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The Earned Income Tax Credit (EITC) is the largest anti-poverty program in the U.S. In 1993, the EITC benefit levels were changed significantly based on the number of children in the family such that families with two or more children experienced an exogenous expansion in their incomes. Using data from the National Longitudinal Survey of Youth 1979...
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... difference was first created as part of the Omnibus Reconciliation Act of 1990, but on a much smaller scale. Because of this policy change, the maximum benefits for families with two or more children more than doubled and for the first time a meaningful separation was created for eligible families based on the number of children as reported in Table 1. 5 The credit has three parameters that policymakers can manipulate: the credit rate (column 1), the maximum amount of the credit (column 2) and the phase out rate/range (columns 3, 4 and 5). ...
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... of this policy change, the maximum benefits for families with two or more children more than doubled and for the first time a meaningful separation was created for eligible families based on the number of children as reported in Table 1. 5 The credit has three parameters that policymakers can manipulate: the credit rate (column 1), the maximum amount of the credit (column 2) and the phase out rate/range (columns 3, 4 and 5). As is clear from Table 1, back in 1991, the difference in maximum benefits between families with one child and families with two or more children was less than $40. In 1996, however, this difference jumped to over $1,400. ...
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... It could also instructive to look at some raw numbers describing smoking behavior before and after the EITC expansion for the control and treatment groups by race. Appendix Table 1, providing columns show the DD+FE results using the linear probability model. 14 For all the columns in Table 5, we use the binary dependent variable which equals 1 if the mother smokes at the time of interview and 0 if not. ...
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... Table 1, providing columns show the DD+FE results using the linear probability model. 14 For all the columns in Table 5, we use the binary dependent variable which equals 1 if the mother smokes at the time of interview and 0 if not. The shared set of covariates includes age, education, Hispanic or not, currently married or not, living in an urban area, residential state, family income, a dummy variable equal to one if family income missing 15 , state level cigarette taxes, AFDC maximum benefit level, and unemployment rate, and number of children in the household. ...
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... therefore estimate our model excluding all the mothers who changed their marital status between 1992 and 1998. Results are robust and shown in Table 10. Some of the other robustness checks we conduct are: excluding state dummy variables, excluding variables controlling for state-level differences in labor market conditions, welfare reforms, and smoking policies, and changing the functional forms for some of the independent variables such as age, education, and marital status. ...
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... Although not unequivocal Hamad & Rehkopf, 2015;Pega et al., 2013;Wehby et al., 2020), research suggests that smoking, at least, may decrease with cash transfers (Averett & Wang, 2012;Cowan & Tefft, 2012;Fu & Liu, 2019;Hoynes et al., 2015;Rehkopf et al., 2014;Strully et al., 2010). And fourth, poverty produces elevated levels of stress and reactivity to stress (Aneshensel, 1992;Kessler & Cleary, 1980;Pearlin, 1989;Thoits, 2010;Turner et al., 1995). ...
Research suggests that generous social welfare programs play a role in maternal and child health. However, most studies examine a single policy in isolation. Drawing from research documenting low-income families ‘packaging’ of social policies, we create a novel measure summarizing the value of a collection of income support policies for the working poor. This collection includes: the Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax Credit (EITC), the minimum wage, and the unemployment insurance (UI) program. Using U.S. state-level administrative data from 1996 to 2014, we estimate fixed effects regression models to examine the relationship between birth outcomes and income support policies (individually and combined). We find that increases in the combined value of the four income supports are significantly associated with reductions in preterm births and low birthweight births, but not infant mortality rates. States with the highest observed levels of combined income support had 14% fewer PTBs and 7% fewer LBWs than states with the lowest levels of income support. Of the four individual income support policies, only unemployment insurance has no significant independent effects. SNAP benefits have the largest and most consistent effects, reducing poor birth outcomes across all three indicators. An annual increase of $1000 in SNAP benefits is associated with a 3% decline in infant deaths, 5% decline in preterm births, and 2% decline in low birthweight births. These results suggest that increasing the generosity of income support policies may be a promising strategy for improving birth outcomes in the United States.
... The EITC improves economic outcomes (14,15), although the evidence for health has been mixed. Among adults, studies have shown reduced smoking and improved food security but increased obesity and worsened metabolic markers (16)(17)(18)(19). Among children, studies have shown improved birth weight and behavioral problems (20)(21)(22) but more very low birth weight and no effect on obesity (23,24). ...
