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Poverty, Pregnancy, and Birth Outcomes: A Study of the Earned Income Tax Credit.

ABSTRACT: BACKGROUND:Economic interventions are increasingly recognised as a mechanism to address perinatal health outcomes among disadvantaged groups. In the US, the earned income tax credit (EITC) is the largest poverty alleviation programme. Little is known about its effects on perinatal health among recipients and their children. We exploit quasi-random variation in the size of EITC payments to examine the effects of income on perinatal health. METHODS:The study sample includes women surveyed in the 1979 National Longitudinal Survey of Youth (n?=?2985) and their children born during 1986-2000 (n?=?4683). Outcome variables include utilisation of prenatal and postnatal care, use of alcohol and tobacco during pregnancy, term birth, birthweight, and breast-feeding status. We first examine the health effects of both household income and EITC payment size using multivariable linear regressions. We then employ instrumental variables analysis to estimate the causal effect of income on perinatal health, using EITC payment size as an instrument for household income. RESULTS:We find that EITC payment size is associated with better levels of several indicators of perinatal health. Instrumental variables analysis, however, does not reveal a causal association between household income and these health measures. CONCLUSIONS:Our findings suggest that associations between income and perinatal health may be confounded by unobserved characteristics, but that EITC income improves perinatal health. Future studies should continue to explore the impacts of economic interventions on perinatal health outcomes, and investigate how different forms of income transfers may have different impacts.

SUBMITTER: Hamad R

PROVIDER: S-EPMC4536129 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Poverty, Pregnancy, and Birth Outcomes: A Study of the Earned Income Tax Credit.

Hamad Rita R Rehkopf David H DH

Paediatric and perinatal epidemiology 20150724 5

<h4>Background</h4>Economic interventions are increasingly recognised as a mechanism to address perinatal health outcomes among disadvantaged groups. In the US, the earned income tax credit (EITC) is the largest poverty alleviation programme. Little is known about its effects on perinatal health among recipients and their children. We exploit quasi-random variation in the size of EITC payments to examine the effects of income on perinatal health.<h4>Methods</h4>The study sample includes women su ...[more]

PMID: 26212041

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Project description:ObjectiveTo assess the relationship between the presence and generosity of state-level Earned Income Tax Credits (EITC) and multiple self-reported measures of general health.Data sourcesData on state-level tax credits and covariates were obtained from the National Bureau of Economic Research and University of Kentucky Center for Poverty Research, respectively. These data were merged with Behavioral Risk Factor Surveillance System survey records from 1993-2016.Study designUsing difference-in-differences approaches and survey-weighted Poisson regression that accounted for clustering of observations and included state and year fixed-effects, we assessed relationships between EITC and self-reported overall health, frequent mental distress, and frequent poor physical health in the prior 30 days. Covariates included state minimum wage, state GDP, and adoption of Medicaid expansion. Sensitivity analyses revealed that parallel trends were plausible; there were no significant lead and lag effects.Data extraction methodsAnalyses were restricted to respondents with no more than a high school diploma or equivalent because less-educated adults are more likely to be low-wage earners and therefore qualify for EITC.Principal findingsAmong adults with no education beyond high school (n = 2 884 790), each additional 10-percentage-point increase in the generosity of state EITC-relative to the federal credit-was associated with fewer reports of frequent mental distress (-97.3 per 100 000; 95% CI: -237.2, 42.6) and frequent poor physical health (-149.6 per 100 000; 95% CI: -284.4, -14.9). When restricted to individuals interviewed during the three months when tax rebates are commonly disbursed, the magnitude of the association between EITC and prevalence of reported frequent mental distress was greater (-329.7 per 100 000; 95% CI: -636.0, -23.5).ConclusionsThe generosity of state EITC policies is positively associated with significant reductions in frequent mental distress and poor physical health, especially during months when the credit is received. Interventions to reduce poverty may positively impact health by reducing material hardship and stress.

Dataset Information

Poverty, Pregnancy, and Birth Outcomes: A Study of the Earned Income Tax Credit.

Publications

Poverty, Pregnancy, and Birth Outcomes: A Study of the Earned Income Tax Credit.

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