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Dallmeyer S, Breuer C. The introduction of a minimum wage in Germany and the effects on physical activity participation. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:211-229. [PMID: 38536634 PMCID: PMC11108941 DOI: 10.1007/s10754-024-09375-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/12/2024] [Indexed: 05/22/2024]
Abstract
The relationship between income and physical activity has been extensively studied. This paper utilizes the introduction of the minimum wage in Germany in 2015 as a quasi-experiment to determine the causal effect of minimum wages on the frequency of physical activity participation. Employing survey data from the German Socio-Economic Panel between 2013 and 2017, regression-adjusted difference-in-difference models combined with matching techniques are estimated. Our findings reveal a notable negative effect immediately after the minimum wage implementation on physical activity frequency. Given that the introduction of the minimum wage did not increase monthly gross income but reduced working hours, it appears that affected individuals exhibit preferences and engage in utility maximization that do not emphasize healthy behaviors. This effect is particularly pronounced among older females in white-collar occupations.
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Affiliation(s)
- Sören Dallmeyer
- Department of Sport Economics and Sport Management, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
| | - Christoph Breuer
- Department of Sport Economics and Sport Management, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany
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Sansone N, Tyano S, Melillo A, Schouler-Ocak M, Galderisi S. Comparing the World Psychiatric Association and European Psychiatric Association Codes of Ethics: Discrepancies and shared grounds. Eur Psychiatry 2024; 67:e38. [PMID: 38712570 PMCID: PMC11362998 DOI: 10.1192/j.eurpsy.2024.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Codes of ethics provide guidance to address ethical challenges encountered in clinical practice. The harmonization of global, regional, and national codes of ethics is important to avoid gaps and discrepancies. METHODS We compare the European Psychiatric Association (EPA) and the World Psychiatric Association (WPA) Codes of Ethics, addressing main key points, similarities, and divergences. RESULTS The WPA and EPA codes are inspired by similar fundamental values but do show a few differences. The two codes have a different structure. The WPA code includes 4 sections and lists 5 overarching principles as the basis of psychiatrists' clinical practice; the EPA code is articulated in 8 sections, lists 4 ethical principles, and several fundamental values. The EPA code does not include a section on psychiatrists' education and does not contain specific references to domestic violence and death penalty. Differences can be found in how the two codes address the principle of equity: the EPA code explicitly refers to the principle of universal health care, while the WPA code mentions the principle of equity as reflected in the promotion of distributive justice. CONCLUSIONS We recommend that both WPA and EPA periodically update their ethical codes to minimize differences, eliminate gaps, and help member societies to develop or revise national codes in line with the principles of the associations they belong to.Minimizing differences between national and international codes and fostering a continuous dialogue on ethical issues will provide guidance for psychiatrists and will raise awareness of the importance of ethics in our profession.
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Affiliation(s)
- Noemi Sansone
- University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Samuel Tyano
- Department of Psychiatry, Tel Aviv University Medical School, Tel Aviv, Israel
| | | | - Meryam Schouler-Ocak
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
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Chan JK, Marzuki AA, Vafa S, Thanaraju A, Yap J, Chan XW, Harris HA, Todi K, Schaefer A. A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain. BMC Psychol 2024; 12:237. [PMID: 38671542 PMCID: PMC11046828 DOI: 10.1186/s40359-024-01715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders. METHODS Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health. RESULTS Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst. CONCLUSIONS This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.
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Affiliation(s)
- Jee Kei Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Sunway University Malaysia, Room: 4-4-11, Jalan Lagoon Selatan, Bandar Sunway, Petaling Jaya, 47500, Selangor, Malaysia.
| | - Aleya A Marzuki
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Samira Vafa
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Arjun Thanaraju
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Jie Yap
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Xiou Wen Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Hanis Atasha Harris
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Khushi Todi
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Alexandre Schaefer
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
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Wood BM, Cubbin C, Rubalcava Hernandez EJ, DiNitto DM, Vohra-Gupta S, Baiden P, Mueller EJ. The Price of Growing Up in a Low-Income Neighborhood: A Scoping Review of Associated Depressive Symptoms and Other Mood Disorders among Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6884. [PMID: 37835154 PMCID: PMC10572337 DOI: 10.3390/ijerph20196884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/24/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
Neighborhoods, as built and social environments, have significant implications for mental health. Children raised in high-poverty neighborhoods, who are disproportionately Black, Indigenous, and people of color, have a greater risk of adverse life outcomes. Neighborhood gentrification is also salient when examining mental health outcomes as neighborhood economic contexts shift around a child. This review scopes, describes, synthesizes, and critiques the existing literature on the relationship between neighborhood poverty/gentrification and mood disorder symptoms among children ages 3-17 in the United States (U.S.). Given the history of structural racism in the creation of U.S. neighborhoods, inclusion criteria required that study samples be racially diverse. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews, seven databases and grey literature were searched; 17 studies were included (total n = 122,089). Fourteen studies found significant associations between neighborhood poverty/gentrification and child depression. Three longitudinal studies found significant results suggesting that childhood neighborhood poverty/gentrification may have a lagged effect, with depression emerging later in life. Neighborhood poverty and gentrification require further examination as social determinants of mental health. Researchers should examine neighborhood poverty and gentrification as social determinants of mental health. Policies that reduce neighborhood economic disparities are needed across the U.S.
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Affiliation(s)
- Bethany M. Wood
- School of Social Work, The University of Texas at Arlington, 211 S Cooper St, Arlington, TX 76019, USA; (E.J.R.H.); (P.B.)
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA; (C.C.); (D.M.D.); (S.V.-G.)
| | | | - Diana M. DiNitto
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA; (C.C.); (D.M.D.); (S.V.-G.)
| | - Shetal Vohra-Gupta
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA; (C.C.); (D.M.D.); (S.V.-G.)
| | - Philip Baiden
- School of Social Work, The University of Texas at Arlington, 211 S Cooper St, Arlington, TX 76019, USA; (E.J.R.H.); (P.B.)
| | - Elizabeth J. Mueller
- School of Architecture, The University of Texas at Austin, 310 Inner Campus Drive, Austin, TX 78712, USA;
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Bai Y, Kim C, Chum A. Impact of the minimum wage increase on smoking behaviour: A quasi-experimental study in South Korea. Soc Sci Med 2023; 333:116135. [PMID: 37562244 DOI: 10.1016/j.socscimed.2023.116135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND While there's a growing body of research studying the health effects of minimum wage increases, evidence of its impact on smoking is inconsistent. Using nationally representative statistics, our quasi-experimental study examines the impacts of South Korea's 2018 minimum wage increase on smoking patterns, offering a distinctive context due to the significant wage growth and the country's permissive smoking culture. METHODS Using the Korean Welfare Panel Study (KOWEPS), we conducted a difference-in-differences analysis using two-way fixed effect (TWFE) and Callaway and Sant'Anna Difference-in-differences (CSDID) methods. The study sample (n = 3494) included individuals aged 19-64 at baseline in 2016, and employed in the entire study period (2016-2019). RESULTS The model results suggest a roughly 2% increase in the probability of current smoking with an insignificant impact on average daily cigarette consumption following the 2018 minimum wage increase in Korea. These effects were most pronounced among men and age groups (45-64). We also found policy effects on those earning up to 150% of the minimum wage. CONCLUSION In a culture with widespread acceptance of smoking, an exogenous increase in disposable income due to elevated minimum wage might enhance vulnerability to societal pressure to smoke. Although TWFE and CSDID both suggest the same overall trend, the latter approach allows a more detailed examination by acknowledging heterogeneous treatment effects. These results could guide policymakers to contemplate the potential for increased smoking resulting from minimum wage hikes in societies where tobacco use is common, and accordingly strategize anti-smoking public health initiatives.
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Affiliation(s)
- Yihong Bai
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Buszkiewicz JH, Hajat A, Hill HD, Otten JJ, Drewnowski A. Racial, ethnic, and gender differences in the association between higher state minimum wages and health and mental well-being in US adults with low educational attainment. Soc Sci Med 2023; 322:115817. [PMID: 36905725 PMCID: PMC11321499 DOI: 10.1016/j.socscimed.2023.115817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND To date, research evaluating the association between minimum wage and health has been heterogenous and varies based on the specific subpopulation or health outcomes under evaluation while associations across racial, ethnic, and gender identities have been understudied. METHODS A triple difference-in-differences strategy using modified Poisson regression was used to evaluate the associations between minimum wage and obesity, hypertension, fair or poor general health, and moderate psychological distress in 25-64-year-old adults with a high school education/GED or less. Data from the 1999-2017 Panel Study of Income Dynamics was linked to state policies and characteristics to estimate the risk ratio (RR) associated with a $1 increase in current and 2-year lagged state minimum wages overall and by race, ethnicity, and gender (non-Hispanic or non-Latino (NH) White men, NH White women, Black, indigenous, or people of color (BIPOC) men, and BIPOC women) adjusting for individual and state-level confounding. RESULTS No associations between minimum wage and health were observed overall. Among NH White men 2-year lagged minimum wage was associated with reduced risk of obesity (RR = 0.82, 95% CI = 0.67, 0.99). Among NH White women, current minimum wage was associated lower risk of moderate psychological distress (RR = 0.73, 95% CI = 0.54, 1.00) while 2-year lagged minimum wage was associated with higher obesity risk (RR = 1.35, 95% CI = 1.12, 1.64) and lower risk of moderate psychological distress (RR = 0.75, 95% CI = 0.56, 1.00). Among BIPOC women, current minimum wage was associated with higher risk of fair or poor health (RR = 1.19, 95% CI = 1.02, 1.40). No associations were observed among BIPOC men. CONCLUSION While no associations were observed overall, heterogeneous associations between minimum wage, obesity, and psychological distress by racial, ethnic, and gender strata warrant further study and have implications for health equity research.
