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Tsai MM, Yeb JA, Jackson KE, Gosliner W, Fernald LC, Hamad R. Understanding Multiprogram Take-Up of Safety Net Programs Among California Families. AJPM Focus 2024; 3:100216. [PMID: 38638939 PMCID: PMC11024909 DOI: 10.1016/j.focus.2024.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Introduction The U.S. safety net, which provides critical aid to households with low income, is composed of a patchwork of separate programs, and many people with low income benefit from accessing <1 program. However, little is known about multiprogram take-up, that is, participation conditioned on eligibility. This study examined individual and multiprogram take-up patterns and sociodemographic factors associated with multiprogram take-up of U.S. safety net programs. Methods The Assessing California Communities' Experiences with Safety Net Supports study interviewed Californians and reviewed their 2019 tax forms between August 2020 and May 2021. Take-up of safety net programs was calculated among eligible participants (n=365), including the Earned Income Tax Credit; Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; and Medicaid. Multivariable regressions identified sociodemographic factors associated with take-up of multiple programs. Results Take-up was highest for Medicaid (90.6%) and lowest for Supplemental Nutrition Assistance Program (57.5%). Among people who received benefits from at least 1 other program, take-up ranged from 81.7% to 84.8% for the Earned Income Tax Credit; 54.4%-62.0% for Supplemental Nutrition Assistance Program; 74.3%-80.1% for Special Supplemental Nutrition Program for Women, Infants, and Children; and 89.7%-98.1% for Medicaid. Having a lower income and being younger were associated with concurrent take-up of Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children. Among Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children recipients, having higher income, being older, and being primarily English speaking were associated with Earned Income Tax Credit take-up. Conclusions Individual and multiprogram take-up vary between programs and by sociodemographic factors. Findings suggest opportunities to increase take-up of potentially synergistic programs by improving cross-program coordination, data sharing, and targeted recruitment of underenrolled subgroups (Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children).
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Affiliation(s)
- Marisa M. Tsai
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Joseph A. Yeb
- Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts
| | - Kaitlyn E. Jackson
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Wendi Gosliner
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Lia C.H. Fernald
- Community Health Sciences Division, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Rita Hamad
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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MUENNIG PETER, BELSKY DANIELW, MALINSKY DANIEL, NGUYEN KIEU, ROSEN ZOHN, ALLEN HEIDI. The Effect of the Earned Income Tax Credit on Physical and Mental health-Results from the Atlanta Paycheck Plus Experiment. Milbank Q 2024; 102:122-140. [PMID: 37788392 PMCID: PMC10938929 DOI: 10.1111/1468-0009.12675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
Policy Points The Paycheck Plus randomized controlled trial tested a fourfold increase in the Earned Income Tax Credit (EITC) for single adults without dependent children over 3 years in New York and Atlanta. In New York, the intervention improved economic, mental, and physical health outcomes. In Atlanta, it had no economic benefit or impact on physical health and may have worsened mental health. In Atlanta, tax filing and bonus receipt were lower than in the New York arm of the trial, which may explain the lack of economic benefits. Lower mental health scores in the treatment group were driven by disadvantaged men, and the study sample was in good mental health. CONTEXT The Paycheck Plus experiment examined the effects of an enhanced Earned Income Tax Credit (EITC) for single adults on economic and health outcomes in Atlanta, GA and New York City (NYC). The NYC study was completed two years prior to the Atlanta study and found mental and physical benefits for the subgroups that responded best to the economic incentives provided. In this article, we present the findings from the Atlanta study, in which the uptake of the treatment (tax filings and EITC bonus) were lower and economic and health benefits were not observed. METHODS Paycheck Plus Atlanta was an unblinded randomized controlled trial that assigned n = 3,971 participants to either the standard federal EITC (control group) or an EITC supplement of up to $2,000 (treatment group) for three tax years (2017-2019). Administrative data on employment and earnings were obtained from the Georgia Department of Labor and survey data were used to examine validated measures of health and well-being. FINDINGS In Atlanta, the treatment group had significantly higher earnings in the first project year but did not have significantly higher cumulative earnings than the control group overall (mean difference = $1,812, 95% CI = -150, 3,774, p = 0.07). The treatment group also had significantly lower scores on two measures of mental health after the intervention was complete: the Patient Health Questionnaire 8 (mean difference = 0.19, 95% CI = 0.06, 0.32, p = 0.005) and the Kessler 6 (mean difference = 0.15, 95% CI = 0.03, 0.27, p = 0.012). Secondary analyses suggested these results were driven by disadvantaged men, but the study sample was in good mental health. CONCLUSIONS The EITC experiment in Atlanta was not associated with gains in earnings or improvements in physical or mental health.
