Improvements in stress and sleep following 24-months of Guaranteed Income, results from a randomized trial among Black women in Georgia

Objective To estimate differences in mental distress, sleep quality, and sleep duration following twelve and twenty-four months of receipt of guaranteed income (GI) between program participants and a comparison group. Methods We conducted a community-engaged intervention study (In Her Hands) between 2022 and 2024 in Georgia, United States. Participants included self-identified Black women with income ≤ 200 % of the federal poverty level who participated in follow-up surveys (12-month participation rates: intervention: 40.8 %; control: 11.9 %). GI recipients were selected via lottery; comparison participants were those not selected at baseline who completed follow-up surveys. We measured mental distress using the Kessler-10 and sleep quality and duration via the Pittsburgh Sleep Quality Index at 12- and 24-months following enrollment. We fit linear regression models using generalized estimating equations, accounting for site, age, and wave to estimate differences and 95 % confidence intervals. Results We include 468 GI recipients and 374 controls (99.93 % Black; mean age 37.0 years, median annual income: $11,400). Following 12 and 24 months of GI receipt, GI recipients reported better sleep quality (24 month difference in PSQI score, −1.33 (-1.83, −0.82)) and lower mental distress (24 month K10 difference: −3.99 (-5.45, −2.52)) but not significant differences in sleep duration (24 month difference: 0.22 (-0.15, 0.60) compared to non-recipients. Conclusions At 12 and 24 months of GI, intervention participants reported higher sleep quality and lower mental distress compared to a comparison group.