Interfaculty Initiative in Health Policy, Harvard University, Cambridge, Massachusetts.
Perelman School of Medicine, University of Pennsylvania, Philadelphia.
JAMA Netw Open. 2024 Oct 1;7(10):e2440810. doi: 10.1001/jamanetworkopen.2024.40810.
Mental health disorders are increasing for children and adolescents in the US, with those in poverty having especially high rates. More evidence is needed about the association between economic policies, such as the minimum wage, and children's mental health.
To test the association between minimum wages and the mental health of children and adolescents.
DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional, population-based US study used data from 2001 to 2022. Participants included state-representative, stratified random samples of children from the National Survey of Children's Health and adolescents from the Youth Risk Behavior Surveillance System. Data analysis was performed from January 2023 to August 2024.
State minimum wage policies.
A total of 15 outcomes reported by caregivers or adolescents from survey data were evaluated: depression, anxiety, attention deficit disorder and/or attention-deficit/hyperactivity disorder, behavior disorders, mood symptoms, gastrointestinal symptoms, considered and attempted suicide, any unmet health care and mental health care, alcohol and marijuana use, physical fights, school absenteeism, and paid employment. The associations between minimum wage policies and mental health were tested using 2-way fixed-effects models, lifetime minimum wage models, and difference-in-differences models with event studies, all with state, year, and birth cohort fixed effects. Additional controls included individual-level demographics and state-level health insurance and welfare policies.
Analyses included 239 534 children (aged 3-17 years; 117 111 girls [48.9%]) from the 2016 to 2022 National Survey of Children's Health, and 1 453 043 adolescents (aged 12-18 years; 711 380 girls [49.0%]) from the 2001 to 2021 Youth Risk Behavior Surveillance System. Across diverse modeling approaches, increases in minimum wages were not associated with clear, consistent improvements in mental health. For example, in 2-way fixed-effects models, a $1 increase in the minimum wage was not associated with changes in rates of depression (0.06 percentage points [pp]; 95% CI, -0.11 to 0.23 pp; P = .48), unmet mental health care (0.13 pp; 95% CI, -0.04 to 0.30 pp; P = .14), or attempted suicide (-0.17 pp; 95% CI, -0.47 to 0.13 pp; P = .26). There also were no clear improvements when stratifying by household income, parental education, race and ethnicity, nativity, or urbanicity.
In this repeated cross-sectional study, changes in minimum wage policies over the past 2 decades were not accompanied by clear improvements in children's and adolescents' mental health. More evidence is needed on policy approaches to improve the mental well-being of children, particularly those from economically disadvantaged families.
美国儿童和青少年的心理健康障碍正在增加，贫困儿童的发病率尤其高。需要更多证据来证明最低工资等经济政策与儿童心理健康之间的关联。
测试最低工资与儿童和青少年心理健康之间的关联。
设计、地点和参与者：这是一项在美国进行的重复横断面、基于人群的研究，使用了 2001 年至 2022 年的数据。参与者包括来自国家儿童健康调查的代表性、分层随机儿童样本和来自青少年风险行为监测系统的青少年样本。数据分析于 2023 年 1 月至 2024 年 8 月进行。
州最低工资政策。
使用来自调查数据的护理人员或青少年报告的总共 15 种结果进行评估：抑郁、焦虑、注意缺陷障碍和/或注意缺陷多动障碍、行为障碍、情绪症状、胃肠道症状、考虑和尝试自杀、任何未满足的医疗保健和心理健康保健、酒精和大麻使用、身体打架、逃学和有薪就业。使用双向固定效应模型、终身最低工资模型和带有事件研究的差分差异模型，以及州、年和出生队列固定效应，测试最低工资政策与心理健康之间的关联。其他控制因素包括个人层面的人口统计学数据以及州级健康保险和福利政策。
分析包括来自 2016 年至 2022 年国家儿童健康调查的 239534 名儿童（年龄 3-17 岁；117111 名女孩[48.9%]）和来自 2001 年至 2021 年青少年风险行为监测系统的 1453043 名青少年（年龄 12-18 岁；711380 名女孩[49.0%]）。在各种建模方法中，最低工资的增加与心理健康的明显、一致改善无关。例如，在双向固定效应模型中，最低工资增加 1 美元与抑郁率的变化无关（0.06 个百分点[pp]；95%CI，-0.11 至 0.23 pp；P=0.48），未满足的心理健康护理（0.13 pp；95%CI，-0.04 至 0.30 pp；P=0.14）或自杀企图（-0.17 pp；95%CI，-0.47 至 0.13 pp；P=0.26）。在按家庭收入、父母教育程度、种族和民族、出生地或城市化程度进行分层时，也没有明显的改善。
在这项重复的横断面研究中，过去 20 年来最低工资政策的变化并没有伴随着儿童和青少年心理健康的明显改善。需要更多关于改善儿童心理健康的政策方法的证据，特别是那些来自经济弱势家庭的儿童。
