The impact of minimum wages on population health: evidence from 24 OECD countries

Determinants of life-expectancy and disability-adjusted life years (DALYs) in European and Organisation for Economic Co-operation and Development (OECD) countries: A longitudinal analysis (1990-2019)

•We relate 68 factors to population health observed in 61 countries over 30 years.•Using random forests, multiple imputation and generalized estimating equations.•GDP per capita and demographics are key; income inequality is not.•Health and social expenditure are more influential than freedom and corruption.•On the macro-level, life-style effects appear to be mediated by cultural context.

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

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.

Minimum wages and health: evidence from European countries

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.

COVID-19 Spotlights Connections between Disease and Multiple Lifestyle Factors

The SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2), and the disease it causes (COVID-19), have had a profound impact on global human society and threaten to continue to have such an impact with newly emerging variants. Because of the widespread effects of SARS-CoV-2, understanding how lifestyle choices impact the severity of disease is imperative. This review summarizes evidence for an involvement of chronic, non-resolving inflammation, gut microbiome disruption (dysbiosis with loss of beneficial microorganisms), and impaired viral defenses, all of which are associated with an imbalanced lifestyle, in severe disease manifestations and post-acute sequelae of SARS-CoV-2 (PASC). Humans' physiological propensity for uncontrolled inflammation and severe COVID-19 are briefly contrasted with bats' low propensity for inflammation and their resistance to viral disease. This insight is used to identify positive lifestyle factors with the potential to act in synergy for restoring balance to the immune response and gut microbiome, and thereby protect individuals against severe COVID-19 and PASC. It is proposed that clinicians should consider recommending lifestyle factors, such as stress management, balanced nutrition and physical activity, as preventative measures against severe viral disease and PASC.

History of Low Hourly Wage and All-Cause Mortality Among Middle-aged Workers

Importance

Earning a low wage is an increasingly recognized public health concern, yet little research exists on the long-term health consequences of sustained low-wage earning.

Objective

To examine the association of sustained low-wage earning and mortality in a sample of workers with hourly wage reported biennially during peak midlife earning years.

Design, Setting, and Participants

This longitudinal study included 4002 US participants, aged 50 years or older, from 2 subcohorts of the Health and Retirement Study (1992-2018) who worked for pay and reported earning hourly wages at 3 or more time points during a 12-year period during their midlife (1992-2004 or 1998-2010). Outcome follow-up occurred from the end of the respective exposure periods until 2018.

Exposures

Low-wage-less than the hourly wage for full-time, full-year work at the federal poverty line-earning history was categorized as never earning a low wage, intermittently earning a low wage, and sustained earning a low wage.

Main Outcomes and Measures

Cox proportional hazards and additive hazards regression models sequentially adjusted for sociodemographics, and economic and health covariates were used to estimate associations between low-wage history and all-cause mortality. We examined interaction with sex or employment stability on multiplicative and additive scales.

Results

Of the 4002 workers (aged 50-57 years at the beginning of exposure period and 61-69 years at the end), 1854 (46.3%) were female; 718 (17.9%) experienced employment instability; 366 (9.1%) had a history of sustained low-wage earning; 1288 (32.2%) had intermittent low-wage earning periods; and 2348 (58.7%) had never earned a low wage. In unadjusted analyses, those who had never earned low wages experienced 199 deaths per 10 000 person-years, those with intermittent low wages, 208 deaths per 10 000 person-years, and those with sustained low wages, 275 deaths per 10 000 person-years. In models adjusted for key sociodemographic variables, sustained low-wage earning was associated with mortality (hazard ratio [HR], 1.35; 95% CI, 1.07-1.71) and excess deaths (66; 95% CI, 6.6-125); these findings were attenuated with additional adjustments for economic and health covariates. Significant excess death and elevated mortality risk were observed for workers with sustained low-wage exposure and employment fluctuations (eg, for sustained low-wage × employment fluctuated, HR, 2.18; 95% CI, 1.35-3.53; for sustained low-wage × stable employment, HR, 1.17; 95% CI, 0.89,-1.54; P for interaction = .003).

Conclusions and Relevance

Sustained low-wage earning may be associated with elevated mortality risk and excess deaths, especially when experienced alongside unstable employment. If causal, our findings suggest that social and economic policies that improve the financial standing of low-wage workers (eg, minimum wage laws) could improve mortality outcomes.

