The EARN-Health Trial: Intervening on Economic Determinants of Health

Project Summary

The research team evaluated an EARN savings intervention, or Individual Development Account (IDA), that encourages financial saving among low-income US adults to see if improved financial security impacts mental health and health behaviors.

Research Question(s)

  • Does an intervention that encourages financial savings among low-income U.S. adults improve health behaviors and mental health?


  • Inform policy-makers looking for interventions that can simultaneously address the pressing topical issues of wealth inequality and health inequality.
  • Develop new insights into how intervening on inadequate financial savings can influence population health and health equity and address a critical upstream economic determinant of health.


No significant, long-term effects were found. Individuals in the IDA program did not experience a significant improvement in their mental or physical health, as compared to controls, potentially because the matching amount was relatively small. Further evaluation is needed. Incentives of varying amounts should be tested to determine whether larger matches might yield better outcomes.


Health: Self-reported health-related quality of life, physical and mental health, tobacco and alcohol use, depression symptoms

Other: Self-reported financial stress, locus of control, optimism, improvements in long-term financial outlooks


Mixed-methods, waitlist-controlled trial

Quantitative: Intent-to-treat analysis using mixed models to compare survey responses between the intervention and wait list control groups.

Qualitative: Analysis of semi-structured qualitative telephone interviews to further understand the linkages between the intervention and self-reported health outcomes.

Doctor holding a piggy bank
Grantee and Partner organizations

Stanford University School of Medicine

Grant status
Principal investigators
Sanjay Basu, MD, PhD
Start date
Award amount
24 months

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