ Wright, 46, started participating in Rx Kids when she was pregnant with her 2-year-old daughter. She said the money was helpful after her husband was injured at his job as a forklift operator. And when she had complications that led to an emergency cesarean section, she used the extra cash to hire a doula for help at home.
She said she appreciated the freedom to use the money how she needed. “I could use it for a car payment or day care for my other child. I didn’t have to use it strictly for diapers and formula,” Ms. Wright said.
“It made a huge difference,” she said, “because there are no strings attached.”
Roni Caryn Rabin is a Times health reporter focused on maternal and child health, racial and economic disparities in health care, and the influence of money on medicine.
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