The minimum wage and parent time use

This study used a differences-in-differences strategy with national time diary data from 2003 to 2018 to examine the effects of minimum wage changes on parents' time with children and in child-related activities. Findings indicate that a $1 increase in the minimum wage was associated with a small increase (2.6%) in the likelihood parents with one or more children under age 16 spent time actively caring for or helping children on weekends, and in more total time with children (a 2% increase in secondary child care time). In general, coefficients were larger for mothers' time use, particularly non-employed mothers, with potential implications for gender disparities in caregiving. Unmarried parents and parents of color showed increases in their time spent in activities related to children's health (~55% increase). Mothers showed an increase (8%) in the likelihood they spent any time in child education-related activities, and increases in child care time appeared concentrated among parents whose youngest child was 6-15 years of age. Findings suggest that increases in state minimum wages may lead to small increases in parents' time investments in children, with some variation among subgroups.

A Kaupapa Māori conceptualization and efforts to address the needs of the growing precariat in Aotearoa New Zealand: A situated focus on Māori

In Aotearoa New Zealand, the precariat is populated by at least one in six New Zealanders, with Māori (Indigenous peoples) being over-represented within this emerging social class. For Māori, this socio-economic positioning reflects a colonial legacy spanning 150 years of economic and cultural subjugation, and intergenerational experiences of material, cultural and psychological insecurities. Relating our Kaupapa Māori approach (Māori cultural values and principles underlining research initiatives) to the precariat, this article also draws insights from existing scholarship on social class in psychology and Assemblage Theory in the social sciences to extend present conceptualizations of the Māori precariat. In keeping with the praxis orientation central to our approach, we consider three exemplars of how our research into Māori precarity is mobilized in efforts to inform public deliberations and government policies regarding poverty reduction, humanizing the welfare system and promoting decent work. Note: Aotearoa New Zealand has been popularized within the everyday lexicon of New Zealanders as a political statement of Indigenous rights for Māori.

Towards work-life balance or away? The impact of work from home factors on work-life balance among software engineers during Covid-19 pandemic

The paradigm shifts of conventional office spaces for virtual workspaces which practiced Work from Home (WFH) due to Covid-19, created a serious change in the lifestyles of employees, due to the overlap of 'work' and 'life' domains in one's life. Since software engineers have a possibility of permanently adapting into WFH, the objective of this study is to unveil factors which would have a significant impact on the work-life balance of software engineers in Sri Lanka, while WFH. Only a very limited researches have shed light on this context, thereby this study would contribute to fill the empirical gap. The study undertook a quantitative approach by collecting primary data through a questionnaire from 384 participants, based on simple random sampling, and analyzing collected data based on Partial Least Squares Structural Equation Modelling (PLS-SEM), using Smart PLS 3.3.9 software. Study results revealed that 'supervisor's trust and support' and the 'individual workspace,' have a significant impact on work-life balance, while 'working conditions,' 'possibility to access the organization's networks' and 'number of children' have no such significant impact. Thereby the study infers that, sound support and trust extended by supervisors and a designated distraction-free workspace; as measures to demarcate the boundary of work and life. Distinctive findings of this study would primarily be fruitful for software engineers to dive into a balanced state of work and life not only during Covid-19 but in future too. Study findings will also contribute to software industry personnel and policymakers in Sri Lanka as well as other developing countries, to establish effective strategies in favor of software engineers who WFH. Further, considering IT industry's significant contribution towards Sri Lanka's economic growth amidst Covid-19, results of this study would be high-yielding to indirectly succor IT-services-supported economic growth amidst the pandemic-driven hardships in Sri Lanka.

U.S. state policy contexts and mortality of working-age adults

The rise in working-age mortality rates in the United States in recent decades largely reflects stalled declines in cardiovascular disease (CVD) mortality alongside rising mortality from alcohol-induced causes, suicide, and drug poisoning; and it has been especially severe in some U.S. states. Building on recent work, this study examined whether U.S. state policy contexts may be a central explanation. We modeled the associations between working-age mortality rates and state policies during 1999 to 2019. We used annual data from the 1999-2019 National Vital Statistics System to calculate state-level age-adjusted mortality rates for deaths from all causes and from CVD, alcohol-induced causes, suicide, and drug poisoning among adults ages 25-64 years. We merged that data with annual state-level data on eight policy domains, such as labor and taxes, where each domain was scored on a 0-1 conservative-to-liberal continuum. Results show that the policy domains were associated with working-age mortality. More conservative marijuana policies and more liberal policies on the environment, gun safety, labor, economic taxes, and tobacco taxes in a state were associated with lower mortality in that state. Especially strong associations were observed between certain domains and specific causes of death: between the gun safety domain and suicide mortality among men, between the labor domain and alcohol-induced mortality, and between both the economic tax and tobacco tax domains and CVD mortality. Simulations indicate that changing all policy domains in all states to a fully liberal orientation might have saved 171,030 lives in 2019, while changing them to a fully conservative orientation might have cost 217,635 lives.

