San Diego County has launched a new guaranteed income program in partnership with the San Diego Foundation, aimed at supporting high-risk pregnant women. The initiative, called Born Well, seeks to improve birth outcomes for mothers and newborns in communities facing significant health disparities.
The San Diego Foundation is contributing $1 million to this public-private collaboration. The funds will help expand access to prenatal and postpartum care, support service providers, and strengthen coordination among agencies.
A key part of Born Well is a pilot program that will provide $750 per month in cash payments to 25 expectant mothers for one year. Eligible participants will be referred through the County’s Perinatal Equity Initiative program and must be in their first or second trimester of pregnancy.
Guaranteed income programs are designed to give families direct, unconditional cash assistance. This approach allows recipients to address their most urgent needs—such as food, childcare, medical expenses, or rent—according to their own priorities.
In San Diego County, babies from the highest risk groups face serious challenges: they can be up to six times more likely to die before their first birthday and 60 percent more likely to be born prematurely compared with those in lower-risk groups. Statewide data shows that high-risk mothers in California are over three times more likely than others to die from pregnancy-related causes (https://www.cdph.ca.gov/Programs/CFH/DMCAH/Pages/Maternal-Mortality.aspx).
These disparities persist regardless of age, income, or education level and are linked to systemic issues such as unequal access to healthcare, toxic stress environments, and broader social and economic inequities.
“While we are seeing improvements in the number of infant deaths in San Diego County overall, the rate of infant deaths in the highest-risk groups are still far above any other group,” said Liz Hernandez, Director of Public Health Services. “There is more work to be done to improve disparities. This guaranteed income program is one step in reducing barriers for pregnant women at risk, like financial worries.”
San Diego County has previously participated in other guaranteed income initiatives. The Family Income for Empowerment Program began in April 2023 through a partnership with Jewish Family Service. It provides low-income families referred by the Child and Family Well-Being Department with $500 per month for 24 months as unrestricted cash payments (https://www.jfssd.org/blog/jewish-family-service-launches-guaranteed-income-pilot-program-for-san-diego-families/). More than 450 families have taken part so far; some have begun transitioning out of the program. While final results will not be available until all participants finish the program, early feedback indicates positive changes—families report increased confidence about housing security and an improved ability to meet monthly financial obligations.
Another effort was the Recovery Action Fund for Tomorrow (RAFT), also conducted with Jewish Family Service. RAFT provided one-time payments of $4,000 each to over 2,200 low-income families and seniors affected by financial hardships during the COVID-19 pandemic (https://www.sandiegouniontribune.com/news/social-justice/story/2023-05-23/san-diego-county-launches-guaranteed-income-programs). Initial findings show that most funds were used on housing costs; participants also spent about 30 percent on food and groceries, 23 percent on retail purchases such as at Costco or Target stores, and 16 percent on transportation including gasoline.
The County’s Pilot Shallow Rental Subsidy Program offers another form of support by providing nearly 400 older adults with monthly rent subsidies of $500 paid directly to landlords for periods ranging from 18–30 months. Although this is not a guaranteed income initiative since payments go directly toward housing costs rather than being given unconditionally as cash assistance (https://www.sdcounty.ca.gov/content/dam/sdc/hhsa/programs/phs/documents/Senior_Rental_Subsidy_Pilot_Program.pdf), it has expanded since its launch last year. Participants receive case management services connecting them with additional resources.
The Office of Evaluation, Performance, and Analytics is currently assessing how these programs affect people’s lives and well-being across San Diego County. Preliminary results may become available by late 2025.