The earned income tax credit (EITC) is the largest U.S. poverty alleviation program, yet few studies examine its effects on the health of recipients' children. We employed quasi-experimental techniques to test the hypothesis that EITC refund receipt is associated with short-term improvements in child health. The data set included children surveyed in the Third National Health and Nutrition Examination Survey (N=7,444). We employed a difference-in-differences approach, exploiting the seasonal nature of EITC refund receipt. We compared children of EITC-eligible families interviewed immediately after refund receipt (February-April) with those interviewed during other months (May-January), differencing out seasonal variation among non-EITC-eligible families. We examined outcomes that were likely to be affected immediately after refund receipt, including general health, nutrition, metabolic and inflammatory biomarkers, and test scores. There were improvements in physician-reported overall health after refund receipt, but no changes in infection, serum metabolic or inflammatory markers, or test scores, and contradictory findings for food insufficiency. In summary, EITC refunds are not strongly associated with most short-term health outcomes among recipients' children, although numerous previous studies have demonstrated impacts on longer-term outcomes. This highlights the importance of examining the effects of public policies on beneficiaries and their children using varying study designs.
... 16 We do not find an association between maternal smoking and EITC payment size, although prior work finds that payments are associated with reduced maternal smoking. 10,28,29 These differences may be due to differences in measurement of the exposure: one of these prior studies focused on the Scale is a measure of locus of control, Pearlin Scale is a measure of perceived control, Rosenberg Scale is a measure of self-esteem, AFQT is a measure of intelligence, and SF-12 is a measure of physical and mental health. ...
Economic interventions are increasingly recognised as a mechanism to address perinatal health outcomes among disadvantaged groups. In the US, the earned income tax credit (EITC) is the largest poverty alleviation programme. Little is known about its effects on perinatal health among recipients and their children. We exploit quasi-random variation in the size of EITC payments to examine the effects of income on perinatal health.
The study sample includes women surveyed in the 1979 National Longitudinal Survey of Youth (n = 2985) and their children born during 1986-2000 (n = 4683). Outcome variables include utilisation of prenatal and postnatal care, use of alcohol and tobacco during pregnancy, term birth, birthweight, and breast-feeding status. We first examine the health effects of both household income and EITC payment size using multivariable linear regressions. We then employ instrumental variables analysis to estimate the causal effect of income on perinatal health, using EITC payment size as an instrument for household income.
We find that EITC payment size is associated with better levels of several indicators of perinatal health. Instrumental variables analysis, however, does not reveal a causal association between household income and these health measures.
Our findings suggest that associations between income and perinatal health may be confounded by unobserved characteristics, but that EITC income improves perinatal health. Future studies should continue to explore the impacts of economic interventions on perinatal health outcomes, and investigate how different forms of income transfers may have different impacts.
© 2015 John Wiley & Sons Ltd.
... among low-educated mothers. Very recently, researchers have begun studying whether the EITC affects smoking behavior among low-income adults (Strully, Rehkopf, and Xuan, 2010;Averett and Wang, 2011). We discuss specific differences in our data and methodology in Section 2, but we mention here that our study is the first to use both national and state-level variation in EITC benefits combined with a large, nationally representative dataset with detailed annual smoking information to identify the effect of the EITC on the prevalence of female smoking. ...
We investigate the impact of Earned Income Tax Credit (EITC) expansions on the smoking behavior of women. The differential increases in federal EITC benefits by family size as part of the 1993 OBRA expansion allow for a comparison of smoking status changes between women with and without children and between mothers with one and more than one child. We exploit these changes in a difference-in-differences framework using data from the 1993-2001 waves of the Behavioral Risk Factor Surveillance System (BRFSS) to show that the increase in EITC benefits yielded a significant decline in the likelihood of smoking among unmarried women with less than a college degree. These results are also robust to an alternative measure of EITC expansion, specifically the maximum state-level EITC benefit (in dollars), which varies across states and over the full course of the sample time frame.
The earned income tax credit (EITC) is the largest U.S. poverty alleviation program for families with children, and state EITC policies provide a modest supplement to the federal program. Yet there are few studies of the effects of state EITC policies on population health. We examined whether state EITC policies affect mental health and health behaviors. Participants were drawn from the 1995-2015 waves of the Panel Study of Income Dynamics, a diverse national cohort study (N=10,567). We used a quasi-experimental difference-in-differences analysis to examine the effects of state EITC programs among eligible individuals, accounting for secular trends among similar individuals in non-EITC states. Outcomes included self-reported general health, psychological distress, alcohol use, and smoking. The average size of state EITC refunds in our sample was $265 for eligible individuals. In the overall sample, state EITC programs were not associated with any health outcomes of interest. This finding was robust to alternative specifications, and similar in subgroup analyses by gender and marital status. This study suggests that state EITC programs, which tend to provide smaller refunds than the federal program, may not be large enough to have a positive impact on mental health and health behaviors. These findings may inform policymaking related to the generosity of state EITC programs, especially as states seek to address the socioeconomic consequences of the COVID-19 pandemic.