Nonmedical Interventions For Type 2 Diabetes: Evidence, Actionable Strategies, And Policy Opportunities

This systematic review identified studies of nonmedical interventions designed to reduce risk for and improve clinical outcomes for type 2 diabetes. Specifically, this review sought to identify interventions that target structural racism and social determinants of health. To be included, studies were published in English; published between database initiation and January 2022; conducted in the United States; measured an intervention effect using a clinical trial, quasi-experimental, or pre-post design; included a population of adults at risk for or with type 2 diabetes; and targeted hemoglobin A1c levels, blood pressure, lipids, self-care, or quality of life as outcomes. The findings of our review indicate that interventions with targeted, multicomponent designs that combine both medical and nonmedical approaches can reduce risk for and improve clinical outcomes for type 2 diabetes. HbA1c levels improved significantly with the use of food supplementation with referral and diabetes support; the use of financial incentives with education and skills training; the use of housing relocation with counseling support; and the integration of nonmedical interventions into medical care using the electronic medical record. Our findings demonstrate that the literature on nonmedical interventions designed to address relevant social factors and target structural racism is limited. The article offers actionable strategies and identifies policy opportunities for targeting structural inequalities and decreasing social risk among adults with type 2 diabetes.

Pandemic or Not, Worker Subjective Wellbeing Pivots About the Living Wage Point: A Replication, Extension, and Policy Challenge in Aotearoa New Zealand

Recent pre-pandemic research suggests that living wages can be pivotal for enhancing employee attitudes and subjective wellbeing. This article explores whether or not the present COVID-19 pandemic is impacting pivotal links between living wages and employee attitudes and subjective wellbeing, with replication indicating robustness. Twin cohorts each of 1,000 low-waged workers across New Zealand (NZ), one pre- (2018), and one present-pandemic (2020) were sample surveyed on hourly wage, job attitudes, and subjective wellbeing as linked to changes in the world of work associated with the pandemic (e.g., job security, stress, anxiety, depression, and holistic wellbeing). Using locally estimated scatter-point smoothing, job attitudes and subjective wellbeing scores tended to pivot upward at the living wage level in NZ. These findings replicate earlier findings and extend these into considering subjective wellbeing in the context of a crisis for employee livelihoods and lives more generally. Convergence across multiple measures, constructs, and contexts, suggests the positive impacts of living wages are durable. We draw inspiration from systems dynamics to argue that the present government policy of raising legal minimum wages (as NZ has done) may not protect subjective wellbeing until wages cross the living wage Rubicon. Future research should address this challenge.

U.S. State Policy Contexts and Physical Health among Midlife Adults

This study examines how state policy contexts may have contributed to unfavorable adult health in recent decades. It merges individual-level data from the 1993-2016 Behavioral Risk Factor Surveillance System (n=2,166,835) with 15 state-level policy domains measured annually on a conservative to liberal continuum. We examined associations between policy domains and health among adults ages 45-64 years and assess how much of the associations is accounted by adults' socioeconomic, behavioral/lifestyle, and family factors. A more liberal version of the civil rights domain was associated with better health. It was disproportionately important for less-educated adults and women, and its association with adult health was partly accounted by educational attainment, employment, and income. Environment, gun safety, and marijuana policy domains were, to a lesser degree, predictors of health in some model specifications. In sum, health improvements require a greater focus on macro-level factors that shape the conditions in which people live.

Treatment design, health outcomes, and demographic categories in the literature on minimum wages and health

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.

Association of State Minimum Wage Rates and Health in Working-Age Adults Using the National Health Interview Survey

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.

Recent quantitative research on determinants of health in high income countries: A scoping review

Background

Identifying determinants of health and understanding their role in health production constitutes an important research theme. We aimed to document the state of recent multi-country research on this theme in the literature.