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Affiliation(s)
- James H Buszkiewicz
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Heather D Hill
- Daniel J. Evans School of Public Policy and Governance, University of Washington, Seattle, WA, USA
| | - Jennifer J Otten
- Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA, USA; Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam Drewnowski
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA, USA; Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA, USA
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Lebihan L. Minimum wages and health: evidence from European countries. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2023; 23:85-107. [PMID: 36417144 PMCID: PMC9685008 DOI: 10.1007/s10754-022-09340-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
This study investigates the effects of minimum wage on health, well-being, and income security in European countries. The empirical strategy consists of exploiting variations in the minimum wage across European countries over time. We show that minimum wage increases improve individuals' self-reported health and income security. Minimum wage increases also improve life satisfaction and happiness. The effects are largest among women, employed individuals, married individuals, and those with less than a secondary education. Our results are robust to several robustness checks and consistent with existing evidence on the relationship between minimum wage and health.
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Affiliation(s)
- Laetitia Lebihan
- Department of Economics, University of Reunion Island, 15 avenue René Cassin - CS 92003, 97744, Saint-Denis Cedex 9, Reunion Island, France.
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Restrepo BJ, Zeballos E. Working from Home and Emotional Well-Being during Major Daily Activities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3616. [PMID: 36834309 PMCID: PMC9963343 DOI: 10.3390/ijerph20043616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The effect of WFH (working from home) on the quality of life of U.S. workers is not well understood. We analyze the association between WFH and overall emotional well-being during major daily activities. Using data from the 2021 Well-Being Module of the American Time Use Survey, we conduct a principal component analysis to construct a measure of overall emotional well-being and jointly estimate the association between WFH and overall emotional well-being scores in a seemingly unrelated regression framework. Our results show that compared to workers who worked outside the home, those who WFH had higher emotional well-being scores while working and eating away from home. However, no statistically significant differences were found for home-based daily activities such as relaxing, leisure, food preparation, and eating at home. These findings inform how WFH may shape the quality of a life day.
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Affiliation(s)
- Brandon J. Restrepo
- Economic Research Service, U.S. Department of Agriculture, Washington, DC 20250, USA
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Minimum wages and mental health: Evidence from Canada. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Wollburg C, Steinert JI, Reeves A, Nye E. Do cash transfers alleviate common mental disorders in low- and middle-income countries? A systematic review and meta-analysis. PLoS One 2023; 18:e0281283. [PMID: 36812171 PMCID: PMC9946251 DOI: 10.1371/journal.pone.0281283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/19/2023] [Indexed: 02/24/2023] Open
Abstract
A large literature has demonstrated the link between poverty and mental ill-health. Yet, the potential causal effects of poverty alleviation measures on mental disorders are not well-understood. In this systematic review, we summarize the evidence of the effects of a particular kind of poverty alleviation mechanism on mental health: the provision of cash transfers in low- and middle-income countries. We searched eleven databases and websites and assessed over 4,000 studies for eligibility. Randomized controlled trials evaluating the effects of cash transfers on depression, anxiety, and stress were included. All programs targeted adults or adolescents living in poverty. Overall, 17 studies, comprising 26,794 participants in Sub-Saharan Africa, Latin America, and South Asia, met the inclusion criteria of this review. Studies were critically appraised using Cochrane's Risk of Bias tool and publication bias was tested using funnel plots, egger's regression, and sensitivity analyses. The review was registered in PROSPERO (CRD42020186955). Meta-analysis showed that cash transfers significantly reduced depression and anxiety of recipients (dpooled = -0.10; 95%-CI: -0.15, -0.05; p<0.01). However, improvements may not be sustained 2-9 years after program cessation (dpooled = -0.05; 95%-CI: -0.14, 0.04; ns). Meta-regression indicates that impacts were larger for unconditional transfers (dpooled = -0.14; 95%-CI: -0.17, -0.10; p<0.01) than for conditional programs (dpooled = 0.10; 95%-CI: 0.07, 0.13; p<0.01). Effects on stress were insignificant and confidence intervals include both the possibility of meaningful reductions and small increases in stress (dpooled = -0.10; 95%-CI: -0.32, 0.12; ns). Overall, our findings suggest that cash transfers can play a role in alleviating depression and anxiety disorders. Yet, continued financial support may be necessary to enable longer-term improvements. Impacts are comparable in size to the effects of cash transfers on, e.g., children's test scores and child labor. Our findings further raise caution about potential adverse effects of conditionality on mental health, although more evidence is needed to draw robust conclusions.
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Affiliation(s)
- Clara Wollburg
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Janina Isabel Steinert
- TUM School of Social Sciences and Technology, Technical University Munich, Munich, Germany
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Elizabeth Nye
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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Molarius A. Socioeconomic inequalities in health - debates on the persistence. Perspect Public Health 2023; 143:20-21. [PMID: 36694968 DOI: 10.1177/17579139221138447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A Molarius
- Region Värmland, Centre for Clinical Research, 651 85 Karlstad, Sweden.,Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
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Glenn NM, Yashadhana A, Jaques K, Belon A, de Leeuw E, Nykiforuk CIJ, Harris P. The Generative Mechanisms of Financial Strain and Financial Well-Being: A Critical Realist Analysis of Ideology and Difference. Int J Health Policy Manag 2022; 12:6930. [PMID: 37579468 PMCID: PMC10125179 DOI: 10.34172/ijhpm.2022.6930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 10/15/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Rapid, strategic action is required to mitigate the negative and unequal impact of the coronavirus disease 2019 (COVID-19) pandemic on the financial well-being (FWB) of global populations. Personal financial strain (FS) worsened most significantly among systematically excluded groups. Targeted government- and community-led initiatives are needed to address these inequities. The purpose of this applied research was to identify what works for whom, under what conditions, and why in relation to community and government initiatives that promote personal and household FWB and/or address FS in high income economies. METHODS We employed a critical realist analysis to literature that reported on FWB/FS initiatives in high income countries. This included initiatives introduced in response to the pandemic as well as those that began prior to the pandemic. We included sources based on a rapid review. We coded academic, published literature (n=39) and practice-based (n=36) reports abductively to uncover generative mechanisms - ie, underlying, foundational factors related to community or government initiatives that either constrained and/or enabled FWB and FS. RESULTS We identified two generative mechanisms: (1) neoliberal ideology; and (2) social equity ideology. A third mechanism, social location (eg, characteristics of identity, location of residence), cut across the two ideologies and demonstrated for whom the initiatives worked (or did not) in what circumstances. Neoliberal ideology (ie, individual responsibility) dominated initiative designs, which limited the positive impact on FS. This was particularly true for people who occupied systematically excluded social locations (eg, low-income young mothers). Social equity-based initiatives were less common within the literature, yet mostly had a positive impact on FWB and produced equitable outcomes. CONCLUSION Equity-centric initiatives are required to improve FWB and reduce FS among systemically excluded and marginalized groups. These findings are of relevance now as nations strive for financial recovery in the face of the ongoing global pandemic.
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Affiliation(s)
- Nicole M. Glenn
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada
- PolicyWise for Children & Families, Edmonton, AB, Canada
| | - Aryati Yashadhana
- Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- School of Social Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Karla Jaques
- Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
| | - Ana Belon
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Evelyne de Leeuw
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Candace I. J. Nykiforuk
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Patrick Harris
- Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
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Rath AA, Lau EH, Schooling CM. The impact of the minimum wage on suicide rates in Hong Kong. Soc Sci Med 2022; 314:115236. [PMID: 36308889 DOI: 10.1016/j.socscimed.2022.115236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 01/26/2023]
Abstract
Increases in minimum wages have been associated with reductions in suicide rates in the United States, but little evidence is available for Asia where social and contextual factors, as well as drivers of suicide, may be different. We investigated the impact of the introduction of the minimum wage in Hong Kong in May 2011 on suicide rates using an interrupted time series design for the period January 2006 to December 2016. We investigated both immediate and gradual changes in monthly suicide rates after the introduction of the minimum wage taking into account secular trends. We conducted stratified analyses by age and gender. In total 9396 suicides were recorded in Hong Kong during the 11-year study period. Introduction of the minimum wage was associated with an immediate decrease of 13.0% in the monthly suicide rate (95% confidence interval (CI) 5.4%-19.9%, P = 0.001). There was an immediate decrease of 15.8% in older working aged (25-64 years) men (95% CI: 4.2%-25.9%, P = 0.009). Point estimates of immediate effect for other subgroups were also in a negative direction, but were not statistically significant. There was no evidence of a gradual effect on suicide rates at the population level or by subgroup other than a small increase in younger working aged men. We estimate that 633 suicides were prevented by the minimum wage legislation for the period from May 2011 to December 2016, the majority in older working aged men. Our results provide new evidence that, similar to findings in Western settings, minimum wages may help to reduce suicide in Asia, particularly for working age men. Our study highlights the importance of examining the health impacts of government economic policy and suggests minimum wages may provide policy makers with an upstream population-based strategy to reduce suicide rates.
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Affiliation(s)
- Abigail A Rath
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong (AAR, EHYL and CMS), CUNY Graduate School of Public Health and Health Policy, New York, United States.
| | - Eric Hy Lau
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong (AAR, EHYL and CMS), CUNY Graduate School of Public Health and Health Policy, New York, United States
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong (AAR, EHYL and CMS), CUNY Graduate School of Public Health and Health Policy, New York, United States
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Kezios KL, Zhang A, Kim S, Lu P, Glymour MM, Elfassy T, Al Hazzouri AZ. Association of Low Hourly Wages in Middle Age With Faster Memory Decline in Older Age: Evidence From the Health and Retirement Study. Am J Epidemiol 2022; 191:2051-2062. [PMID: 36131387 DOI: 10.1093/aje/kwac166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/03/2022] [Accepted: 09/14/2022] [Indexed: 02/01/2023] Open
Abstract
Little research has investigated the long-term relationship between low wages and memory decline, despite the growing share of low-wage workers in the US labor market. Here, we examined whether cumulative exposure to low wages over 12 years in midlife is associated with memory decline in later life. Using 1992-2016 data from the Health and Retirement Study, we analyzed data from 2,879 individuals born in 1936-1941 using confounder-adjusted linear mixed-effects models. Low-wage work was defined as an hourly wage lower than two-thirds of the federal median wage for the corresponding year and was categorized into "never," "intermittent," and "sustained" based on wages earned from 1992 to 2004. Memory function was measured at each study visit from 2004 to 2016 via a memory composite score. The confounder-adjusted annual rate of memory decline among "never" low-wage earners was -0.12 standard units (95% confidence interval: -0.13, -0.10). Compared with this, memory decline among workers with sustained earning of low midlife wages was significantly faster (βtime×sustained = -0.014, 95% confidence interval: -0.02, -0.01), corresponding to an annual rate of -0.13 standard units for this group. Sustained low-wage earning in midlife was significantly associated with a downward trajectory of memory performance in older age. Enhancing social policies to protect low-wage workers may be especially beneficial for their cognitive health.
