Absence of conflict of interest.
Citation
Highlights
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The study's objective was to examine the impact of the impact of minimum wage policies on healthcare, health behavior, and reported health among low-skill workers.
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The authors used a regression analysis to estimate the association between minimum wage increases and health outcomes. The authors used 1993-2014 data from the Behavioral Risk Factor Surveillance System (BRFSS) and state-level data for other employment and health measures.
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Findings from this study suggest that increases in the minimum wage were associated with higher rates of health insurance coverage among low-skill adults, aged 21 to 64, who reported an educational attainment of high school or lower.
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The quality of causal evidence presented in this study is low because the authors were not able to ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to the impact of minimum wage increases; other factors are likely to have contributed.
Intervention Examined
Increases in the minimum wage
Features of the Intervention
The minimum wage is the minimum amount of pay an individual may legally receive for her/his labor. While many states set their own minimum wages, federal law establishes the baseline for minimum wages. Prior research has suggested that minimum wage increases increase wages for low-wage workers and may also reduce employment.
Features of the Study
The authors of this study used a regression analysis to estimate the association between minimum wage increases and health outcomes, including whether individuals reported having health insurance coverage and whether individuals reported missing healthcare due to cost. To measure health behaviors and outcomes, the authors used data from the Behavioral Risk Factor Surveillance System (BRFSS) over the period 1993-2014. The BRFSS is an annual survey administered by state health departments with support from the Center for Disease Control and Prevention (CDC). The BRFSS data are a pooled-cross section, meaning that the respondents for the survey are re-sampled each year and individuals appear in the data at only a single point in time.
The authors combined individual-level BRFSS data with state-level data on minimum wages and labor market characteristics collected by the Bureau of Labor Statistics (BLS), the Bureau of Economy Analysis, and the University of Kentucky Center for Poverty Research. Over the period 1993 – 2014 across all 50 U.S. states, the authors identified 313 changes to the minimum wage due to state or federal legislation.
To identify low-skill workers for this analysis, the authors focused on BRFSS respondents between the ages of 21 and 64 with educational attainment of high school or lower. The authors estimate correlations between changes in the minimum wage and health outcomes for the entire population of low-skilled workers, and for subgroups defined by race, ethnicity, and gender.
The authors used a statistical model to estimate the correlation between a $1 change in the minimum wage and health outcomes. The regression model included controls for other state policy measures likely to impact low-skill workers as well as individual-level controls for age, race, ethnicity, gender, education, and household composition.
Findings
Employer Benefits Receipt
- Findings from this study suggested that there was a positive, statistically significant association between minimum wage increases and rates of health insurance coverage among the full sample of low-skill workers.
Considerations for Interpreting the Findings
The authors did not include a control for prior health insurance status. Because individuals appear only once in the BRFSS data, the authors cannot measure the health insurance status of survey respondents both before and after a change in the minimum wage. Thus, unmeasured pre-existing differences in insurance coverage – and not changes to the minimum wage – could explain observed correlations.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not account for individuals’ pre-intervention health insurance status. This means we are not confident that the estimated effects are attributable to minimum wage increases; other factors are likely to have contributed.