A powerful prescription for better public health: raise the minimum wage

by Rajiv Bhatia, M.D.

Over the past three decades, real wages for low-income workers in the United States have either stagnated or declined. The federal minimum wage is intended to maintain a decent standard of living, but has fallen woefully behind. The current federal minimum of $7.25 an hour is now worth less than it was in 1968.

Evidence from decades of research has convinced many public health professionals that there is no single factor more important to healthy living than a minimum standard of income and no single factor more harmful to health than persistent poverty. Income affects health not only through one’s ability to meet material needs, but also through access to health care, the quality of neighborhoods in which people can afford to live, child health and development, chronic stress, and interpersonal relationships.

Armed with this knowledge, health professionals should be at the forefront of campaigns for raising the minimum wage.

Dr. Edward P. Ehlinger, commissioner of the Minnesota Department of Health, wrote in a recent commentary:

When people think about minimum wage, they most often think about the impact on their bank account and their job. But policies that impact employment and income are actually about health – the health of individuals, families and communities.

Legislation currently in Congress would raise the current federal minimum to $10.10 an hour and then index it to the Consumer Price Index. A $10.10 minimum wage would benefit about 16.5 million workers and raise almost 1 million people over the federal poverty line.

Not waiting for Congress, states are also taking or considering action. In 2014, legislatures in 34 states have proposed increases to the state minimum wage. Connecticut, Delaware, Hawaii, Maryland, Michigan, Minnesota, and West Virginia and the District of Columbia have already enacted increases.

In May, Human Impact Partners and the Health Officers Association of California released Health Impacts of Raising California's Minimum Wage, intended to inform the consideration of legislation that would raise the state’s minimum wage to $13 an hour by 2017.

Our most dramatic finding is that a $13 minimum wage would avert an estimated 389 premature deaths of low-income Californians a year. An analysis of the California Health Interview Survey, the nation’s largest health survey, also found:

• Californians in families whose income increased as a result of the higher minimum wage would be more likely to be born healthier, develop stronger bodies and brains, and suffer from fewer chronic diseases as adults and into old age.
• Fewer Californians would live in poverty, ensuring that they would get enough to eat. Fewer would be forced to live in the unhealthy environments of substandard housing and poor neighborhoods. More Californians would have adequate health care and access to health insurance.
• More of California's children would be well prepared for school and achieve more in school, which in itself leads to healthier adult lives. Children would miss fewer school days.
• Fewer people would smoke. In California, adults in families in poverty are 50% more likely to smoke than those in families earning more than three times the poverty level.
• More would exercise regularly and fewer would be obese or overweight. In California, teens in families living below the poverty level are 2.5 times as likely to be overweight or obese as teens in families whose incomes are at least three times the poverty level.
• Fewer Californians would suffer from emotional and psychological problems, such as depression and poor self-esteem. Families who live in poverty are over twice as likely to face serious psychological distress and to suffer from family life impairment as those in higher income families.

A decent standard of living is a powerful prescription for public health. The voices of the health community can help get this prescription filled.

Rajiv Bhatia, M.D., is a founder and board member of Human Impact Partners, an Oakland, Calif., nonprofit that studies the health and equity impacts of public policy. He is the former director of environmental health for the City and County of San Francisco and currently a visiting scholar at the University of California at Berkeley.