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Malik AO, Jones PG, Mena-Hurtado C, Burg MM, Shishehbor MH, Hejjaji V, Tran A, Spertus JA, Smolderen KG. Derivation and validation of a predictive model for chronic stress in patients with cardiovascular disease. PLoS One 2022; 17:e0275729. [PMID: 36256655 PMCID: PMC9578618 DOI: 10.1371/journal.pone.0275729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Chronic stress in patients with cardiovascular disease (CVD), including peripheral artery disease (PAD), is independently associated worse outcomes. A model that can reliably identify factors associated with risk of chronic stress in patients with CVD is needed. METHODS In a prospective myocardial infarction (MI) registry (TRIUMPH), we constructed a logistic regression model using 27 patient demographic, socioeconomic, and clinical factors, adjusting for site, to identify predictors of chronic stress over 1 year. Stress at baseline and at 1-, 6- and 12-month follow-up was measured using the 4-item Perceived Stress Scale (PSS-4) [range 0-16, scores ≥6 depicting high stress]. Chronic stress was defined as at least 2 follow-up PSS-4 scores ≥6. We identified and validated this final model in another prospective registry of patients with symptomatic PAD, the PORTRAIT study. RESULTS Our derivation cohort consisted of 4,340 patients with MI (mean age 59.1 ± 12.3 years, 33% females, 30% non-white), of whom 30% had chronic stress at follow-up. Of the 27 factors examined, female sex, current smoking, socioeconomic status, and economic burden due to medical care were positively associated with chronic stress, and ENRICHD Social Support Instrument (ESSI) score and age were inversely related to chronic stress. In the validation cohort of 797 PAD patients (mean age 68.6±9.7 years, 42% females, 28% non-white, 18% chronic stress) the c-statistic for the model was 0.77 and calibration was excellent. CONCLUSIONS We can reliably identify factors that are independently associated with risk of chronic stress in patients with CVD. As chronic stress is associated with worse outcomes in this population, our work identifies potential targets for interventions to as well as the patients that could benefit from these.
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Affiliation(s)
- Ali O. Malik
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - Philip G. Jones
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | | | - Matthew M. Burg
- Yale School of Medicine, New Haven, CO, United States of America
| | | | - Vittal Hejjaji
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - Andy Tran
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - John A. Spertus
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - Kim G. Smolderen
- Yale School of Medicine, New Haven, CO, United States of America
- * E-mail:
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Sigaud L, Daley A, Rubin J, Noblet C. The effects of recent minimum wage increases on self-reported health in the United States. Soc Sci Med 2022; 305:115110. [PMID: 35691212 DOI: 10.1016/j.socscimed.2022.115110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/07/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
Minimum wage policy continues to receive considerable popular and legislative attention in the United States. Despite a fast-growing empirical literature on the relationship between the minimum wage and health, previous studies generally use data from the 1990s to 2014. In this study, we estimate the impact of recent changes in state-level minimum wages on the self-reported health of adults in the post-Great Recession era. Using data from the Behavioral Risk Factor Surveillance System and a difference-in-differences design, we exploit more than 150 state-level increases in the minimum wage between 2011 and 2019. Our results indicate that a higher minimum wage increases men's physical and mental health burdens but has an ambiguous effect on a more general measure of health. Among women, the minimum wage improves general health and reduces their physical and mental health burdens. Compared to past studies, our work indicates that the relationship between the minimum wage and health has changed over time. It also illustrates the need for policymakers to consider the broader consequences of minimum wage policy, including health effects and gender differences therein.
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Affiliation(s)
- Liam Sigaud
- School of Economics, University of Maine, 5782 Winslow Hall, Orono, ME, 04469, USA.
| | - Angela Daley
- School of Economics, University of Maine, 5782 Winslow Hall, Orono, ME, 04469, USA.
| | - Jonathan Rubin
- School of Economics, University of Maine, 302C Winslow Hall, Orono, ME, 04469, USA.
| | - Caroline Noblet
- School of Economics, University of Maine, 305 Winslow Hall, Orono, ME, 04469, USA.
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17
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Thomson RM, Igelström E, Purba AK, Shimonovich M, Thomson H, McCartney G, Reeves A, Leyland A, Pearce A, Katikireddi SV. How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis. Lancet Public Health 2022; 7:e515-e528. [PMID: 35660213 PMCID: PMC7614874 DOI: 10.1016/s2468-2667(22)00058-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lower incomes are associated with poorer mental health and wellbeing, but the extent to which income has a causal effect is debated. We aimed to synthesise evidence from studies measuring the impact of changes in individual and household income on mental health and wellbeing outcomes in working-age adults (aged 16-64 years). METHODS For this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, PsycINFO, ASSIA, EconLit, and RePEc on Feb 5, 2020, for randomised controlled trials (RCTs) and quantitative non-randomised studies. We had no date limits for our search. We included English-language studies measuring effects of individual or household income change on any mental health or wellbeing outcome. We used Cochrane risk of bias (RoB) tools. We conducted three-level random-effects meta-analyses, and explored heterogeneity using meta-regression and stratified analyses. Synthesis without meta-analysis was based on effect direction. Critical RoB studies were excluded from primary analyses. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). This study is registered with PROSPERO, CRD42020168379. FINDINGS Of 16 521 citations screened, 136 were narratively synthesised (12·5% RCTs) and 86 meta-analysed. RoB was high: 30·1% were rated critical and 47·1% serious or high. A binary income increase lifting individuals out of poverty was associated with 0·13 SD improvement in mental health measures (95% CI 0·07 to 0·20; n=42 128; 18 studies), considerably larger than other income increases (0·01 SD improvement, 0·002 to 0·019; n=216 509, 14 studies). For wellbeing, increases out of poverty were associated with 0·38 SD improvement (0·09 to 0·66; n=101 350, 8 studies) versus 0·16 for other income increases (0·07 to 0·25; n=62 619, 11 studies). Income decreases from any source were associated with 0·21 SD worsening of mental health measures (-0·30 to -0·13; n=227 804, 11 studies). Effect sizes were larger in low-income and middle-income settings and in higher RoB studies. Heterogeneity was high (I2=79-87%). GRADE certainty was low or very low. INTERPRETATION Income changes probably impact mental health, particularly where they move individuals out of poverty, although effect sizes are modest and certainty low. Effects are larger for wellbeing outcomes, and potentially for income losses. To best support population mental health, welfare policies need to reach the most socioeconomically disadvantaged. FUNDING Wellcome Trust, Medical Research Council, Chief Scientist Office, and European Research Council.
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Affiliation(s)
- Rachel M Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
| | - Erik Igelström
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Amrit Kaur Purba
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michal Shimonovich
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Gerry McCartney
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK; Public Health Scotland, Edinburgh, UK
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Alastair Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK; Public Health Scotland, Edinburgh, UK
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Maxwell J, Pryce R, Wilson LB. The impact of increasing the United Kingdom national minimum wage on self-reported health. HEALTH ECONOMICS 2022; 31:1167-1183. [PMID: 35362225 PMCID: PMC9314077 DOI: 10.1002/hec.4490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
There is a growing but mixed literature on the health effects of minimum wages. If minimum wage changes have a statistically significant impact on health, this suggests health effects should be incorporated into cost-benefit analyses to capture wider policy impacts. Whilst most existing UK based literature examines the introduction of a minimum wage, this paper exploits the 2016, 2017 and 2018 UK National Minimum Wage (NMW) increases as natural experiments using a series of difference-in-differences models. Short Form-12 (SF-12) mental and physical component summary scores are used as dependent variables. In the base case and all sensitivity analyses, the estimated impact of NMW increases on mental and physical health are insignificant. The policy implication is that health effects should not be included in cost-benefit analyses examining the NMW.
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Affiliation(s)
- Jacob Maxwell
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Robert Pryce
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Luke B. Wilson
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
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19
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Merrill-Francis M, Vernick JS, McGinty EE, Pollack Porter KM. Association Between Fatal Occupational Injuries and State Minimum-Wage Laws, 2003-2017. Am J Prev Med 2022; 62:878-884. [PMID: 35597567 DOI: 10.1016/j.amepre.2021.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/24/2021] [Accepted: 09/13/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Low wages are associated with an increased risk of occupational injuries. Increasing the minimum wage is one way to increase workers' wages; however, a previous study found that higher state minimum wage was associated with an increase in nonfatal occupational injuries and illnesses. This study aims to examine the association between state minimum-wage laws and fatal occupational injuries. METHODS Fatal occupational injury data (2003-2017) for the 50 U.S. states were obtained from the Census of Fatal Occupational Injuries. State minimum-wage law information was obtained from Temple's LawAtlas website. Linear and Poisson regression models were used to analyze the association between state minimum-wage laws and the rates of fatal occupational injury per 100,000 workers. All data were analyzed in 2020. RESULTS Having a state minimum wage higher than the federal minimum had no statistically significant association with fatal occupational injury rate, (-4.0%, 95% CI= -9.1, 1.5). State minimum wage amount was also not associated with fatal occupational injuries (-4.0%, 95% CI= -9.1, 1.5). CONCLUSIONS Although previous research suggested that state minimum-wage laws were associated with increased rates of nonfatal occupational injuries, these findings indicate that these laws are not associated with an increased risk of fatal occupational injuries. Concerns that raising the minimum wage will lead to worse workplace safety may be unfounded.
