Philip R. Lee Institute for Health Policy Studies, Department of Family and Community Medicine, University of California San Francisco, San Francisco, California.
Department of Family and Community Medicine, University of California San Francisco, San Francisco, California.
Am J Epidemiol. 2018 Dec 1;187(12):2633-2641. doi: 10.1093/aje/kwy179.
The Earned Income Tax Credit (EITC) is the largest US poverty-alleviation program, yet few studies examine its effects on the health of recipients' children. We employed quasiexperimental techniques to test the hypothesis that EITC refund receipt is associated with short-term improvements in child health. The data set included children in families surveyed in the Third National Health and Nutrition Examination Survey (n = 7,444). We employed a difference-in-differences approach, exploiting the seasonal nature of EITC refund receipt. We compared children of EITC-eligible families interviewed immediately after refund receipt (February to April) with those interviewed during other months (May to January), differencing out seasonal variation among non-EITC-eligible families. We examined outcomes that were likely to be affected immediately after refund receipt, including general health, nutrition, metabolic and inflammatory biomarkers, and test scores. There were improvements in physician-reported overall health after refund receipt but no changes in infection, serum metabolic or inflammatory markers, or test scores, and there were contradictory findings for food insufficiency. In summary, EITC refunds are not strongly associated with most short-term health outcomes among recipients' children, although numerous previous studies have demonstrated impacts on longer-term outcomes. This highlights the importance of examining the effects of public policies on beneficiaries and their children using varying study designs.
所得税抵免(EITC)是美国最大的扶贫计划,但很少有研究考察它对接受者子女健康的影响。我们采用准实验技术来检验这样一个假设,即 EITC 退款收据与儿童健康的短期改善有关。该数据集包括在第三次国家健康和营养检查调查(n = 7444)中接受调查的家庭中的儿童。我们采用了差异中的差异方法,利用 EITC 退款收据的季节性。我们比较了在退款收据后立即接受采访的 EITC 合格家庭的儿童(二月至四月)与其他月份(五月至一月)接受采访的儿童,从非 EITC 合格家庭中剔除季节性差异。我们检查了可能在退款后立即受到影响的结果,包括一般健康、营养、代谢和炎症生物标志物以及考试成绩。在退款后,医生报告的整体健康状况有所改善,但感染、血清代谢或炎症标志物或考试成绩没有变化,而且对于食物不足也存在矛盾的发现。总之,EITC 退款与接受者子女的大多数短期健康结果并没有很强的关联,尽管许多先前的研究已经证明了对长期结果的影响。这凸显了使用不同研究设计来检查公共政策对受益人和他们的孩子的影响的重要性。