Methods

We followed the PRISMA-ScR guidelines to systematically identify, triage and review literature (January 2013—July 2019). We searched for studies that performed cross-national statistical analyses aiming to evaluate the impact of one or more aggregate level determinants on one or more general population health outcomes in high-income countries. To assess in which combinations and to what extent individual (or thematically linked) determinants had been studied together, we performed multidimensional scaling and cluster analysis.

Results

Sixty studies were selected, out of an original yield of 3686. Life-expectancy and overall mortality were the most widely used population health indicators, while determinants came from the areas of healthcare, culture, politics, socio-economics, environment, labor, fertility, demographics, life-style, and psychology. The family of regression models was the predominant statistical approach. Results from our multidimensional scaling showed that a relatively tight core of determinants have received much attention, as main covariates of interest or controls, whereas the majority of other determinants were studied in very limited contexts. We consider findings from these studies regarding the importance of any given health determinant inconclusive at present. Across a multitude of model specifications, different country samples, and varying time periods, effects fluctuated between statistically significant and not significant, and between beneficial and detrimental to health.

Conclusions

We conclude that efforts to understand the underlying mechanisms of population health are far from settled, and the present state of research on the topic leaves much to be desired. It is essential that future research considers multiple factors simultaneously and takes advantage of more sophisticated methodology with regards to quantifying health as well as analyzing determinants’ influence.

Addressing Inequality: The First Step Beyond COVID-19 and Towards Sustainability

The COVID-19 pandemic has impacted billions of lives across the world and has revealed and worsened the social and economic inequalities that have emerged over the past several decades. As governments consider public health and economic strategies to respond to the crisis, it is critical they also address the weaknesses of their economic and social systems that inhibited their ability to respond comprehensively to the pandemic. These same weaknesses have also undermined efforts to advance equality and sustainability. This paper explores over 30 interventions across the following nine categories of change that hold the potential to address inequality, provide all citizens with access to essential goods and services, and advance progress towards sustainability: (1) Income and wealth transfers to facilitate an equitable increase in purchasing power/disposable income; (2) broadening worker and citizen ownership of the means of production and supply of services, allowing corporate profit-taking to be more equitably distributed; (3) changes in the supply of essential goods and services for more citizens; (4) changes in the demand for more sustainable goods and services desired by people; (5) stabilizing and securing employment and the workforce; (6) reducing the disproportionate power of corporations and the very wealthy on the market and political system through the expansion and enforcement of antitrust law such that the dominance of a few firms in critical sectors no longer prevails; (7) government provision of essential goods and services such as education, healthcare, housing, food, and mobility; (8) a reallocation of government spending between military operations and domestic social needs; and (9) suspending or restructuring debt from emerging and developing countries. Any interventions that focus on growing the economy must also be accompanied by those that offset the resulting compromises to health, safety, and the environment from increasing unsustainable consumption. This paper compares and identifies the interventions that should be considered as an important foundational first step in moving beyond the COVID-19 pandemic and towards sustainability. In this regard, it provides a comprehensive set of strategies that could advance progress towards a component of Sustainable Development Goal (SDG) 10 to reduce inequality within countries. However, the candidate interventions are also contrasted with all 17 SDGs to reveal potential problem areas/tradeoffs that may need careful attention.

The Initial Nonprofit Exposure and Response to Seattle's Minimum Wage Ordinance

Nearly 40 local governments adopted minimum wage rates higher than the federal minimum in the last decade. Research on such laws focuses on employment and price adjustments of for-profit firms. Higher minimum wage rates, however, may pose unique challenges to community-based nonprofit organizations, many of which serve vulnerable communities and have limited ability to modify business practices. We use survey and in-depth interview data with more than 125 nonprofit executives to explore how nonprofit organizations were exposed to, understood, and responded to the initial phase-in of Seattle's $15 minimum wage ordinance. Although most nonprofits with low-wage workers do not report substantial programmatic changes in response to the minimum wage, we do find evidence nonprofits are pursuing several avenues to raise revenue to cover higher anticipated labor costs. Results suggest that the channels of adjustment available to nonprofits have a different character than those available to for-profit firms.

Population-Based Approaches to Mental Health: History, Strategies, and Evidence

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.

Differential relationship between state-level minimum wage and infant mortality risk among US infants born to white and black mothers

BACKGROUND

Compared to other Organisation for Economic Co-operation and Development (OECD) nations, US infant mortality rates (IMRs) are particularly high. These differences are partially driven by racial disparities, with non-Hispanic black having IMRs that are twice those of non-Hispanic white. Income inequality (the gap between rich and poor) is associated with infant mortality. One proposed way to decrease income inequality (and possibly to improve birth outcomes) is to increase the minimum wage. We aimed to elucidate the relationship between state-level minimum wage and infant mortality risk using individual-level and state-level data. We also determined whether observed associations were heterogeneous across racial groups.