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Affiliation(s)
- Molly Merrill-Francis
- Public Health Assessment Division, Health Promotion and Wellness Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Aberdeen, Maryland; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jon S Vernick
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Emma E McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Keshia M Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Craig P, Barr B, Baxter AJ, Brown H, Cheetham M, Gibson M, Katikireddi SV, Moffatt S, Morris S, Munford LA, Richiardi M, Sutton M, Taylor-Robinson D, Wickham S, Xiang H, Bambra C. Evaluation of the mental health impacts of Universal Credit: protocol for a mixed methods study. BMJ Open 2022; 12:e061340. [PMID: 35396318 PMCID: PMC8996017 DOI: 10.1136/bmjopen-2022-061340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The UK social security system is being transformed by the implementation of Universal Credit (UC), which combines six existing benefits and tax credits into a single payment for low-income households. Despite extensive reports of hardship associated with the introduction of UC, no previous studies have comprehensively evaluated its impact on mental health. Because payments are targeted at low-income households, impacts on mental health will have important consequences for health inequalities. METHODS AND ANALYSIS We will conduct a mixed methods study. Work package (WP) 1 will compare health outcomes for new recipients of UC with outcomes for legacy benefit recipients in two large population surveys, using the phased rollout of UC as a natural experiment. We will also analyse the relationship between the proportion of UC claimants in small areas and a composite measure of mental health. WP2 will use data collected by Citizen's Advice to explore the sociodemographic and health characteristics of people who seek advice when claiming UC and identify features of the claim process that prompt advice-seeking. WP3 will conduct longitudinal in-depth interviews with up to 80 UC claimants in England and Scotland to explore reasons for claiming and experiences of the claim process. Up to 30 staff supporting claimants will also be interviewed. WP4 will use a dynamic microsimulation model to simulate the long-term health impacts of different implementation scenarios. WP5 will undertake cost-consequence analysis of the potential costs and outcomes of introducing UC and cost-benefit analyses of mitigating actions. ETHICS AND DISSEMINATION We obtained ethical approval for the primary data gathering from the University of Glasgow, College of Social Sciences Research Ethics Committee, application number 400200244. We will use our networks to actively disseminate findings to UC claimants, the public, practitioners and policy-makers, using a range of methods and formats. TRIAL REGISTRATION NUMBER The study is registered with the Research Registry: researchregistry6697.
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Affiliation(s)
- Peter Craig
- MRC/CO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Benjamin Barr
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - Andrew J Baxter
- MRC/CO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Heather Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mandy Cheetham
- Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
- North East and North Cumbria Applied Research Collaboration, Newcastle-upon-Tyne, UK
| | - Marcia Gibson
- MRC/CO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - Suzanne Moffatt
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Steph Morris
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Aaron Munford
- Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, Manchester, UK
| | - Matteo Richiardi
- Centre for Microsimulation and Policy Analysis, University of Essex, Colchester, Essex, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, Manchester, UK
| | - David Taylor-Robinson
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - Sophie Wickham
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - Huasheng Xiang
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Modelling Maternal Depression: An Agent-Based Model to Examine the Complex Relationship between Relative Income and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074208. [PMID: 35409890 PMCID: PMC8998540 DOI: 10.3390/ijerph19074208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
Depression is a major public health concern among expectant mothers in Canada. Income inequality has been linked to depression, so interventions for reducing income inequality may reduce the prevalence of maternal depression. The current study aims to simulate the effects of government transfers and increases to minimum wage on depression in mothers. We used agent-based modelling techniques to identify the predicted effects of income inequality reducing programs on maternal depression. Model parameters were identified using the All Our Families cohort dataset and the existing literature. The mean age of our sample was 30 years. The sample was also predominantly white (78.6%) and had at least some post-secondary education (89.1%). When income was increased by just simulating an increase in minimum wage, the proportion of depressed mothers decreased by 2.9% (p < 0.005). Likewise, simulating the Canada Child Benefit resulted in a 5.0% decrease in the prevalence of depression (p < 0.001) and Ontario’s Universal Basic Income pilot project resulted in a simulated 5.6% decrease in the prevalence of depression (p < 0.001). We also assessed simulated changes to the mother’s social networks. Progressive income policies and increasing social networks are predicted to decrease the probability of depression.
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22
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Anderson NJ, Smith CK, Foley MP. Work-related injury burden, workers' compensation claim filing, and barriers: Results from a statewide survey of janitors. Am J Ind Med 2022; 65:173-195. [PMID: 34897753 PMCID: PMC9300089 DOI: 10.1002/ajim.23319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Janitors are a low-wage, ethnically and linguistically diverse, hard-to-reach population of workers with a high burden of occupational injury and illness. METHODS Data from an extensive multimodal (mail, phone, web) survey of janitors in Washington State were analyzed to characterize their working conditions and occupational health experiences. The survey included questions on demographics, work organization and tasks, health and safety topics, and discrimination and harassment. The survey was administered in eight languages. RESULTS There were 620 complete interviews. The majority completed the survey by mail (62.6%), and in English (85.8%). More than half of responding janitors were female (56.9%), and the mean age was 45 years. Twenty percent reported having a (health-care-provider diagnosed) work-related injury or illness (WRII) in the past twelve months. Women and janitors who were Latino had significantly higher relative risk of WRII. Increased risk was also associated with several work organization factors that may indicate poor working conditions, insufficient sleep, and possible depression. Half of injured janitors did not file workers' compensation (WC) claims. CONCLUSIONS Janitors reported a high percentage of WRII, which exceeded previously published estimates from Washington State. Women and Latino janitors had significantly increased risk of WRII, and janitors' working conditions may influence the unequal distribution of risk. WRII surveillance via WC or medical care usage in janitors and other low-wage occupations may reflect substantial underreporting. Characterizing the nature of janitors' work experience can help identify avenues for prevention, intervention, and policy changes to protect the health and safety of janitors.
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Affiliation(s)
- Naomi J. Anderson
- Washington State Department of Labor & Industries Olympia Washington USA
| | - Caroline K. Smith
- Washington State Department of Labor & Industries Olympia Washington USA
| | - Michael P. Foley
- Washington State Department of Labor & Industries Olympia Washington USA
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Akanni L, Lenhart O, Morton A. Income trajectories and self-rated health status in the UK. SSM Popul Health 2022; 17:101035. [PMID: 35146114 PMCID: PMC8818564 DOI: 10.1016/j.ssmph.2022.101035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 11/24/2022] Open
Abstract
In line with the wide recognition of the connection between socioeconomic status and health outcomes, attention in the recent literature is extending the static perspective to the dynamic implications of income on health. This study contributes to the growing literature on the income-health nexus by evaluating income dynamics on various self-rated health measures in the UK. We explore the impact of different indicators of income experiences on self-rated health and wellbeing outcomes using data from the 11 Waves of Understanding Society UK Household Longitudinal Study between 2009 and 2019. First, we estimate a fixed-effects ordered logit model for various health and wellbeing measures, allowing us to control for unobserved time-invariant heterogeneity. Second, we evaluate the effects of income trajectories by linking longitudinal household income to cross-sectional health outcomes. Our results confirm the general evidence of positive impacts of increasing family income on health. Besides, we find that stability in income position is strongly associated with improved health and wellbeing. On the other hand, income volatility increases the odds of reporting poor health outcomes, particularly for those in low-income households. Also, more years spent in a lower-income quartile reduces the odds of reporting improved self-rated health. Finally, the significant difference in the estimated effects of income before and after 2016 highlights the significant shifts in the effects of income trajectories on self-reported health and wellbeing following the National Living Wage policy implementation. The paper evaluates the impact of income trajectories on health and wellbeing outcomes. Income stability is associated with increased likelihood of improved self-reported health. Income volatility and low-income spells predicts poor health and wellbeing.
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Leigh JP. Treatment design, health outcomes, and demographic categories in the literature on minimum wages and health. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101043. [PMID: 34425521 DOI: 10.1016/j.ehb.2021.101043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 04/30/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
This literature review analyzes studies from the US, Canada, the UK, and Europe from inception to April 1, 2021 and focuses on treatment designs, health outcomes, demographic categories and data issues. Study designs are classified as treatment-effect-on-the-treated (7 studies), intent-to-treat (37), and what may be called possible-effects-on-anyone (10). Treatment-effects-on-the-treated designs are best for addressing the longstanding question: does income affect health or vice versa? I argue that they are also better for estimating the overall effect of minimum wages on health. Health outcomes are grouped into seven broad categories, such as overall physiological health and behavior, and 33 narrow categories, such as self-rated health and smoking. Demographic categories include gender, race/ethnicity, and age. The preponderance of evidence suggests that studies relying on the treatment-effect-on-the-treated and possible-effects-on-anyone designs find minimum wages improve health; there is no preponderance of evidence for overall health within intent-to-treat designs. With respect to specific health outcomes and demographic categories, there is no preponderance of evidence, except for improving infant and child health. One data issue concerns whether either intent-to-treat or possible-effects-on-everyone studies are reliable given that likely more than 70 % of people in their samples earn substantially above minimum wages thereby favoring the null hypothesis. Treatment-effect-on-the-treated designs are likely the best designs, and findings are largely consistent in showing that minimum wages improve some measures of health, for example, financial anxiety.
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Affiliation(s)
- J Paul Leigh
- Department of Public Health Sciences, University of California, Davis, Medical School, United States; Center for Poverty and Inequality Research, University of California, Davis, United States; Center for Healthcare Policy and Research, University of California, Davis, Medical School, United States.
