Am J Epidemiol. 2022 Jul 23;191(8):1444-1452. doi: 10.1093/aje/kwab164.
Antipoverty policies have the potential to improve mental health. We conducted a randomized trial (Paycheck Plus Health Study Randomized Controlled Trial, New York, New York) to investigate whether a 4-fold increase in the Earned Income Tax Credit for low-income Americans without dependent children would reduce psychological distress relative to the current federal credit. Between 2013 and 2014, a total of 5,968 participants were recruited; 2,997 were randomly assigned to the treatment group and 2,971 were assigned to the control group. Survey data were collected 32 months postrandomization (n = 4,749). Eligibility for the program increased employment by 1.9 percentage points and after-bonus earnings by 6% ($635/year), on average, over the 3 years of the study. Treatment was associated with a marginally statistically significant decline in psychological distress, as measured by the 6-item Kessler Psychological Distress Scale, relative to the control group (score change = -0.30 points, 95% confidence interval (CI): -0.63, 0.03; P = 0.072). Women in the treated group experienced a half-point reduction in psychological distress (score change = -0.55 points, 95% CI: -0.97, -0.13; P = 0.032), and noncustodial parents had a 1.36-point reduction (95% CI: -2.24, -0.49; P = 0.011). Expansion of a large antipoverty program to individuals without dependent children reduced psychological distress for women and noncustodial parents-the groups that benefitted the most in terms of increased after-bonus earnings.
扶贫政策有可能改善心理健康。我们进行了一项随机试验(纽约州的工资附加健康研究随机对照试验),以调查对于没有抚养子女的美国低收入人群,将其应纳税所得额抵免额(Earned Income Tax Credit,EITC)提高 4 倍,是否会相对于现行联邦信贷减少心理困扰。2013 年至 2014 年期间,共招募了 5968 名参与者;2997 人被随机分配到治疗组,2971 人被分配到对照组。在随机分组后 32 个月收集了调查数据(n=4749)。该计划使符合条件的人群的就业率提高了 1.9 个百分点,奖金后收入平均每年增加 6%(635 美元),在研究的 3 年内。与对照组相比,治疗组的心理困扰程度(用 6 项 Kessler 心理困扰量表衡量)略有统计学意义上的显著下降(评分变化=-0.30 分,95%置信区间(CI):-0.63,0.03;P=0.072)。接受治疗的女性心理困扰减少了半分(评分变化=-0.55 分,95% CI:-0.97,-0.13;P=0.032),非监护父母的心理困扰减少了 1.36 分(95% CI:-2.24,-0.49;P=0.011)。将一个大型扶贫计划扩大到没有抚养子女的个人,减少了女性和非监护父母的心理困扰,这两个群体在奖金后收入增加方面获益最多。