METHODS

Data were from US Vital Statistics 2010 Cohort Linked Birth and Infant Death records and the 2010 US Bureau of Labor Statistics. We fit multilevel logistic models to test whether state minimum wage was associated with infant mortality. Minimum wage was standardised using the z-transformation and was dichotomised (high vs low) at the 75th percentile. Analyses were stratified by mother's race (non-Hispanic black vs non-Hispanic white).

RESULTS

High minimum wage (adjusted OR (AOR)=0.93, 95% CI 0.83 to 1.03) was associated with decreased odds of infant mortality but was not statistically significant. High minimum wage was significantly associated with reduced infant mortality among non-Hispanic black infants (AOR=0.80, 95% CI 0.68 to 0.94) but not among non-Hispanic white infants (AOR=1.04, 95% CI 0.92 to 1.17).

CONCLUSIONS

Increasing the minimum wage might be beneficial to infant health, especially among non-Hispanic black infants, and thus might decrease the racial disparity in infant mortality.

States with higher minimum wages have lower STI rates among women: Results of an ecological study of 66 US metropolitan areas, 2003-2015

Prior research has found that places and people that are more economically disadvantaged have higher rates and risks, respectively, of sexually transmitted infections (STIs). Economic disadvantages at the level of places and people, however, are themselves influenced by economic policies. To enhance the policy relevance of STI research, we explore, for the first time, the relationship between state-level minimum wage policies and STI rates among women in a cohort of 66 large metropolitan statistical areas (MSAs) in the US spanning 2003-2015. Our annual state-level minimum wage measure was adjusted for inflation and cost of living. STI outcomes (rates of primary and secondary syphilis, gonorrhea and chlamydia per 100,000 women) were obtained from the CDC. We used multivariable hierarchical linear models to test the hypothesis that higher minimum wages would be associated with lower STI rates. We preliminarily explored possible socioeconomic mediators of the minimum wage/STI relationship (e.g., MSA-level rates of poverty, employment, and incarceration). We found that a $1 increase in the price-adjusted minimum wage over time was associated with a 19.7% decrease in syphilis rates among women and with an 8.5% drop in gonorrhea rates among women. The association between minimum wage and chlamydia rates did not meet our cutpoint for substantive significance. Preliminary mediation analyses suggest that MSA-level employment among women may mediate the relationship between minimum wage and gonorrhea. Consistent with an emerging body of research on minimum wage and health, our findings suggest that increasing the minimum wage may have a protective effect on STI rates among women. If other studies support this finding, public health strategies to reduce STIs among women should include advocating for a higher minimum wage.

Low-income workers' perceptions of wages, food acquisition, and well-being

Although studies have demonstrated an association between increased economic resources and improvements in food security and health, there is a paucity of qualitative research regarding the relationships between household resources, food security, and health. Policy changes related to increasing low wages are potential opportunities to understand changes to material resources. The aims of this analysis were to describe how low-wage workers perceive household resources in relation to food acquisition and to explore how workers in low-wage jobs connect food and diet to perceptions of health and well-being. We analyzed 190 transcripts from 55 workers in low-wage jobs who were living in households with children who were part of the Seattle Minimum Wage Study (up to three in-depth qualitative interviews and one phone survey per participant, conducted between 2015 and 2017). We coded and analyzed interviews using Campbell's food acquisition framework and best practices for qualitative research. Participants relied on a combination of wages, government assistance, and private assistance from community or family resources to maintain an adequate food supply. Strategies tended to focus more on maintaining food quality than food quantity. Restricted resources also limited food-related leisure activities, which many participants considered important to quality of life. Although many low-wage workers would like to use additional income to purchase higher quality foods or increase food-related leisure activities, they often perceive trade-offs that limit income-based adjustments to food-spending patterns. Future studies should be specifically designed to examine food choices in response to changes in income.

Minimum wages and public health: A literature review

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.