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Wickham S, Fancourt D. Perspective Commentary: The Implementation of Welfare Policies Are Not Held to the Same Ethical Standards as Research: Raising Intergenerational Health Inequality Concerns. Front Public Health 2021; 9:764559. [PMID: 34888286 PMCID: PMC8650605 DOI: 10.3389/fpubh.2021.764559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Over the last 12 years the United Kingdom (UK) has seen the introduction of an austerity programme-a fiscal policy-with the primary goal to reduce the government's budget deficit and the role of the welfare system. Between 2010 and 2015 there was an estimated reduction of £14.5 billion in spending, attributable to decreasing the value of benefits and restricting entitlement to benefit claimants. By 2020, there had been an estimated unprecedented £27 billion less spent on welfare compared with spending in 2010. Whilst fiscally-successful at reducing spending, some implemented welfare policies have had direct consequences for people's health, increasing inequalities which have been heavily criticized. Moreover, there is growing concern that this has an intergenerational effect. In this paper, we describe the ethical principles in human research, how these have been considered in public health policy, and the existing evidence of the direct and intergenerational health and welfare consequences of some recent, nationally-implemented welfare policies. We argue that ethical principles, specifically the ethical principle of safety that is applied in all research, should be applied to all public welfare policies to stop the rising inequalities in health we are seeing across generations. We highlight that initial changes implemented to welfare policies as a response to COVID-19 demonstrate that there can be a political and societal perceived value in going further to support individuals and their families during times of adversity, and consider the ethical implications of this.
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Affiliation(s)
- Sophie Wickham
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
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Drydakis N. Adverse working conditions and immigrants' physical health and depression outcomes: a longitudinal study in Greece. Int Arch Occup Environ Health 2021; 95:539-556. [PMID: 34490499 DOI: 10.1007/s00420-021-01757-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Τhe study examines whether adverse working conditions for immigrants in Greece bear an association with deteriorated physical health and increased levels of depression during 2018 and 2019. METHODS A panel dataset resulted from the collaboration with centers providing free Greek language courses to immigrant population groups. Random Effects models assess the determinants of physical health and depression. RESULTS Findings indicate that workers with no written contract of employment, receiving hourly wages lower than the national hourly minimum wages, and experiencing insults and/or threats in their present job experience worse physical health and increased levels of depression. Moreover, the study found that the inexistence of workplace contracts, underpayment, and verbal abuse in the workplace may coexist. An increased risk of underpayment and verbal abuse reveals itself when workers do not have a contract of employment and vice versa. CONCLUSION Immigrant workers without a job contract might experience a high degree of workplace precariousness and exclusion from health benefits and insurance. Immigrant workers receiving a wage lower than the corresponding minimum potentially do not secure a living income, resulting in unmet needs and low investments in health. Workplace abuse might correspond with vulnerability related to humiliating treatment. These conditions can negatively impact workers' physical health and foster depression. Policies should promote written employment contracts and ensure a mechanism for workers to register violations of fair practices.
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Affiliation(s)
- Nick Drydakis
- Faculty of Business and Law, School of Economics, Finance and Law, Centre for Pluralist Economics, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK.
- Pembroke College, University of Cambridge, Cambridge, UK.
- Centre for Science and Policy, University of Cambridge, Cambridge, UK.
- Institute for the Study of Labor, Bonn, Germany.
- Global Labor Organization, Essen, Germany.
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Lepinteur A. The asymmetric experience of gains and losses in job security on health. HEALTH ECONOMICS 2021; 30:2217-2229. [PMID: 34142395 DOI: 10.1002/hec.4369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 06/12/2023]
Abstract
Is workers' health more sensitive to losses than gains in job security? I address this question using the 1999 rise in the French Delalande tax as a quasi-natural experiment. The tax design allows to separately identify the causal impact of exogenous gains and losses in job security on workers' health. Difference-in-differences estimation results show that a greater job insecurity reduces significantly self-reported health. At the same time, more job security does not translate into a higher level of self-reported health.
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Kromydas T, Thomson RM, Pulford A, Green MJ, Katikireddi SV. Which is most important for mental health: Money, poverty, or paid work? A fixed-effects analysis of the UK Household Longitudinal Study. SSM Popul Health 2021; 15:100909. [PMID: 34584931 PMCID: PMC8455855 DOI: 10.1016/j.ssmph.2021.100909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The relative importance of income, poverty and unemployment status for mental health is unclear, and understanding this has implications for income and welfare policy design. We aimed to assess the association between changes in these exposures and mental health. METHODS We measured effects of three transition exposures between waves of the UK Household Longitudinal Study from 2010/11-2019/20 (n=38,697, obs=173,859): income decreases/increases, moving in/out of poverty, and job losses/gains. The outcome was General Health Questionnaire (GHQ), which measures likelihood of common mental disorder (CMD) as a continuous (GHQ-36) and binary measure (score ≥4 = case). We used fixed-effects linear and linear probability models to adjust for time invariant and time-varying confounders. To investigate effect modification, we stratified analyses by age, sex and highest education. RESULTS A 10% income decrease/increase was associated with a 0.02% increase (95% CI 0.00, 0.04) and 0.01% reduction (95% CI -0.03, 0.02) in likelihood of CMD respectively. Effect sizes were larger for moving into poverty (+1.8% [0.2, 3.5]), out of poverty (-1.8%, [-3.2, -0.3]), job loss (+15.8%, [13.6, 18.0]) and job gain (-11.4%, [-14.4, -8.4]). The effect of new poverty was greater for women (+2.3% [0.8, 3.9] versus +1.2% [-1.1, 3.5] for men) but the opposite was true for job loss (+17.8% [14.4, 21.2] for men versus +13.5% [9.8, 17.2] for women). There were no clear differences by age, but those with least education experienced the largest effects from poverty transitions, especially moving out of poverty (-2.9%, [-5.7, -0.0]). CONCLUSIONS Moving into unemployment was most strongly associated with CMD, with poverty also important but income effects generally much smaller. Men appear most sensitive to employment transitions, but poverty may have larger impacts on women and those with least education. As the COVID-19 pandemic recedes, minimising unemployment as well as poverty is crucial for population mental health.
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Affiliation(s)
- Theocharis Kromydas
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Rachel M Thomson
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Andrew Pulford
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
- Public Health Scotland, United Kingdom
| | - Michael J Green
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - S Vittal Katikireddi
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, United Kingdom
- Public Health Scotland, United Kingdom
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Young T, Pakenham KI. The mental health of aid workers: risk and protective factors in relation to job context, working conditions, and demographics. DISASTERS 2021; 45:501-526. [PMID: 32358843 DOI: 10.1111/disa.12440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study utilised a cross-sectional survey of 369 participants in 77 countries to examine 15 possible risk and protective factors pertaining to the mental health of aid workers-many of which have not been assessed before-in the categories of job context, working conditions, and demographics. Risk factors associated with job context include emergency postings and being an international worker. No significant differences were found between humanitarian and development workers and none between organisation type; the number of past traumas was not associated with negative mental health outcomes. Protective factors with regard to working conditions include higher income, long-term contracts, previous psychosocial training, and voluntary postings. With respect to demographics, protective factors include older age, more work experience, and greater religiosity and spirituality, while female gender was a risk factor. Ultimately, this study provides a more nuanced understanding of the aid worker sector, which can inform the development of more targeted mental health support.
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Affiliation(s)
- Tarli Young
- PhD Candidate, School of Psychology, The University of Queensland, Australia
| | - Kenneth I Pakenham
- Emeritus Professor, School of Psychology, The University of Queensland, Australia
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Granström F, Garvin P, Molarius A, Kristenson M. Distinguishing independent and shared effects of material/structural conditions and psychosocial resources on educational inequalities in self-rated health: results from structural equation modelling. Public Health 2021; 196:10-17. [PMID: 34129915 DOI: 10.1016/j.puhe.2021.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 04/12/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study was to distinguish independent and shared effects of material/structural factors and psychosocial resources in explaining educational inequalities in self-rated health (SRH) by using structural equation modelling. STUDY DESIGN Cross-sectional survey. METHODS Data were derived from a questionnaire sent to a random sample of the population in five counties in Sweden in 2008. The study population (aged 25-75 years) included 15,099 men and 17,883 women. Exploratory structural equation modelling was used to analyse the pathways from educational level to SRH. RESULTS The pathway including both material/structural factors (e.g. financial buffer and unemployment) and psychosocial resources (e.g. sense of coherence and social participation) explained about 40% of educational differences in SRH for both men and women. The pathways including only the independent effects of psychosocial resources (14% in men and 20% in women) or material/structural factors (9% and 18%, respectively) explained substantial but smaller proportions of the differences. CONCLUSIONS The major pathway explaining educational inequalities in SRH included both material/structural factors and psychosocial resources. Therefore, to reduce educational inequalities in SRH, interventions need to address both material/structural conditions and psychosocial resources across educational groups.
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Affiliation(s)
- F Granström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
| | - P Garvin
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Research and Development Unit in Region Östergötland, Linköping University, Linköping, Sweden
| | - A Molarius
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden; Department of Public Health, Karlstad University, Karlstad, Sweden
| | - M Kristenson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Fishman SH, Gutin I. Debts of despair: Education, financial losses, and precursors of deaths of despair. SSM Popul Health 2021; 14:100759. [PMID: 33732865 PMCID: PMC7944094 DOI: 10.1016/j.ssmph.2021.100759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/19/2021] [Accepted: 02/16/2021] [Indexed: 01/04/2023] Open
Abstract
Recent deaths of despair literature hypothesizes that financial losses are a key mechanism through which education is associated with higher risk for drug use, alcohol abuse, and suicidal ideation. However, few studies have empirically assessed the significance of this harmful pathway or compared it to other hypothesized explanations. Drawing on data from over 8000 respondents in the National Longitudinal Study of Adolescent to Adult Health, this paper finds that lower education-levels are associated with heightened risk of drug use, painkiller use, frequent binge drinking, and suicidal ideation; in turn, decompositions reveal that financial losses mediate about 20 percent of the association between education with drug use and suicidal ideation. The results support a core assumption of the deaths of despair hypothesis-that financial losses among those with low education-levels drive the increase in harmful despair-associated behaviors, which often precede disease and mortality. Future research should extend this work by linking individual-level socioeconomic and health patterns with broader economic changes to better understand how individuals' educational attainment interacts with macro-level structural factors to shape their vulnerability to despair-associated disease and death.
