Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, California.
University of California, Los Angeles National Clinician Scholars Program, Los Angeles, California.
JAMA Health Forum. 2023 Jun 2;4(6):e231672. doi: 10.1001/jamahealthforum.2023.1672.
The 2021 Expanded Child Tax Credit (ECTC) provided families with children monthly payments from July 2021 to December 2021. The association of this policy with adult health is understudied.
To examine changes in adult self-reported health and household food security before and during ECTC monthly payments.
DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study used multivariable regression with a difference-in-differences estimator to assess adult health and food security for 39 479 respondents to the National Health Interview Survey (January 2019 to December 2021) before vs during monthly payments. Analyses were stratified by income to focus on low-income vs middle-income and upper-income households.
Eligibility for ECTC monthly payments from July 2021 to December 2021.
Overall self-reported adult health and household food security as binary outcomes (excellent or very good health vs good, fair, or poor health; food secure vs food insecure).
In this nationally representative cross-sectional study of 39 479 US adults (mean [SD] age, 41.0 [13.0] years; 7234 [21.7%] Hispanic, 321 [0.9%] non-Hispanic American Indian/Alaska Native, 2205 [5.7%] non-Hispanic Asian, 5113 [13.7%] non-Hispanic Black, and 23 704 [55.8%] White individuals), respondents were predominantly female (21 511 [52.4%]), employed (33 035 [86.7%]), and married (19 838 [55.7%]). Before disbursement of ECTC monthly payments, 7633 ECTC-eligible adults (60.1%) reported excellent or very good health, and 10 950 (87.8%) reported having food security. Among ECTC-ineligible adults, 10 778 (54.9%) reported excellent or very good health and 17 839 (89.1%) reported food security. Following disbursement of monthly payments, ECTC-eligible adults experienced a 3.0 percentage point (pp) greater adjusted increase (95% CI, 0.2-5.7) in the probability of reporting excellent or very good health compared with ECTC-ineligible adults. Additionally, ECTC-eligible adults experienced a 1.9 pp greater adjusted increase (95% CI, 0.1-3.7) in the probability of food security than ECTC-ineligible adults. In income-stratified analyses, the association between ECTC eligibility and overall health was concentrated among middle-income and upper-income households (3.7-pp increase in excellent or very good health; 95% CI, 0.5-6.9). Conversely, the association between ECTC eligibility and food security was concentrated among low-income adults (3.9-pp increase in food security; 95% CI, 0-7.9).
The results of this cross-sectional study suggest that monthly ECTC payments were associated with improved adult overall health and food security. Cash transfer programs may be effective tools in improving adult health and household nutrition.
2021 年扩大儿童税收抵免（ECTC）为有子女的家庭从 2021 年 7 月到 2021 年 12 月提供了每月的付款。这项政策与成人健康的关联研究较少。
研究 ECTC 每月付款前后成年人自我报告的健康状况和家庭粮食安全状况的变化。
设计、地点和参与者：本重复横断面研究使用多变量回归和差分差异估计器，对全国健康访谈调查（2019 年 1 月至 2021 年 12 月）的 39479 名受访者进行分析，以评估成年人在 ECTC 每月付款前后的健康和粮食安全状况。分析按收入分层，重点关注低收入和中等收入与高收入家庭。
有资格从 2021 年 7 月到 2021 年 12 月获得 ECTC 每月付款。
总体上自我报告的成年人健康和家庭粮食安全作为二项结果（优秀或非常好的健康与好、公平或差的健康；粮食安全与粮食不安全）。
在这项对 39479 名美国成年人（平均[标准差]年龄，41.0[13.0]岁；7234[21.7%]西班牙裔，321[0.9%]非西班牙裔美国印第安人/阿拉斯加原住民，2205[5.7%]非西班牙裔亚洲人，5113[13.7%]非西班牙裔黑人，23704[55.8%]白人个体）的全国代表性横断面研究中，受访者主要为女性（21511[52.4%]）、就业（33035[86.7%]）和已婚（19838[55.7%]）。在 ECTC 每月付款发放之前，有 7633 名 ECTC 合格的成年人（60.1%）报告了优秀或非常好的健康状况，10950 名（87.8%）报告了粮食安全。在 ECTC 不合格的成年人中，有 10778 名（54.9%）报告了优秀或非常好的健康状况，17839 名（89.1%）报告了粮食安全。在发放每月付款后，ETC 合格的成年人在报告优秀或非常好的健康状况的可能性方面，调整后的增加幅度为 3.0 个百分点（95%置信区间，0.2-5.7），高于 ETC 不合格的成年人。此外，ETC 合格的成年人在粮食安全方面的调整后增加幅度为 1.9 个百分点（95%置信区间，0.1-3.7），高于 ETC 不合格的成年人。在按收入分层的分析中，ETC 资格与整体健康之间的关联主要集中在中等收入和高收入家庭（优秀或非常好的健康增加 3.7 个百分点；95%置信区间，0.5-6.9）。相反，ETC 资格与粮食安全之间的关联主要集中在低收入成年人（粮食安全增加 3.9 个百分点；95%置信区间，0-7.9）。
这项横断面研究的结果表明，每月 ECTC 付款与成年人整体健康和粮食安全的改善有关。现金转移计划可能是改善成人健康和家庭营养的有效工具。
