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Can antipoverty programmes save lives? Quasi-experimental evidence from the Earned Income Tax Credit in the USA.

ABSTRACT: OBJECTIVE:To estimate the impact of state-level supplements of the Earned Income Tax Credit (EITC) on mortality in the USA. The EITC supplements the wages of lower-income workers by providing larger returns when taxes are filed. SETTING:Nationwide sample spanning 25 cohorts of people across every state in the USA. PARTICIPANTS:793?000 respondents within the National Longitudinal Mortality Survey (NLMS) between 1986 and 2011, a representative sample of the USA. INTERVENTION:State-level supplementation to the EITC programme. Some, but not all, states added EITC supplementation to varying degrees beginning in 1986 (Wisconsin) and most recently in 2015 (California). Participants who were eligible in states with supplementary programmes were compared with those who were not eligible for supplementation. Comparisons were made both before and after implementation of the supplementary programme (a difference-in-difference, intent-to-treat analysis). This quasi-experimental approach further controls for age, gender, marital status, race or ethnicity, educational attainment, income and employment status. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome measure was survival at 10 years. Secondary outcome measures included survival at 5 years and survival to the end of the intervention period. RESULTS:We find an association between state supplemental EITC and survival, with a HR of 0.973 (95% CI=0.951-0.996) for each US$100 of EITC increase (p<0.05). CONCLUSION:State-level supplemental EITC may be an effective means of increasing survival in the USA.

SUBMITTER: Muennig P

PROVIDER: S-EPMC7443298 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Can antipoverty programmes save lives? Quasi-experimental evidence from the Earned Income Tax Credit in the USA.

Muennig Peter P Vail Daniel D Hakes Jahn K JK

BMJ open 20200820 8

<h4>Objective</h4>To estimate the impact of state-level supplements of the Earned Income Tax Credit (EITC) on mortality in the USA. The EITC supplements the wages of lower-income workers by providing larger returns when taxes are filed.<h4>Setting</h4>Nationwide sample spanning 25 cohorts of people across every state in the USA.<h4>Participants</h4>793 000 respondents within the National Longitudinal Mortality Survey (NLMS) between 1986 and 2011, a representative sample of the USA.<h4>Interventi ...[more]

PMID: 32819990

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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

Can antipoverty programmes save lives? Quasi-experimental evidence from the Earned Income Tax Credit in the USA.

Publications

Can antipoverty programmes save lives? Quasi-experimental evidence from the Earned Income Tax Credit in the USA.

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