Brown-Podgorski Brittany L, Doran-Brubaker Stephanie, Vohra-Gupta Shetal
Department of Health Policy and Management, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA.
Health Equity. 2023 May 23;7(1):280-289. doi: 10.1089/heq.2022.0192. eCollection 2023.
Black adults are disproportionately burdened by hypertension. Income inequality is associated with elevated risk of hypertension. Minimum wage increases have been explored as a potential policy lever to address the disparate impact of hypertension on this population. However, these increases may have no significant impact on health among Black adults due to structural racism and "diminished gain" of health effects from socioeconomic resources. This study assesses the relationship between state minimum wage increases and Black-White disparities in hypertension.
We merged state-level minimum wage data with survey data from the Behavioral Risk Factor Surveillance System (2001-2019). Odd survey years included questions about hypertension. Separate difference-in-difference models estimated the odds of hypertension among Black and White adults in states with and without minimum wage increases. Difference-in-difference-in-difference models estimated the impact of minimum wage increases on hypertension among Black adults relative to White adults.
As state wage limits increase, the odds of hypertension significantly decreased among Black adults overall. This relationship is largely driven by the impact of these policies on Black women. However, the Black-White disparity in hypertension worsened as state minimum wage limits increased, and the magnitude of this disparity was larger among women.
States having a minimum wage above the federal wage limit are not sufficient to combat structural racism and reduce the disparities in hypertension among Black adults. Rather, future research should explore livable wages as a policy lever to reduce disparities in hypertension among Black adults.
黑人成年人承受着不成比例的高血压负担。收入不平等与高血压风险升高有关。提高最低工资已被视为解决高血压对这一人群不同影响的潜在政策杠杆。然而,由于结构性种族主义以及社会经济资源对健康影响的“收益递减”,这些提高可能对黑人成年人的健康没有显著影响。本研究评估了州最低工资提高与黑人和白人在高血压方面的差异之间的关系。
我们将州级最低工资数据与行为风险因素监测系统(2001 - 2019年)的调查数据合并。奇数调查年份包含有关高血压的问题。分别使用双重差分模型估计有和没有提高最低工资的州中黑人和白人成年人患高血压的几率。三重差分模型估计了提高最低工资对黑人成年人相对于白人成年人患高血压的影响。
随着州工资上限的提高,黑人成年人总体上患高血压的几率显著降低。这种关系在很大程度上是由这些政策对黑人女性的影响驱动的。然而,随着州最低工资上限的提高,黑人和白人在高血压方面的差异加剧,并且这种差异在女性中更大。
州最低工资高于联邦工资上限不足以对抗结构性种族主义并减少黑人成年人在高血压方面的差异。相反,未来的研究应探索将可维持生计的工资作为减少黑人成年人高血压差异的政策杠杆。