Poverty has consistently been linked to poor mental health and risky health behaviors, yet few studies evaluate the effectiveness of programs and policies to address these outcomes by targeting poverty itself. We test the hypothesis that the earned income tax credit (EITC)—the largest U.S. poverty alleviation program—improves short-term mental health and health behaviors in the months immediately after income receipt. We conducted parallel analyses in two large longitudinal national data sets: the National Health Interview Survey (NHIS, 1997-2016, N=379,603) and the Panel Study of Income Dynamics (PSID, 1985-2015, N=29,808). Outcomes included self-rated health, psychological distress, tobacco use, and alcohol consumption. We employed difference-in-differences analysis, a quasi-experimental technique. We exploited seasonal variation in disbursement of the EITC, which is distributed as a tax refund every spring: we compared outcomes among EITC-eligible individuals interviewed immediately after refund receipt (Feb-Apr) with those interviewed in other months more distant from refund receipt (May-Jan), “differencing out” seasonal trends among non-eligible individuals. For most outcomes, we were unable to rule out the null hypothesis that there was no short-term effect of the EITC. Findings were cross-validated in both data sets. The exception was an increase in smoking in PSID, although this finding was not robust to sensitivity analyses. While we found no short-term “check effect” of the EITC on mental health and health behaviors, others have found long-term effects on these outcomes. This may be because recipients anticipate EITC receipt and smooth their income accordingly.
By improving two social determinants of health (poverty and unemployment) in low- and middle-income families on or at risk of welfare, in-work tax credit for families (IWTC) interventions could impact health status and outcomes in adults.
To assess the effects of IWTCs on health outcomes in working-age adults (18 to 64 years).
We searched 16 electronic academic databases, including the Cochrane Public Health Group Specialised Register, Cochrane Database of Systematic Reviews (The Cochrane Library 2012, Issue 7), MEDLINE and EMBASE, as well as six grey literature databases between July and September 2012 for records published between January 1980 and July 2012. We also searched key organisational websites, handsearched reference lists of included records and relevant journals, and contacted academic experts.
We included randomised and quasi-randomised controlled trials and cohort, controlled before-and-after (CBA) and interrupted time series (ITS) studies of IWTCs in working-age adults. Included primary outcomes were: self rated general health; mental health/psychological distress; mental illness; overweight/obesity; alcohol use and tobacco use.
Two review authors independently extracted data and assessed the risk of bias in included studies. We contacted study authors to obtain missing information.
Five studies (one CBA and four ITS) comprising a total of 5,677,383 participants (all women) fulfilled the inclusion criteria and were synthesised narratively. The in-work tax credit intervention assessed in all included studies is the permanent Earned Income Tax Credit in the United States, established in 1975. This intervention distributed nearly USD 62 billion to over 27 million individuals in 2011, and its administration costs were less than one per cent of its total costs. All included studies carried a high risk of bias (especially from confounding and insufficient control for underlying time trends). Due to the small number of (observational) studies and their high risk of bias, we judged this body of evidence to have very low overall quality.One study found that IWTC had no detectable effect on self rated general health and mental health/psychological distress five years after its implementation (i.e. a considerable change in the generosity of the permanent IWTC) and on overweight/obesity eight years after implementation. One study found no effect of IWTC on tobacco use five years after implementation, one a moderate reduction in tobacco use one year after implementation (odds ratio 0.95, 95% confidence interval (CI) 0.94 to 0.96), and one differential effects, with no effect in African-Americans and a large reduction in European-Americans two years after implementation (risk difference -11.1%, 95% CI -20.9% to -1.3%). No evidence was available for the effect of IWTC on mental illness and alcohol use. No adverse effects of IWTC were identified.One study also found no detectable effect of IWTC on the number of bad physical health days and of risky biomarkers for inflammation, cardiovascular disease and metabolic conditions eight years after implementation. One study found that IWTC had a large, positive effect on income from wages or salaries one year after implementation. Two studies found no effect on employment two and five years after implementation, whereas two found a moderate increase five and eight years after implementation and one a large increase in employment due to IWTC one year after implementation.No differences in outcomes between groups with different educational status were found for self rated health and mental health/psychological distress. In one study European-American women with lower levels of education were more likely to reduce tobacco use, while tobacco use did not change among African-American women with lower levels of education. However, no differences in tobacco use by educational status were observed in a second study. Two studies found that the intervention may have reduced inequity with respect to employment, where women with less education were more likely to move into employment (although one did not establish whether this difference was statistically significant), while two studies found no such difference and no studies found differences by ethnic group on employment rates.
In summary, the small and methodologically limited existing body of evidence with a high risk of bias provides no evidence for an effect of in-work tax credit for families interventions on health status (except for mixed evidence for tobacco smoking) in adults.
