MedicalResearch.com Interview with:
Kelli A. Komro, MPH, PhD, Professor
Director of Graduate Studies
Behavioral Sciences and Health Education
Jointly Appointed, Epidemiology
Rollins School of Public Health
Atlanta, GA 30322
MedicalResearch.com: What is the background for this study?
Dr. Komro: Epidemiologists have done a thorough job describing the income-health gradient, which shows a clear association between income and health. That is, as income increases, exposure to health risks and premature mortality decreases. Each step down on the income ladder decreases one’s health for many reasons related to material resources, physical environment exposures and social circumstances.
The income to health association begins at birth, and more than one in four women giving birth in the U.S. are below the poverty level, putting nearly 1 million babies at risk each year. Low-income mothers are more likely to give birth prematurely, to have low birth weight babies, and to suffer the death of their infant during the post-neonatal period (28 to 364 days old).
Given the importance of the income-health gradient, we set out to test the health effects of policies that are designed to increase economic security among low-income families. Our main question is: Do policies designed to reduce poverty and improve family economic security also improve health?
One relevant policy is minimum wage laws. A federal minimum wage was first enacted in 1938. The real value (in 2015 dollars) of the federal minimum wage reached a high of $10.85 in 1968. The current federal rate is $7.25. Many cities and states have passed minimum wage laws that are higher than the federal rate, and currently there is a range of minimum wage increases under active public and policymaker discussion.
Given that some states pass minimum wage standards and others do not, and that laws within states change over time, we took advantage of all the changes that have occurred to design a natural experiment. Our natural experiment examined the effects of state minimum wage laws on infant health.
MedicalResearch.com: What are the main findings?
Dr. Komro: The study, recently published in the American Journal of Public Health, evaluated the effects of 206 legal changes in state minimum wages from 1980 to 2011. Over this time period, we calculated the difference between state-level minimum wage and the federal minimum wage in each state and month. Our analysis accounted for any changes over time in infant outcomes common across states and time-invariant differences between states. Our research design efficiently controls for a host of other factors affecting birth outcomes, both measured and unmeasured. However, to be conservative, we also controlled four factors known to be associated with birth outcomes: poverty rate, cigarette sales, percentage African American mothers, and mean age of mother.
Results showed a consistent pattern over time of health improvement associated with a higher state minimum wage. Across all models analyzed, a dollar increase in the minimum wage above the federal level was associated with a significant 1 to 2 percent decrease in low weight births and a 4 percent decrease in post-neonatal mortality.
MedicalResearch.com: What should readers take away from your report?
Dr. Komro: We found that state laws on minimum wages are associated with rates of low weight births and post-neonatal deaths. Results indicate that if all states in 2014 had increased their minimum wage by $1, there would likely have been 2,790 fewer babies born with lower birth weights and 518 fewer post-neonatal deaths.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Komro: We hope that these new findings spur further research about specific ways to reduce poverty and its many negative health effects.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Komro: The annual social and health cost of preterm or low weight births in the Unites States was at least $26.2 billion in 2005. The pain and suffering from the deaths of so many infants in their first year of life are incalculable. That past modest changes to state minimum wage laws appear to have had such important effects bodes well for possible beneficial effects of a range of minimum wage increases currently under consideration.
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