Association for Public Policy Analysis & Management

The prevalence of obesity, diabetes, and hypertension has grown steadily in the United States, but the burden of these chronic conditions have not been equally shouldered across all socioeconomic groups. Growing income and wage inequities since the 1970s have been linked to widening socioeconomic disparities in health. To counter worsening economic inequality, a large number of city, county, and state governments have adopted minimum wage rates above the federal minimum, the real value of which has been in decline since 1968. These laws could plausibly affect health outcomes of lower-paid workers through income, time, and behavioral mechanisms. Theory is ambiguous as to the likely direction of these effects because minimum wages can have countervailing effects on wages, hours, and income. In addition, the effects may differ by both gender and race because both low-paying jobs and health outcomes are stratified by these factors. The present study examined the association between state minimum wages from 2006 to 2013 and obesity, diabetes, and hypertension overall and by gender and race/ethnicity.

At the Northwest Federal Statistical Research Data Center, we accessed annual restricted National Health Interview Survey (NHIS) data linked to state-level measures of minimum wage policies, other related policies, and state economic conditions. We estimated the associations between effective state minimum wages (adjusted for inflation) and obesity, BMI, diabetes, and hypertension. Obesity was defined as a body mass index (BMI) of ≥30kg/m² based on self-reported height and weight data and was examined as a binomial indicator and continuous BMI. Diabetes and hypertension were defined as an affirmative response to a physician diagnosis. We used logistic and linear triple difference-in-differences (DDD) models, with the pseudo-treatment group defined as respondents with a high school diploma or less. We adjusted for individual age, gender, race/ethnicity, citizenship status, region of residence, urban versus rural residence, as well as state sales tax rate, unemployment, Earned Income Tax Credit and Supplemental Nutritional Assistance Program rules. Models were additionally adjusted for state and year fixed effects as well state linear time trends. Sub-group models were estimated by gender and race/ethnicity. Linearized standard errors were clustered by state.

We found no evidence of a relationship between minimum wages and obesity, BMI, hypertension, or diabetes for the general population of less-educated workers. However, there was a significant positive relationship between minimum wage, obesity, and BMI among non-white and Hispanic adults with a high school diploma or less. These results point to the importance of considering heterogeneous policy impacts of minimum wages in research and in policy discussions.