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Affiliation(s)
| | - DANIEL W. BELSKY
- Mailman School of Public HealthColumbia University
- Butler Columbia Aging CenterColumbia University
| | | | | | - ZOHN ROSEN
- Mailman School of Public HealthColumbia University
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Kondratjeva O, Roll SP, Despard M, Grinstein-Weiss M. The Impact of Tax Refund Delays on the Experience of Hardship Among Lower-Income Households. J Consum Policy (Dordr) 2022; 45:239-280. [PMID: 35645437 PMCID: PMC9127047 DOI: 10.1007/s10603-021-09501-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 12/28/2021] [Indexed: 06/15/2023]
Abstract
The Earned Income Tax Credit (EITC) provides substantial financial support to low-income workers in the USA, yet around a quarter of EITC payments are estimated to be erroneous or fraudulent. Beginning in 2017, the Protecting Americans from Tax Hikes Act of 2015 requires the Internal Revenue Service to spend additional time processing early EITC claims, delaying the issuance of tax refunds. Leveraging unique data, this paper investigates how delayed tax refunds affected the experience of hardship and unsecured debt among EITC recipients. Results indicate that early filers experienced increased food insecurity relative to later filers after the implementation of the refund delay.
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Affiliation(s)
| | - S. P. Roll
- Social Policy Institute, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - M. Despard
- Department of Social Work, University of North Carolina at Greensboro, Greensboro, NC USA
| | - M. Grinstein-Weiss
- Social Policy Institute, Brown School, Washington University in St. Louis, St. Louis, MO USA
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Abstract
Using data from the Panel Study of Income Dynamics, this study analyzes the effect of exposure to the Earned Income Tax Credit (EITC) in childhood on marriage and childbearing in early adulthood. Results suggest that EITC exposure in childhood leads women to delay marriage and first births in early adulthood (ages 16-25), but has no effect on men. A $1,000 increase in EITC exposure in childhood leads to a 2%-3% decline in a woman's likelihood of having a first birth and a comparable decline in her likelihood of marrying by her early 20s. We find similar reductions in fertility among Black and White women, though marriage declines are concentrated among White women. Results are focused on children growing up in the bottom half of the income distribution and those who spent the majority of childhood residing with a single parent-two groups that are the primary beneficiaries of the EITC. These findings have important implications for the well-being of individuals exposed to the EITC in childhood, as well as their future children.
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Affiliation(s)
- Katherine Michelmore
- Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - Leonard M Lopoo
- Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
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Courtin E, Allen HL, Katz LF, Miller C, Aloisi K, Muennig PA. Effect of Expanding the Earned Income Tax Credit to Americans Without Dependent Children on Psychological Distress. Am J Epidemiol 2021; 191:1444-1452. [PMID: 34089046 PMCID: PMC9347026 DOI: 10.1093/aje/kwab164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/05/2021] [Accepted: 05/17/2021] [Indexed: 01/28/2023] Open
Abstract
Antipoverty policies have the potential to improve mental health. We conducted a randomized trial (Paycheck Plus Health Study Randomized Controlled Trial, New York, New York) to investigate whether a 4-fold increase in the Earned Income Tax Credit for low-income Americans without dependent children would reduce psychological distress relative to the current federal credit. Between 2013 and 2014, a total of 5,968 participants were recruited; 2,997 were randomly assigned to the treatment group and 2,971 were assigned to the control group. Survey data were collected 32 months postrandomization (n = 4,749). Eligibility for the program increased employment by 1.9 percentage points and after-bonus earnings by 6% ($635/year), on average, over the 3 years of the study. Treatment was associated with a marginally statistically significant decline in psychological distress, as measured by the 6-item Kessler Psychological Distress Scale, relative to the control group (score change = -0.30 points, 95% confidence interval (CI): -0.63, 0.03; P = 0.072). Women in the treated group experienced a half-point reduction in psychological distress (score change = -0.55 points, 95% CI: -0.97, -0.13; P = 0.032), and noncustodial parents had a 1.36-point reduction (95% CI: -2.24, -0.49; P = 0.011). Expansion of a large antipoverty program to individuals without dependent children reduced psychological distress for women and noncustodial parents-the groups that benefitted the most in terms of increased after-bonus earnings.
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Affiliation(s)
- Emilie Courtin
- Correspondence to Dr. Emilie Courtin, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, London WC1H 9SH, United Kingdom (e-mail: )
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Chang YL, Romich JL. The U.S. Safety Net since the Great Recession: Trends and Reforms, 2007-2017. Soc Work 2021; 66:29-37. [PMID: 33517455 DOI: 10.1093/sw/swaa047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/01/2019] [Accepted: 08/22/2019] [Indexed: 06/12/2023]
Abstract
The negative impacts of the Great Recession (GR) (2007 to 2009) on the lives of families with low incomes warrant social work concerns about how well antipoverty policy responded to meet economic needs over this period and since. Given America's long-standing tension between welfare state adequacy and market-oriented policies, how well did the safety net respond to the economic downturn? Did GR-era changes reverse or accelerate trends in public assistance? This article examines key policy changes and indicators of caseloads, inclusion, and generosity for three antipoverty policies: the Temporary Assistance for Needy Families, the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamp Program), and the Earned Income Tax Credit from 2007 to 2017. Authors' analysis shows a continuation of market-oriented U.S. antipoverty policy. Authors argue that the reemphasis of conditioning benefits on employment undermines the countercyclical feature of the social safety net and perpetuates the inequitable redistribution of public resources between those inside and outside of the labor market. Authors discuss social workers' role in strengthening antipoverty policies to improve the economic well-being of people with low incomes and the economic justice of the social safety net.