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Affiliation(s)
- Samuel H. Fishman
- Department of Sociology, Duke University, 276 Rueben-Cooke Building, 417 Chapel Dr., Durham, NC, 27708, USA
| | - Iliya Gutin
- Department of Sociology, University of North Carolina at Chapel Hill, 155 Pauli Murray Hall, Chapel Hill, NC, 27499, USA
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Kola L, Kohrt BA, Hanlon C, Naslund JA, Sikander S, Balaji M, Benjet C, Cheung EYL, Eaton J, Gonsalves P, Hailemariam M, Luitel NP, Machado DB, Misganaw E, Omigbodun O, Roberts T, Salisbury TT, Shidhaye R, Sunkel C, Ugo V, van Rensburg AJ, Gureje O, Pathare S, Saxena S, Thornicroft G, Patel V. COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry 2021; 8:535-550. [PMID: 33639109 PMCID: PMC9764935 DOI: 10.1016/s2215-0366(21)00025-0] [Citation(s) in RCA: 349] [Impact Index Per Article: 116.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/30/2022]
Abstract
Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First, we review the emerging literature on the impact of the pandemic on mental health, which shows high rates of psychological distress and early warning signs of an increase in mental health disorders. Second, we assess the responses in different countries, noting the swift and diverse responses to address mental health in some countries, particularly through the development of national COVID-19 response plans for mental health services, implementation of WHO guidance, and deployment of digital platforms, signifying a welcome recognition of the salience of mental health. Third, we consider the opportunity that the pandemic presents to reimagine global mental health, especially through shifting the balance of power from high-income countries to LMICs and from narrow biomedical approaches to community-oriented psychosocial perspectives, in setting priorities for interventions and research. Finally, we present a vision for the concept of building back better the mental health systems in LMICs with a focus on key strategies; notably, fully integrating mental health in plans for universal health coverage, enhancing access to psychosocial interventions through task sharing, leveraging digital technologies for various mental health tasks, eliminating coercion in mental health care, and addressing the needs of neglected populations, such as children and people with substance use disorders. Our recommendations are relevant for the mental health of populations and functioning of health systems in not only LMICs but also high-income countries impacted by the COVID-19 pandemic, with wide disparities in quality of and access to mental health care.
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Affiliation(s)
- Lola Kola
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria; BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Brandon A Kohrt
- Division of Global Mental Health, Department of Psychiatry, George Washington University, Washington, DC, USA
| | - Charlotte Hanlon
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Siham Sikander
- Global Health Department, Health Services Academy, Islamabad, Pakistan; Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | | | - Corina Benjet
- Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Eliza Yee Lai Cheung
- The Reference Centre for Psychosocial Support, International Federation of the Red Cross and Red Crescent, Hong Kong Special Administrative Region, China; The Red Cross of the Hong Kong Special Administrative Region of China, Hong Kong Special Administrative Region, China
| | - Julian Eaton
- CBM Global and Centre for Global Mental Health, London, UK
| | - Pattie Gonsalves
- Wellcome-DBT India Alliance, Sangath, New Delhi, India; School of Psychology, University of Sussex, Brighton, UK
| | - Maji Hailemariam
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | | | - Daiane B Machado
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Centre for Data and Knowledge Integration for Health, CIDACS-FIOCRUZ, Bahia, Brazil
| | - Eleni Misganaw
- Mental Health Service Users Association Ethiopia, Addis Ababa, Ethiopia; Global Mental Health Peer Network, Pretoria, South Africa
| | - Olayinka Omigbodun
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria; Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tessa Roberts
- Centre for Society and Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; WHO Collaborating Centre for Research and Training in Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Charlene Sunkel
- Global Mental Health Peer Network, Johannesburg, South Africa
| | - Victor Ugo
- Mentally Aware Nigeria Initiative, Lagos, Nigeria; United for Global Mental Health, London, UK
| | - André Janse van Rensburg
- Centre for Rural Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Centre for Health Systems Research and Development, Faculty of Humanities, University of the Free State, Bloemfontein, South Africa
| | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Implementation Science, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Wellcome-DBT India Alliance, Sangath, New Delhi, India
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McKee M, Dunnell K, Anderson M, Brayne C, Charlesworth A, Johnston-Webber C, Knapp M, McGuire A, Newton JN, Taylor D, Watt RG. The changing health needs of the UK population. Lancet 2021; 397:1979-1991. [PMID: 33965065 PMCID: PMC9751760 DOI: 10.1016/s0140-6736(21)00229-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/22/2020] [Accepted: 01/07/2021] [Indexed: 12/23/2022]
Abstract
The demographics of the UK population are changing and so is the need for health care. In this Health Policy, we explore the current health of the population, the changing health needs, and future threats to health. Relative to other high-income countries, the UK is lagging on many health outcomes, such as life expectancy and infant mortality, and there is a growing burden of mental illness. Successes exist, such as the striking improvements in oral health, but inequalities in health persist as well. The growth of the ageing population relative to the working-age population, the rise of multimorbidity, and persistent health inequalities, particularly for preventable illness, are all issues that the National Health Service (NHS) will face in the years to come. Meeting the challenges of the future will require an increased focus on health promotion and disease prevention, involving a more concerted effort to understand and tackle the multiple social, environmental, and economic factors that lie at the heart of health inequalities. The immediate priority of the NHS will be to mitigate the wider and long-term health consequences of the COVID-19 pandemic, but it must also strengthen its resilience to reduce the impact of other threats to health, such as the UK leaving the EU, climate change, and antimicrobial resistance.
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Affiliation(s)
- Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, London, UK.
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Anita Charlesworth
- The Health Foundation, London, UK; College of Social Sciences, Health Services Management Centre, University of Birmingham, Birmingham, UK
| | | | - Martin Knapp
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Alistair McGuire
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - David Taylor
- UCL School of Pharmacy, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Foell A, Pitzer KA, Nebbitt V, Lombe M, Yu M, Villodas ML, Newransky C. Exposure to community violence and depressive symptoms: Examining community, family, and peer effects among public housing youth. Health Place 2021; 69:102579. [PMID: 33971570 DOI: 10.1016/j.healthplace.2021.102579] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 03/30/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.
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Affiliation(s)
- Andrew Foell
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA.
| | - Kyle A Pitzer
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - Von Nebbitt
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - Margaret Lombe
- School of Social Work, Boston College, 140 Commonwealth Avenue, McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Mansoo Yu
- School of Social Work, Department of Public Health, University of Missouri, 720 Clark Hall, Columbia, MO, 65211, USA
| | - Melissa L Villodas
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St #3550, Chapel Hill, NC, 27516, USA
| | - Chrisann Newransky
- School of Social Work, Adelphi University, Social Work Building Room 309, One South Avenue, Garden City, NY, 11530, USA
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Reeves A, Loopstra R, Tarasuk V. Wage-Setting Policies, Employment, and Food Insecurity: A Multilevel Analysis of 492 078 People in 139 Countries. Am J Public Health 2021; 111:718-725. [PMID: 33600245 PMCID: PMC7958043 DOI: 10.2105/ajph.2020.306096] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/04/2022]
Abstract
Objectives. To examine the association between wage-setting policy and food insecurity.Methods. We estimated multilevel regression models, using data from the Gallup World Poll (2014-2017) and UCLA's World Policy Analysis Center, to examine the association between wage setting policy and food insecurity across 139 countries (n = 492 078).Results. Compared with countries with little or no minimum wage, the probability of being food insecure was 0.10 lower (95% confidence interval = 0.02, 0.18) in countries with collective bargaining. However, these associations varied across employment status. More generous wage-setting policies (e.g., collective bargaining or high minimum wages) were associated with lower food insecurity among full-time workers (and, to some extent, part-time workers) but not those who were unemployed.Conclusions. In countries with generous wage-setting policies, employed adults had a lower risk of food insecurity, but the risk of food insecurity for the unemployed was unchanged. Wage-setting policies may be an important intervention for addressing risks of food insecurity among low-income workers.
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Affiliation(s)
- Aaron Reeves
- Aaron Reeves is with the Department of Social Policy and Intervention, University of Oxford, Oxford, UK. Rachel Loopstra is with the Department of Nutritional Sciences, King's College London, London, UK. Valerie Tarasuk is with the Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Loopstra
- Aaron Reeves is with the Department of Social Policy and Intervention, University of Oxford, Oxford, UK. Rachel Loopstra is with the Department of Nutritional Sciences, King's College London, London, UK. Valerie Tarasuk is with the Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Valerie Tarasuk
- Aaron Reeves is with the Department of Social Policy and Intervention, University of Oxford, Oxford, UK. Rachel Loopstra is with the Department of Nutritional Sciences, King's College London, London, UK. Valerie Tarasuk is with the Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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de Vocht F, Katikireddi SV, McQuire C, Tilling K, Hickman M, Craig P. Conceptualising natural and quasi experiments in public health. BMC Med Res Methodol 2021; 21:32. [PMID: 33573595 PMCID: PMC7879679 DOI: 10.1186/s12874-021-01224-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/28/2021] [Indexed: 12/14/2022] Open
Abstract
Background Natural or quasi experiments are appealing for public health research because they enable the evaluation of events or interventions that are difficult or impossible to manipulate experimentally, such as many policy and health system reforms. However, there remains ambiguity in the literature about their definition and how they differ from randomized controlled experiments and from other observational designs. We conceptualise natural experiments in the context of public health evaluations and align the study design to the Target Trial Framework. Methods A literature search was conducted, and key methodological papers were used to develop this work. Peer-reviewed papers were supplemented by grey literature. Results Natural experiment studies (NES) combine features of experiments and non-experiments. They differ from planned experiments, such as randomized controlled trials, in that exposure allocation is not controlled by researchers. They differ from other observational designs in that they evaluate the impact of events or process that leads to differences in exposure. As a result they are, in theory, less susceptible to bias than other observational study designs. Importantly, causal inference relies heavily on the assumption that exposure allocation can be considered ‘as-if randomized’. The target trial framework provides a systematic basis for evaluating this assumption and the other design elements that underpin the causal claims that can be made from NES. Conclusions NES should be considered a type of study design rather than a set of tools for analyses of non-randomized interventions. Alignment of NES to the Target Trial framework will clarify the strength of evidence underpinning claims about the effectiveness of public health interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01224-x.
