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Anti-poverty policy and health: Attributes and diffusion of state earned income tax credits across U.S. states from 1980 to 2020.

ABSTRACT: PURPOSE:The U.S. federal Earned Income Tax Credit (EITC) is often considered the most effective antipoverty program for families in the U.S., leading to a variety of improved outcomes such as educational attainment, work incentives, economic activity, income, and health benefits for mothers, infants and children. State EITC supplements to the federal credit can significantly enhance the magnitude of this intervention. In this paper we advance EITC and health research by: 1) describing the diffusion of state EITC policies over 40 years, 2) presenting patterns in important EITC policy dimensions across space and time, and 3) disseminating a robust data set to advance future research by policy analysts and scientists. METHODS:We used current public health law research methods to systematically collect, conduct textual legal analysis, and numerically code all EITC legislative changes from 1980 through 2020 in the 50 states and Washington, D.C. RESULTS:First, the pattern of diffusion across states and time shows initial introductions during the 1990s in the Midwest, then spreading to the Northeast, with more recent expansions in the West and South. Second, differences by state and time of important policy dimensions are evident, including size of credit and refundability. Third, state EITC benefits vary considerably by household structure. CONCLUSION:Continued research on health outcomes is warranted to capture the full range of potential beneficial effects of EITCs on family and child wellbeing. Lawyers and policy analysts can collaborate with epidemiologists and economists on other high-quality empirical studies to assess the many dimensions of policy and law that potentially affect the social determinants of health.

SUBMITTER: Komro KA

PROVIDER: S-EPMC7678980 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Anti-poverty policy and health: Attributes and diffusion of state earned income tax credits across U.S. states from 1980 to 2020.

Komro Kelli A KA Dunlap Phenesse P Sroczynski Nolan N Livingston Melvin D MD Kelly Megan A MA Pepin Dawn D Markowitz Sara S Rentmeester Shelby S Wagenaar Alexander C AC

PloS one 20201120 11

<h4>Purpose</h4>The U.S. federal Earned Income Tax Credit (EITC) is often considered the most effective antipoverty program for families in the U.S., leading to a variety of improved outcomes such as educational attainment, work incentives, economic activity, income, and health benefits for mothers, infants and children. State EITC supplements to the federal credit can significantly enhance the magnitude of this intervention. In this paper we advance EITC and health research by: 1) describing th ...[more]

PMID: 33216767

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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

Anti-poverty policy and health: Attributes and diffusion of state earned income tax credits across U.S. states from 1980 to 2020.

Publications

Anti-poverty policy and health: Attributes and diffusion of state earned income tax credits across U.S. states from 1980 to 2020.

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