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Andrade FCD, Kramer KZ, Greenlee A, Williams AN, Mendenhall R. Impact of the Chicago Earned Income Tax Periodic Payment intervention on food security. Prev Med Rep 2019; 16:100993. [PMID: 31737468 DOI: 10.1016/j.pmedr.2019.100993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 09/05/2019] [Accepted: 09/17/2019] [Indexed: 11/23/2022] Open
Abstract
This article examines the Earned Income Tax Credit Periodic Payment Pilot and its effectiveness in reducing food insecurity for low-income households. Low-income families in Chicago who were eligible for the Earned Income Tax Credit provided data over four waves of data collection between 2014 and 2015. We utilize longitudinal random effects logit models to test the likelihood of experiencing food insecurity. The sample was composed mostly by women with low educational levels. The intervention significantly decreased the likelihood of experiencing food insecurity over time (T2: β = -0.23, p = .581; T3: β = -0.89, p < .10; T4: β = -2.21, p < .01). The Periodic Payment Pilot seems effective at reducing food insecurity in low-income families. Further research should examine how changes to the Earned Income Tax Credit payment distribution could improve the lives of low-income families, specifically concerning food insecurity.
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Wicks-Lim J, Arno PS. Improving population health by reducing poverty: New York's Earned Income Tax Credit. SSM Popul Health 2017; 3:373-381. [PMID: 29349231 PMCID: PMC5769044 DOI: 10.1016/j.ssmph.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/08/2017] [Accepted: 03/20/2017] [Indexed: 11/09/2022] Open
Abstract
Despite the established relationship between adverse health outcomes and low socioeconomic status, researchers rarely test the link between health improvements and poverty-alleviating economic policies. New research, however, links individual-level health improvements to the Earned Income Tax Credit (EITC), a broad-based income support policy. We build on these findings by examining whether the EITC has ecological, neighborhood-level health effects. We use a difference-in-difference analysis to measure child health outcomes in 90 low- and middle- income neighborhoods before and after the expansion of New York State and New York City's EITC policy between 1997-2010. Our study takes advantage of the relatively exogenous source of income variation supplied by the EITC-legislative changes to EITC policy parameters. This feature minimizes the endogeneity problem in studying the relationship between income and health. Our estimates link a 15-percentage-point increase in EITC benefit rates to a 0.45 percentage-point reduction in the low birthweight rate. We do not observe any measurable link between EITC benefits and prenatal health or asthma-related pediatric hospitalization. The magnitude of the EITC's impact on low birthweight rates suggests ecological effects, and an additional channel through which anti-poverty measures can serve as public health interventions.
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Affiliation(s)
- Jeannette Wicks-Lim
- Political Economy Research Institute, University of Massachusetts, Amherst, United States
| | - Peter S. Arno
- Political Economy Research Institute, University of Massachusetts, Amherst, National Academy of Social Insurance, Washington D.C., United States
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Markowitz S, Komro KA, Livingston MD, Lenhart O, Wagenaar AC. Effects of state-level Earned Income Tax Credit laws in the U.S. on maternal health behaviors and infant health outcomes. Soc Sci Med 2017; 194:67-75. [PMID: 29073507 DOI: 10.1016/j.socscimed.2017.10.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 10/13/2017] [Accepted: 10/14/2017] [Indexed: 11/18/2022]
Abstract
The purpose of this paper is to investigate the effects of state-level Earned Income Tax Credit (EITC) laws in the U.S. on maternal health behaviors and infant health outcomes. Using multi-state, multi-year difference-in-differences analyses, we estimated effects of state EITC generosity on maternal health behaviors, birth weight and gestation weeks. We find little difference in maternal health behaviors associated with state-level EITC. In contrast, results for key infant health outcomes of birth weight and gestation weeks show small improvements in states with EITCs, with larger effects seen among states with more generous EITCs. Our results provide evidence for important health benefits of state-level EITC policies.
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Affiliation(s)
- Sara Markowitz
- Emory University, Department of Economics, Rich Memorial Building, 1602 Fishburne Dr, Atlanta, GA 30322, United States.
| | - Kelli A Komro
- Emory University, Rollins School of Public Health, Department of Behavioral Science and Health Education, Grace Crum Rollins Building, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Melvin D Livingston
- University of North Texas Health Science Center, Department of Biostatistics and Epidemiology, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States.
| | - Otto Lenhart
- University of West Florida, Department of Marketing and Economics, 11000 University Pkwy, Pensacola, FL 32514, United States.
| | - Alexander C Wagenaar
- Emory University, Rollins School of Public Health, Department of Behavioral Science and Health Education, Grace Crum Rollins Building, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
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