Selected Social Policy Instruments in Relation to Tax Policy

Tax sovereignty is now an expression of the phenomenon of state power. In general, there is a widespread but also accepted view that a citizen is dependent on the state and the state is dependent on tax resources. The social status of a citizen in the state is of great importance; it affects the development of personality and, last but not least, reflects the degree of democracy acquired in a particular state. Various tax law measures for the benefit of the citizen are important for the identification of social behavior and are an attempt to improve certain ways of life. The aim and ambition of this article is to emphasize the tools of social policy (e.g., minimum wage, subsistence minimum, social right to work) that are related to the social function of taxing income. In this context, the authors deal with a social function of tax collection and imposing of taxes, justice in taxation, and point out social aspects of the system of taxes in the Slovak Republic. In this article, the authors present the attitudes of both critics and proponents. It also deals with tax justice, which is often a category subjective to the evaluator. The benchmarking attribute of tax collection should be that citizens will have the certainty of social justice in the state and will therefore pay attention to the minimum wage and subsistence minimum as an integral part of tax policy under the legal conditions of the Slovak Republic. All tax legislation, especially tax reform, is perceived with a certain sensitivity regarding tax subjects.

Healthcare, Health, and Income

The medicalization model of poverty leads us to devote considerable resources to treating the healthcare problems caused by poverty while neglecting the root cause of those problems - the poverty itself. Treating symptoms rather than causes is far less effective than treating causes. When correctly understood, poverty is a major public health problem that needs to be addressed directly with effective anti-poverty programs. Only then can we properly serve the healthcare needs of the poor.

State-level minimum wage and heart disease death rates in the United States, 1980-2015: A novel application of marginal structural modeling

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.

Family Economic Security Policies and Child and Family Health

In this review, we examine the effects of family economic security policies (i.e., minimum wage, earned income tax credit, unemployment insurance, Temporary Assistance to Needy Families) on child and family health outcomes, summarize policy generosity across states in the USA, and discuss directions and possibilities for future research. This manuscript is an update to a review article that was published in 2014. Millions of Americans are affected by family economic security policies each year, many of whom are the most vulnerable in society. There is increasing evidence that these policies impact health outcomes and behaviors of adults and children. Further, research indicates that, overall, policies which are more restrictive are associated with poorer health behaviors and outcomes; however, the strength of the evidence differs across each of the four policies. There is significant diversity in state-level policies, and it is plausible that these policy variations are contributing to health disparities across and within states. Despite increasing evidence of the relationship between economic policies and health, there continues to be limited attention to this issue. State policy variations offer a valuable opportunity for scientists to conduct natural experiments and contribute to evidence linking social policy effects to family and child well-being. The mounting evidence will help to guide future research and policy making for evolving toward a more nurturing society for family and child health and well-being.

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

INTRODUCTION

Identification of groups with poor cardiovascular health (CVH) can inform where and how to target public health efforts. National prevalence estimates of CVH were derived for clinical (blood glucose, total cholesterol, blood pressure) and behavioral (BMI, diet quality, physical activity, smoking) factors among U.S. workers aged ≥45 years.

METHODS

This cross-sectional analysis included 6,282 employed black and white men and women aged ≥45 years enrolled in the national population-based REasons for Geographic And Racial Differences in Stroke study from 2003 to 2007. Each CVH factor was scored as ideal (2); intermediate (1); or poor (0) according to American Heart Association criteria, and summed to define optimal composite scores: CVH (sum, 10-14); clinical (sum, 5-6); and behavioral (sum, 6-8) health. Occupational data were collected 2011-2013. Analyses were conducted in 2016.

RESULTS

Only 14% met ideal criteria for all three clinical health factors, and none met ideal criteria for all four behavioral health factors. Sales and low status office workers had a low prevalence of optimal CVH. Service workers in protective services and the food preparation and serving occupations had a low prevalence of optimal clinical health; computer and healthcare support workers had a low prevalence of optimal behavioral health.

CONCLUSIONS

The prevalence of optimal CVH among middle-aged and older workers in the U.S. is low, but considerable differences exist by occupation. Targeted public health interventions may improve the CVH of at-risk older workers with different clinical and behavioral risk factor profiles employed in diverse occupational settings.

Do Higher Minimum Wages Benefit Health? Evidence From the UK

This study examines the link between minimum wages and health outcomes by using the introduction of the National Minimum Wage (NMW) in the United Kingdom in 1999 as an exogenous variation of earned income. A test for health effects by using longitudinal data from the British Household Panel Survey for a period of ten years was conducted. It was found that the NMW significantly improved several measures of health, including self-reported health status and the presence of health conditions. When examining potential mechanisms, it was shown that changes in health behaviors, leisure expenditures, and financial stress can explain the observed improvements in health.