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

The association between chronotype and wages at mid-age

Sleep has been shown to affect economic outcomes, including wages. The mechanisms by which sleep affects wages remain unclear. We examine the relationship between chronotype - morning larks, evening owls - and wages at mid-age. We propose a novel model relating chronotype to wages in consideration of human, social, and health capital constructs. Empirically, we explore the effects of chronotype mediated through life course choices, such as work experience, trust, and health behaviour. The data come from the 46-year-old follow-up study of the Northern Finland Birth Cohort (1966) and from registers of the Finnish Tax Administration. We find evening chronotype to have a significant indirect negative effect on wages, which occurs through accumulating less work experience and through poor health outcomes. The effect is largest for male workers, with a total indirect effect on average wages of - 4%. We also provide evidence that chronotype has a long-term association with wages between 29 and 50 years of age. We conclude that evening-type workers are less suited to typical working hours and accumulate less human, social and health capital which in turn negatively affects their wages. Our findings are of great socio-economic importance because evening chronotypes make up a significant part of the population.

Estimating Effects of Wages on Smoking Prevalence Using Labor Unions as Instrumental Variables

OBJECTIVES

To test for the effects of wages on smoking using labor unions as instrumental variables.

METHODS

We analyzed four waves of the Panel Study of Income Dynamics (2013 to 2019 alternate years). The overall sample included workers aged 18 to 70 years in 2013 and subsamples within blue + clerical/white-collar and private/public sector jobs (N = 37,117 to 8446 person-years). We used two instrumental variables: worker's union membership and states' right-to-work laws.

RESULTS

$1 (2019 US dollars) increases in wages-per-hour resulted in 1.3 ( P < 0.001) percentage point decreases in smoking prevalence (8.2% decreases at the smoking mean). Larger effect sizes and strong statistical significance were found for blue-collar + clerical and private-sector subsamples; smaller sizes and insignificance were found for public-sector and white-collar subsamples.

CONCLUSIONS

Unions increase wages, and higher wages, in turn, reduce smoking. Wages and labor unions are underappreciated social determinants of health.

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.

U.S. State Preemption Laws and Working-Age Mortality

INTRODUCTION

The goal of this study was to estimate how state preemption laws that prohibit local authority to raise the minimum wage or mandate paid sick leave have contributed to working-age mortality from suicide, homicide, drug overdose, alcohol poisoning, and transport accidents.

METHODS

County-by-quarter death counts by cause and sex for 1999-2019 were regressed on minimum wage levels and hours of paid sick-leave requirements, controlling for time-varying covariates and place- and time-specific fixed effects. The model coefficients were then used to predict expected reductions in mortality if the preemption laws were repealed. Analyses were conducted during January 2022-April 2022.

RESULTS

Paid sick-leave requirements were associated with lower mortality. These associations were statistically significant for suicide and homicide deaths among men and for homicide and alcohol-related deaths among women. Mortality may decline by more than 5% in large central metropolitan counties currently constrained by preemption laws if they were able to mandate a 40-hour annual paid sick-leave requirement.

CONCLUSIONS

State legislatures' preemption of local authority to enact health-promoting legislation may be contributing to the worrisome trends in external causes of death.