The effects of minimum wages on the health of working teenagers

State Minimum Wage and Mental Health Among Children and Adolescents

Importance

Mental health disorders are increasing for children and adolescents in the US, with those in poverty having especially high rates. More evidence is needed about the association between economic policies, such as the minimum wage, and children's mental health.

Objective

To test the association between minimum wages and the mental health of children and adolescents.

Design, Setting, and Participants

This repeated cross-sectional, population-based US study used data from 2001 to 2022. Participants included state-representative, stratified random samples of children from the National Survey of Children's Health and adolescents from the Youth Risk Behavior Surveillance System. Data analysis was performed from January 2023 to August 2024.

Exposure

State minimum wage policies.

Main Outcomes and Measures

A total of 15 outcomes reported by caregivers or adolescents from survey data were evaluated: depression, anxiety, attention deficit disorder and/or attention-deficit/hyperactivity disorder, behavior disorders, mood symptoms, gastrointestinal symptoms, considered and attempted suicide, any unmet health care and mental health care, alcohol and marijuana use, physical fights, school absenteeism, and paid employment. The associations between minimum wage policies and mental health were tested using 2-way fixed-effects models, lifetime minimum wage models, and difference-in-differences models with event studies, all with state, year, and birth cohort fixed effects. Additional controls included individual-level demographics and state-level health insurance and welfare policies.

Results

Analyses included 239 534 children (aged 3-17 years; 117 111 girls [48.9%]) from the 2016 to 2022 National Survey of Children's Health, and 1 453 043 adolescents (aged 12-18 years; 711 380 girls [49.0%]) from the 2001 to 2021 Youth Risk Behavior Surveillance System. Across diverse modeling approaches, increases in minimum wages were not associated with clear, consistent improvements in mental health. For example, in 2-way fixed-effects models, a $1 increase in the minimum wage was not associated with changes in rates of depression (0.06 percentage points [pp]; 95% CI, -0.11 to 0.23 pp; P = .48), unmet mental health care (0.13 pp; 95% CI, -0.04 to 0.30 pp; P = .14), or attempted suicide (-0.17 pp; 95% CI, -0.47 to 0.13 pp; P = .26). There also were no clear improvements when stratifying by household income, parental education, race and ethnicity, nativity, or urbanicity.

Conclusions and Relevance

In this repeated cross-sectional study, changes in minimum wage policies over the past 2 decades were not accompanied by clear improvements in children's and adolescents' mental health. More evidence is needed on policy approaches to improve the mental well-being of children, particularly those from economically disadvantaged families.

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.

Working from Home and Emotional Well-Being during Major Daily Activities

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.

The effects of recent minimum wage increases on self-reported health in the United States

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.

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.

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.

Examining the association of changes in minimum wage with health across race/ethnicity and gender in the United States

BACKGROUND

The minimum wage creates both winners (through wage increases) and-potentially-losers (through job losses). Research on the health effects of minimum wage policies has been sparse, particularly across gender and among racial/ethnic minorities. We test the impact of minimum wage increases on health outcomes, health behaviors and access to healthcare across gender and race/ethnicity.

METHODS

Using 1993-2014 data from the Behavioral Risk Factor Surveillance System, variables for access to healthcare (insurance coverage, missed care due to cost), health behavior (exercise, fruit, vegetable and alcohol consumption) and health outcomes (self-reported fair/poor health, hypertension, poor physical health days, poor mental health days, unhealthy days) were regressed on the product of the ratio of the 1-year lagged minimum wage to the state median wage and the national median wage, using Linear Probability Models and Poisson Regression Models for dichotomous and count outcomes, respectively. Regressions (total population, gender-stratified, race/ethnicity stratified (white, black, Latino), gender/race/ethnicity stratified and total population with interaction terms for race/ethnicity/gender) controlled for state-level ecologic variables, individual-level demographics and fixed-effects (state and year). Results were adjusted for complex survey design and Bonferroni corrections were applied to p-values such that the level of statistical significance for a given outcome category was 0.05 divided by the number of outcomes in that category.

RESULTS

Minimum wage increases were positively associated with access to care among white men, black women and Latino women but negatively associated with access to care among white women and black men. With respect to dietary quality, minimum wage increases were associated with improvements, mixed results and negative impacts among white, Latino and black men, respectively. With respect to health outcomes, minimum wage increases were associated with positive, negative and mixed impacts among white women, white men and Latino men, respectively.

CONCLUSIONS

While there is enthusiasm for minimum wage increases in the public health community, such increases may have to be paired with deliberate strategies to protect workers that might be vulnerable to economic dislocation. Such strategies may include more robust unemployment insurance or increased access to job training for displaced workers.

State minimum wage laws and newly diagnosed cases of HIV among heterosexual black residents of US metropolitan areas

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.

Consequences of Routine Work-Schedule Instability for Worker Health and Well-Being

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.

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.