Minimum wages and maternal health in the U.S.

美国的最低工资和孕产妇健康

基本信息

批准号：
10567175
负责人：
Mark McGovern
金额：
$ 51.81万
依托单位：
RUTGERS BIOMEDICAL AND HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-01 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10567175
关键词：
Address Affect Age Canada Charge Child Chronic Disease Chronic stress Color Communities Complex Congresses Data Set Discrimination Disparity Economic Policy Economics Employment Ethnic Origin Evaluation Expenditure Exposure to Family Financial Hardship General Population Gestational Diabetes Health Health Care Costs Health Expenditures Health Services Accessibility Health Status Health behavior Healthcare Heterogeneity Hour Household Income Income Distributions Infant Intervention Lead Lifting Link Literature Low income Marketing Maternal Health Maternal Mortality Mental Depression Mental Health Services Methodology Minority Women Mothers Netherlands Not Hispanic or Latino Obesity Outcome Pathway interactions Persons Play Policies Population Poverty Pre-Eclampsia Pregnancy Pregnant Women Prenatal care Preventive healthcare Public Health Quasi-experiment Race Reproductive Health Research Research Personnel Resources Risk Risk Factors Risk Reduction Role Running Smoke Smoking Societies Source Structural Racism Translating Uninsured United States Wages Woman adverse outcome black women cost disadvantaged women disparity reduction economic disparity economic impact ethnic minority population experience family burden federal poverty level health care delivery health care service utilization health disparity health inequalities health outcome disparity improved lifetime risk maternal morbidity member multidisciplinary people of color peripartum depression poor health outcome post pregnancy postpartum care poverty reduction pregnancy health prepregnancy racial disparity racial minority population reproductive severe maternal morbidity social determinants social health determinants societal costs structural determinants tool

项目摘要

Project Summary/Abstract The United States is experiencing a maternal health crisis, with high rates of severe maternal morbidity (SMM) and other pregnancy-related health problems and rising rates of pre-pregnancy health conditions. Furthermore, a legacy of structural racism and discrimination has led to substantial and persistent racial disparities in SMM and other adverse maternal health outcomes. In addition to the health impact on women, maternal morbidity imposes substantial cost burdens on families and society. Social determinants of health play a significant role in maternal health, with economically disadvantaged women having lower access to care, increased exposure to health risks, and poorer health outcomes before and during pregnancy. Yet there is very limited understanding of whether economic policies aimed at increasing incomes of families can be part of an effective strategy for improving maternal health and reducing disparities. Researchers have estimated that implementing a $15 federal minimum wage (MW) by 2025, as is currently being debated in Congress, would increase the earnings of 32 million workers and lift nearly four million people out of poverty. Because they are overrepresented among lower wage workers, women and people of color could disproportionately benefit. This study examines the role of the MW as a potentially powerful tool for addressing the maternal health crisis in the U.S. In lieu of any federal MW changes since 2009, many states have taken the lead in implementing their own MW increases, with 30 states having higher MW rates than the 2019 federal rate, compared to only 10 in 2010. Although these changes are likely consequential for lower-income and minority women, there is scant evidence on how the MW affects their reproductive and maternal health. Moreover, as the labor market impacts of MW are not uniform across populations, assessing potential heterogeneity is critical for quantifying effects on maternal health disparities. The overall objective of this project is to assess how state MW policies affect maternal health, as well potentially important intermediate outcomes that may lie on the causal pathway. Our multidisciplinary team will leverage recent methodological advances in the quasi-experimental evaluation of staggered policy interventions to estimate causal effects of MW increases on SMM and other pregnancy- related outcomes. We will also explore important outcomes that represent potential intermediary mechanisms linking MW to maternal morbidity outcomes, including changes in household income and employment, health care coverage, health care utilization, health behaviors, and pre-pregnancy health outcomes. Finally, we will examine how the MW affects health care costs associated with pregnancy and delivery. Throughout, we will explore potential heterogeneous effects to better understand how MWs affect health disparities. This research addresses a critically important and potentially very impactful policy-relevant question that has significant implications for mothers, their children, and their families.

项目概要/摘要美国正在经历孕产妇健康危机，严重孕产妇发病率（SMM）很高和其他与怀孕有关的健康问题以及孕前健康状况的发生率上升。此外，结构性种族主义和歧视的遗留问题导致 SMM 中存在严重且持续的种族差异和其他不良孕产妇健康结果。除了对妇女健康的影响外，孕产妇发病率给家庭和社会带来巨大的成本负担。健康的社会决定因素发挥着重要作用在孕产妇保健方面，由于经济上处于不利地位的妇女获得护理的机会较少，接触机会增加健康风险以及怀孕前和怀孕期间较差的健康结果。但数量却非常有限了解旨在增加家庭收入的经济政策是否可以成为有效政策的一部分改善孕产妇健康和缩小差距的战略。研究人员估计，实施目前国会正在讨论，到 2025 年，联邦最低工资 (MW) 为 15 美元，这将提高 3200万工人的收入，使近400万人摆脱贫困。因为他们是妇女和有色人种在低工资工人中所占比例过高，因此可能会受益匪浅。这研究探讨了 MW 作为解决孕产妇健康危机的潜在强大工具的作用美国自 2009 年以来，联邦 MW 没有发生任何变化，许多州已率先实施自己的 MW MW 有所增加，有 30 个州的 MW 费率高于 2019 年联邦费率，而 2010 年只有 10 个州。尽管这些变化可能对低收入和少数族裔女性产生影响，但证据不足关于 MW 如何影响她们的生殖和孕产妇健康。此外，随着 MW 对劳动力市场的影响不同人群之间的差异并不统一，评估潜在的异质性对于量化影响至关重要孕产妇健康差异。该项目的总体目标是评估州兆瓦政策如何影响孕产妇健康，以及因果路径中可能存在的潜在重要中间结果。我们的多学科团队将利用最新的方法学进展进行准实验评估交错的政策干预措施来估计 MW 增加对 SMM 和其他妊娠的因果影响相关结果。我们还将探讨代表潜在中介机制的重要成果将 MW 与孕产妇发病结果联系起来，包括家庭收入和就业、健康的变化护理覆盖范围、医疗保健利用、健康行为和孕前健康结果。最后，我们将研究 MW 如何影响与怀孕和分娩相关的医疗保健费用。在整个过程中，我们将探索潜在的异质效应，以更好地了解 MW 如何影响健康差异。这项研究解决了一个极其重要且可能非常有影响力的政策相关问题，该问题具有重大意义对母亲、她们的孩子和她们的家庭的影响。