Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa.
Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa; Department of Economics, University of Iowa, Iowa City, Iowa; Department of Preventive & Community Dentistry, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa; Public Policy Center, University of Iowa, Iowa City, Iowa; National Bureau of Economic Research, Cambridge, Massachusetts.
Womens Health Issues. 2021 Sep-Oct;31(5):448-454. doi: 10.1016/j.whi.2021.04.004. Epub 2021 May 26.
More than one-half of U.S. states have enacted Earned Income Tax Credit (EITC) programs. Yet little is known about the effects of state EITC programs on the health of recipients. This study examines the effects of refundable and nonrefundable state EITC programs on the health of single low-educated women of childbearing age with two or more children, the group receiving the highest credits on average.
The data come from the Behavioral Risk Factors Surveillance Survey from 1993 through 2018. Outcomes include self-rated general health, days not in good physical health, and days not in good mental health, both in the past 30 days. The research design accounts for time-invariant differences between states, national trends shared across states, and other state policies.
Depending on the outcome measure, the analytical sample ranges between 103,362 and 107,782 mothers. Refundable state EITC programs are associated with improvements in all three health outcomes. A 10 percentage-point increase in refundable state EITC is associated with better self-rated health by 0.02 points (95% confidence interval [CI], 0.006-0.04) on a 1- to 5-point scale, or 0.7% improvement above the sample mean; 0.2 fewer days not in good physical health (95% CI, -0.21 to -0.12) in the past 30 days, or 4.4% lower than the sample mean; and 0.2 fewer days not in good mental health (95% CI, -0.29 to -0.1), or 3.4% lower than the sample mean. Estimates for nonrefundable EITC programs are smaller and not statistically significant. As expected, there are small and statistically insignificant refundable EITC effects for single low-educated childless women who receive low state EITC benefits on average.
These findings suggest that an increase in refundable state EITC improves the health of single women of childbearing age with low incomes and two or more children; this factor may also lead to better preconception health. There is no evidence for effects from nonrefundable state EITC.
超过一半的美国州都制定了所得税收抵免（EITC）计划。然而，对于州 EITC 计划对接受者健康的影响知之甚少。本研究考察了可退还和不可退还的州 EITC 计划对低教育程度的有两个或更多孩子的育龄单身女性的健康的影响，这些女性平均获得最高的信用额度。
数据来自 1993 年至 2018 年的行为风险因素监测调查。结果包括过去 30 天内自我评估的总体健康状况、身体不适的天数和心理健康状况不佳的天数。研究设计考虑了各州之间不变的差异、各州之间共同的国家趋势以及其他州的政策。
根据结果衡量标准，分析样本范围在 103362 至 107782 名母亲之间。可退还的州 EITC 计划与所有三种健康结果的改善有关。可退还的州 EITC 增加 10 个百分点，在 1 到 5 分的量表上自我评估的健康状况提高 0.02 分（95%置信区间[CI]，0.006-0.04），比样本平均值高出 0.7%；过去 30 天内身体不适的天数减少 0.2 天（95%CI，-0.21 至-0.12），比样本平均值低 4.4%；心理健康状况不佳的天数减少 0.2 天（95%CI，-0.29 至-0.1），比样本平均值低 3.4%。不可退还的 EITC 计划的估计值较小且不具有统计学意义。正如预期的那样，对于平均获得低额度州 EITC 福利的单身低教育程度无子女女性，可退还 EITC 的影响较小且不具有统计学意义。
这些发现表明，增加可退还的州 EITC 可改善收入低且有两个或更多孩子的育龄单身女性的健康状况；这一因素也可能导致更好的孕前健康。没有证据表明不可退还的州 EITC 有影响。
