Numerous adverse health outcomes in the United States (U.S.) are closely linked with poverty and low income, affecting children from birth through adulthood and influencing not only their health, but also their quality of life and later economic opportunities. Further, structural factors including discriminatory policies, systems, and societal norms perpetuate income inequality, hinder upward economic mobility, and ultimately exacerbate long-standing health inequities by race and ethnicity. Therefore, addressing the root causes of poverty through structural interventions is crucial for reducing disease burden, mortality rates, and health disparities.Minimum wage policies have been proposed as one potential upstream solution for alleviating poverty. Minimum wage laws address poverty by setting a baseline income level for workers so that they are better able to meet their basic cost-of-living needs. Since low income is an important risk factor for both food insecurity and child maltreatment, it is possible that increased minimum wages could enhance family health and nutrition and prevent maltreatment-related deaths. However, little is currently known about how effective minimum wages are at addressing these outcomes. Further, existing research to date has not adequately examined whether minimum wages mitigate or exacerbate related disparities. This dissertation aims to augment the existing body of literature and fill a critical gap by examining the impact of minimum wages on food insecurity prevalence and child maltreatment mortality rates. We also aim to identify whether these impacts vary among traditionally marginalized subpopulations (i.e. those defined by race and ethnicity, educational attainment, etc.) and thus explore how minimum wages effect existing disparities in food insecurity and child maltreatment. In all studies, we utilize large U.S. population-representative datasets and leverage the changing dollar amounts of state-level minimum wages over time.
The first chapter provides additional background and context on minimum wages and motivates their potential as a structural solution to poverty. It summarizes the current research investigating the effects of minimum wages on poverty and health outcomes, including food insecurity and child maltreatment. It also informs our focus on examining heterogenous effects by race and ethnicity, educational attainment, and family structure.
Chapters 2 and 3 examine the relationship between state-level minimum wages and household food insecurity using data from the largest population-based survey assessing food insecurity in the U.S. Chapter 2 employs a cross-sectional design to estimate the effect of $1 increase in minimum wage on the food insecurity prevalence of 624,770 working-aged households between 2002 and 2019. This work reveals no overall population-level effect of minimum wages on food insecurity while uncovering heterogeneous effects across demographic groups. Specifically increases in minimum wages are found to help protect against food insecurity for households whose head had less than a high school diploma, households headed by single women, Indigenous households, and multiracial households (with children). In contrast, increases in minimum wage are found to increase food insecurity prevalence among Black and multiracial households (overall). Chapter 3 extends this work to look at the relationship between minimum wages and food insecurity among a subset of 15,845 households receiving government food (SNAP) benefits who disproportionally experience high levels of food insecurity as a whole. This population is especially important to examine given that public assistance benefits are mediated by income which makes the net effects of small changes in income difficult to predict. We find that the impact of state-level minimum wages on food insecurity among SNAP recipients depends on household characteristics such as age (elderly vs working aged), family structure (including presence of children and marital status of parents), race and ethnicity, and educational attainment. In both chapters 2 and 3 we discuss potential complex interactions with other safety-net programs which could be responsible for these heterogeneous effects.
Chapter 4 evaluates the impact of state-level minimum wages on child maltreatment-related mortality. We use death certificate data and a novel child maltreatment identification strategy to identify 24,025 deaths in children under 5 years of age between 2000 and 2019. We find that a $1 increase in minimum wage is not associated with child maltreatment-related deaths, but that stratified results suggest possible heterogeneity by racial-ethnic identity.
The final chapter provides a summary of all three studies and discusses how future research can build upon our results to better protect vulnerable populations and eliminate health disparities.