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Affiliation(s)
- Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,NIHR School for Public Health Research, Newcastle, UK. .,NIHR Applied Research Collaboration West, Bristol, UK.
| | | | - Cheryl McQuire
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,NIHR School for Public Health Research, Newcastle, UK
| | - Kate Tilling
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,MRC IEU, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Bristol, UK
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Buszkiewicz JH, Hill HD, Otten JJ. Association of State Minimum Wage Rates and Health in Working-Age Adults Using the National Health Interview Survey. Am J Epidemiol 2021; 190:21-30. [PMID: 32037444 PMCID: PMC7946793 DOI: 10.1093/aje/kwaa018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/07/2019] [Indexed: 01/09/2023] Open
Abstract
States adopt minimum wages to improve workers' economic circumstances and well-being. Many studies, but not all, find evidence of health benefits from higher minimum wages. This study used a rigorous "triple difference" strategy to identify the associations between state minimum wages and adult obesity, body mass index (weight (kg)/height (m)2), hypertension, diabetes, fair or poor health, and serious psychological distress. National Health Interview Survey data (United States, 2008-2015) on adults aged 25-64 years (n = 131,430) were linked to state policies to estimate the prevalence odds ratio or mean difference in these outcomes associated with a $1 increase in current and 2-year lagged minimum wage among less-educated adults overall and by sex, race/ethnicity, and age. In contrast to prior studies, there was no association between current minimum wage and health; however, 2-year lagged minimum wage was positively associated with the likelihood of obesity (prevalence odds ratio = 1.08, 95% confidence interval: 1.00, 1.16) and with elevated body mass index (mean difference = 0.27, 95% confidence interval: 0.04, 0.49). In subgroup models, current and 2-year lagged minimum wage were associated with a higher likelihood of obesity among male and non-White or Hispanic adults. The associations with hypertension also varied by sex and the timing of the exposure.
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Affiliation(s)
- James H Buszkiewicz
- Correspondence to James H. Buszkiewicz, Department of Epidemiology, University of Washington School of Public Health, Chelan Lane, Seattle, WA 98105 (e-mail: )
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39
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Leigh JP. Invited Commentary: Methods for Estimating Effects of Minimum Wages on Health. Am J Epidemiol 2021; 190:31-34. [PMID: 32037443 DOI: 10.1093/aje/kwaa019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/19/2019] [Indexed: 11/13/2022] Open
Abstract
Economists have been researching effects of minimum wages on unemployment, poverty, income inequality, and educational attainment for over 60 years. Epidemiologists have only recently begun researching minimum wages even though unemployment through education are central topics within social epidemiology. Buszkiewicz et al. (Am J Epidemiol. 2021;190(1):21-30) offer a welcome addition to this nascent literature. A commanding advantage of Buszkiewicz et al.'s study over others is its distinction between a "likely affected" group comprised of workers with ≤12 years of schooling versus "not likely affected" groups with ≥13 years of schooling. But there are disadvantages, common to other studies. Buszkiewicz et al. use cross-sectional data; they include the self-employed as well as part-time and part-year workers in their treatment groups. Their definitions of affected groups based on education create samples with 75% or more of workers who earn significantly above minimum wages; definitions are not based on wages. Inclusion of workers not subject to (e.g., self-employed) or affected by minimum wages biases estimates toward the null. Finally, within any minimum wage data set, it is the state-not federal-increases that account for the lion's share of increases and that form the natural experiments; however, state increases can occur annually whereas the development of chronic diseases might take decades.
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40
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Andrea SB, Messer LC, Marino M, Goodman JM, Boone-Heinonen J. The tipping point: could increasing the subminimum wage reduce poverty-related antenatal stressors in U.S. women? Ann Epidemiol 2020; 45:47-53.e6. [PMID: 32336654 DOI: 10.1016/j.annepidem.2020.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 01/27/2020] [Accepted: 03/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Tipped workers, primarily women of reproductive-age, can be paid a "subminimum wage" 71% lower than the federal minimum wage, contributing to economic hardship. Poverty-related antenatal stress has deleterious health effects for women and their children. The purpose of this study was to investigate the effects of increasing the state-level subminimum wage (currently $2.13 per hour) on poverty-related antenatal stress for women in the United States. METHODS Utilizing a difference-in-differences approach comparing state wage policies over time, we estimated the impact of increases in the subminimum wage on poverty-related antenatal stress using data from 35 states participating in the Pregnancy Risk Assessment Monitoring System between 2004 and 2014, linked to state-level wage laws, census, and antipoverty policy data. RESULTS The effect of increasing the subminimum wage on poverty-related stress differed by year and sociodemographics. Wage increases in 2014 were associated with the largest decreases in stress for unmarried women of color with less than a college degree, a population that we estimated would have experienced a 19.7% reduction in stress from 2004 to 2014 if subminimum wage was equivalent to the federal minimum wage. CONCLUSIONS Increasing the subminimum wage can reduce poverty-related stress and may be a potential intervention for reducing poor health outcomes.
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Affiliation(s)
- Sarah B Andrea
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA.
| | | | - Miguel Marino
- OHSU-PSU School of Public Health, Portland, OR; Department of Family Medicine, Oregon Health & Science University, Portland, OR
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41
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Purtle J, Nelson KL, Counts NZ, Yudell M. Population-Based Approaches to Mental Health: History, Strategies, and Evidence. Annu Rev Public Health 2020; 41:201-221. [PMID: 31905323 PMCID: PMC8896325 DOI: 10.1146/annurev-publhealth-040119-094247] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is growing recognition in the fields of public health and mental health services research that the provision of clinical services to individuals is not a viable approach to meeting the mental health needs of a population. Despite enthusiasm for the notion of population-based approaches to mental health, concrete guidance about what such approaches entail is lacking, and evidence of their effectiveness has not been integrated. Drawing from research and scholarship across multiple disciplines, this review provides a concrete definition of population-based approaches to mental health, situates these approaches within their historical context in the United States, and summarizes the nature of these approaches and their evidence. These approaches span three domains: (a) social, economic, and environmental policy interventions that can be implemented by legislators and public agency directors, (b) public health practice interventions that can be implemented by public health department officials, and (c) health care system interventions that can be implemented by hospital and health care system leaders.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania 19104, USA;
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania 19104, USA;
| | | | - Michael Yudell
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania 19104, USA
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42
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Hanefeld J, Reeves A, Brown C, Östlin P. Achieving health equity: democracy matters. Lancet 2019; 394:1600-1601. [PMID: 31519433 DOI: 10.1016/s0140-6736(19)32128-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Johanna Hanefeld
- London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Chris Brown
- WHO Office for Investment for Health and Development, Venice, Italy
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43
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Gertner AK, Rotter JS, Shafer PR. Association Between State Minimum Wages and Suicide Rates in the U.S. Am J Prev Med 2019; 56:648-654. [PMID: 30905484 DOI: 10.1016/j.amepre.2018.12.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The suicide rate in the U.S. has been increasing in recent years. Previous studies have consistently identified financial stress as a contributing factor in suicides. Nevertheless, there has been little research on the effect of economic policies that can alleviate financial stress on suicide rates. The purpose of this study is to determine whether increases in state minimum wages have been associated with changes in state suicide rates. METHODS A retrospective panel data study was conducted. In 2018, linear regression models with state fixed effects were used to estimate the relationship between changes in state minimum wages and suicide rates for all 50U.S. states between 2006 and 2016. Models controlled for time-varying state characteristics that could be associated with changes in minimum wages and suicide rates. RESULTS There were approximately 432,000 deaths by suicide in the study period. A one-dollar increase in the real minimum wage was associated on average with a 1.9% decrease in the annual state suicide rate in adjusted analyses. This negative association was most consistent in years since 2011. An annual decrease of 1.9% in the suicide rate during the study period would have resulted in roughly 8,000 fewer deaths by suicide. Analyses by race and sex did not reveal substantial variation in the association between minimum wages and suicides. CONCLUSIONS Increases in real minimum wages have been associated with slower growth in state suicide rates in recent years. Increasing the minimum wage could represent a strategy for addressing increases in suicide rates.
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Affiliation(s)
- Alex K Gertner
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
| | - Jason S Rotter
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Paul R Shafer
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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44
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Cloud DH, Beane S, Adimora A, Friedman SR, Jefferson K, Hall HI, Hatzenbuehler M, Johnson AS, Stall R, Tempalski B, Wingood GM, Wise A, Komro K, Cooper HL. State minimum wage laws and newly diagnosed cases of HIV among heterosexual black residents of US metropolitan areas. SSM Popul Health 2019; 7:100327. [PMID: 30581963 PMCID: PMC6287056 DOI: 10.1016/j.ssmph.2018.100327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/08/2018] [Accepted: 11/18/2018] [Indexed: 02/07/2023] Open
Abstract
This ecologic cohort study explores the relationship between state minimum wage laws and rates of HIV diagnoses among heterosexual black residents of U.S metropolitan areas over an 8-year span. Specifically, we applied hierarchical linear modeling to investigate whether state-level variations in minimum wage laws, adjusted for cost-of-living and inflation, were associated with rates of new HIV diagnoses among heterosexual black residents of metropolitan statistical areas (MSAs; n=73), between 2008 and 2015. Findings suggest that an inverse relationship exists between baseline state minimum wages and initial rates of newly diagnosed HIV cases among heterosexual black individuals, after adjusting for potential confounders. MSAs with a minimum wage that was $1 higher at baseline had a 27.12% lower rate of newly diagnosed HIV cases. Exploratory analyses suggest that income inequality may mediate this relationship. If subsequent research establishes a causal relationship between minimum wage and this outcome, efforts to increase minimum wages should be incorporated into HIV prevention strategies for this vulnerable population.
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Affiliation(s)
- David H. Cloud
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Stephanie Beane
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Adaora Adimora
- Department of Medicine, University of North Carolina School of Medicine, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
| | | | - Kevin Jefferson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - H. Irene Hall
- HIV Incidence and Case Surveillance Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark Hatzenbuehler
- Department of Sociomedical Sciences, Lerner Center for Public Health Promotion, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Anna Satcher Johnson
- HIV Incidence and Case Surveillance Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ron Stall
- Department of Behavioral and Community Health Sciences and Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Gina M. Wingood
- Department of Sociomedical Sciences, Lerner Center for Public Health Promotion, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Akilah Wise
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kelli Komro
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hannah L.F. Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Schneider D, Harknett K. Consequences of Routine Work-Schedule Instability for Worker Health and Well-Being. AMERICAN SOCIOLOGICAL REVIEW 2019; 84:82-114. [PMID: 33311716 PMCID: PMC7730535 DOI: 10.1177/0003122418823184] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Research on precarious work and its consequences overwhelmingly focuses on the economic dimension of precarity, epitomized by low wages. But the rise in precarious work also involves a major shift in its temporal dimension, such that many workers now experience routine instability in their work schedules. This temporal instability represents a fundamental and under-appreciated manifestation of the risk shift from firms to workers. A lack of suitable existing data, however, has precluded investigation of how precarious scheduling practices affect workers' health and well-being. We use an innovative approach to collect survey data from a large and strategically selected segment of the U.S. workforce: hourly workers in the service sector. These data reveal that exposure to routine instability in work schedules is associated with psychological distress, poor sleep quality, and unhappiness. Low wages are also associated with these outcomes, but unstable and unpredictable schedules are much more strongly associated. Precarious schedules affect worker well-being in part through the mediating influence of household economic insecurity, yet a much larger proportion of the association is driven by work-life conflict. The temporal dimension of work is central to the experience of precarity and an important social determinant of well-being.
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Affiliation(s)
| | - Kristen Harknett
- Department of Social and Behavioral Sciences at the University of California, San Francisco (UCSF) with research interests in the areas of work, family, and social policy
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46
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Paul Leigh J, Leigh WA, Du J. Minimum wages and public health: A literature review. Prev Med 2019; 118:122-134. [PMID: 30316876 DOI: 10.1016/j.ypmed.2018.10.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 10/01/2018] [Accepted: 10/08/2018] [Indexed: 11/27/2022]
Abstract
We evaluate evidence for the effectiveness of raising minimum wages on various measures of public health within the US, Canada, the UK, and Europe. We search four scientific websites from the inception of the research through May 20, 2018. We find great variety (20+) in measured outcomes among the 33 studies that pass our initial screening. We establish quality standards in a second screening resulting in 15 studies in which we create outcome-based groups. Outcomes include four broad measures (general overall health, behavior, mental health, and birth weight) and eight narrow measures (self-reported health, "bad" health days, unmet medical need, smoking, problem-drinking, obesity, eating vegetables, and exercise). We establish criteria for "stronger" findings for outcomes and methods. Stronger findings include: $1 increases in minimum wages are associated with 1.4 percentage point (4% evaluated at mean) decreases in smoking prevalence; failure to reject null hypotheses that minimum wages have no effects for most outcomes; and no consistent evidence that minimum wages harm health. One "suggestive" finding is that the best-designed studies have well-defined treatment (or likely affected) and control (unaffected) groups and contain longitudinal data. The major methodological weaknesses afflicting many studies are the lack of focus on persons likely affected by minimum wages and omission of "falsification tests" on persons likely unaffected. An additional weakness is lack of attention to how findings might differ across populations such as teenagers, adults, men, women, continuously employed and unemployed persons. Research into health effects of minimum wages is in its infancy and growing rapidly. We present a list of "better practices" for future research.
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Affiliation(s)
- J Paul Leigh
- Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, CA, USA; Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA; Center for Poverty Research, University of California, Davis, USA.
| | | | - Juan Du
- Department of Economics, Old Dominion University, Norfolk, VA, USA
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47
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The association between economic uncertainty and suicide in the short-run. Soc Sci Med 2019; 220:403-410. [DOI: 10.1016/j.socscimed.2018.11.035] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/03/2018] [Accepted: 11/23/2018] [Indexed: 11/21/2022]
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48
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Astell-Burt T, Rowbotham S, Hawe P. Communicating the benefits of population health interventions: The health effects can be on par with those of medication. SSM Popul Health 2018; 6:54-62. [PMID: 30202781 PMCID: PMC6128033 DOI: 10.1016/j.ssmph.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/09/2018] [Accepted: 06/12/2018] [Indexed: 12/25/2022] Open
Abstract
How can we communicate to the public that population level health interventions are effective at improving health? Perhaps the most familiar "currency" of effect is that which can be brought about via medication. Comparisons of effect sizes may be effective ways of communicating the benefits of population health interventions if they are seen and understood in the same way that medications are. We developed a series of comparisons to communicate benefits of population health interventions in terms of similar gains to be obtained from statins, metformin and antihypertensive medications for prevention of cardiovascular events, type 2 diabetes, obesity and hypertension. A purposive search identified evidence of population health intervention-related benefits. This evidence ranged from meta-analyses of RCTs to that from observational cohort studies. Population health interventions included implementation of national smoke free legislation, enhanced neighbourhood walkability, increased opportunities for active travel and protection of urban green space. In some cases, the benefits of population health interventions were found to be equivalent to, or even outweighed those of the medications to which they were compared. For example, RCT-based evidence suggested that exercise taken with a view of a green space was associated with 12 mmHg and 6 mmHg reductions in systolic and diastolic blood pressure, respectively, which was at least on par with the reductions associated with antihypertensive medications. Future work will test the effectiveness of these comparisons for increasing the familiarity, credibility and acceptability of population health interventions and, in particular, examine the importance of communicating putative mechanisms and potential co-benefits.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, and The Australian Prevention Partnership Centre, Sydney, Australia
- School of Public Health, Peking Union Medical College, and The Chinese Academy of Medical Sciences, Beijing, China
| | - Samantha Rowbotham
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, and The Australian Prevention Partnership Centre, Sydney, Australia
| | - Penelope Hawe
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, and The Australian Prevention Partnership Centre, Sydney, Australia
- O’Brien Institute of Public Health, University of Calgary, Canada
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49
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Van Dyke ME, Komro KA, Shah MP, Livingston MD, Kramer MR. State-level minimum wage and heart disease death rates in the United States, 1980-2015: A novel application of marginal structural modeling. Prev Med 2018; 112:97-103. [PMID: 29625130 PMCID: PMC5970990 DOI: 10.1016/j.ypmed.2018.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 04/01/2018] [Accepted: 04/03/2018] [Indexed: 12/18/2022]
Abstract
Despite substantial declines since the 1960's, heart disease remains the leading cause of death in the United States (US) and geographic disparities in heart disease mortality have grown. State-level socioeconomic factors might be important contributors to geographic differences in heart disease mortality. This study examined the association between state-level minimum wage increases above the federal minimum wage and heart disease death rates from 1980 to 2015 among 'working age' individuals aged 35-64 years in the US. Annual, inflation-adjusted state and federal minimum wage data were extracted from legal databases and annual state-level heart disease death rates were obtained from CDC Wonder. Although most minimum wage and health studies to date use conventional regression models, we employed marginal structural models to account for possible time-varying confounding. Quasi-experimental, marginal structural models accounting for state, year, and state × year fixed effects estimated the association between increases in the state-level minimum wage above the federal minimum wage and heart disease death rates. In models of 'working age' adults (35-64 years old), a $1 increase in the state-level minimum wage above the federal minimum wage was on average associated with ~6 fewer heart disease deaths per 100,000 (95% CI: -10.4, -1.99), or a state-level heart disease death rate that was 3.5% lower per year. In contrast, for older adults (65+ years old) a $1 increase was on average associated with a 1.1% lower state-level heart disease death rate per year (b = -28.9 per 100,000, 95% CI: -71.1, 13.3). State-level economic policies are important targets for population health research.
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Affiliation(s)
- Miriam E Van Dyke
- 1518 Clifton Rd. NE, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Kelli A Komro
- 1518 Clifton Rd. NE, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Monica P Shah
- 1518 Clifton Rd. NE, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Melvin D Livingston
- 3500 Camp Bowie Blvd., Department of Biostatistics and Epidemiology, University of North Texas Health Sciences Center, Fort Worth, TX 76107, USA.
| | - Michael R Kramer
- 1518 Clifton Rd. NE, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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50
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Pevalin DJ, Reeves A, Baker E, Bentley R. The impact of persistent poor housing conditions on mental health: A longitudinal population-based study. Prev Med 2017; 105:304-310. [PMID: 28963007 DOI: 10.1016/j.ypmed.2017.09.020] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/19/2017] [Accepted: 09/24/2017] [Indexed: 10/18/2022]
Abstract
Living with housing problems increases the risk of mental ill health. Housing problems tend to persist over time but little is known about the mental health consequences of living with persistent housing problems. We investigated if persistence of poor housing affects mental health over and above the effect of current housing conditions. We used data from 13 annual waves of the British Household Panel Survey (1996 to 2008) (81,745 person/year observations from 16,234 individuals) and measured the persistence of housing problems by the number of years in the previous four that a household experienced housing problems. OLS regression models and lagged-change regression models were used to estimate the effects of past and current housing conditions on mental health, as measured by the General Health Questionnaire. Interaction terms tested if tenure type modified the impact of persistent poor housing on mental health. In fully adjusted models, mental health worsened as the persistence of housing problems increased. Adjustment for current housing conditions attenuated, but did not explain, the findings. Tenure type moderated the effects of persistent poor housing on mental health, suggesting that those who own their homes outright and those who live in social housing are most negatively affected. Persistence of poor housing was predictive of worse mental health, irrespective of current housing conditions, which added to the weight of evidence that demonstrates that living in poor quality housing for extended periods of time has negative consequences for mental health.
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Affiliation(s)
- David J Pevalin
- School of Health and Human Sciences, University of Essex, Colchester, Essex, UK.
| | - Aaron Reeves
- International Inequalities Institute, London School of Economics, London, UK
| | - Emma Baker
- School of Architecture and Built Environment, University of Adelaide, Adelaide, South Australia, Australia
| | - Rebecca Bentley
- Centre for Health Equity & Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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