A natural experiment evaluating the effect of a minimum wage increase on obesity and diet-related outcome

最低工资法越来越被认为是一种可能的政策杠杆， 人口健康和健康公平，有可能在地方、州和国家各级实施。 2017年6月30日，明尼苏达州明尼阿波利斯市成为第40个将最低工资标准设定在 国家一级。到2022年7月1日，该市将逐步将最低工资提高到每小时15美元。 员工超过100人的公司;在此期间，小型公司的最低工资将增加到13.50美元 期该条例预计将增加可能受影响的71，000名工人的工资， 非西班牙裔黑人和西班牙裔工人比例过高。现有证据表明， 工资法可能与一系列健康结果有关。这包括肥胖，因为增加工资可以 改善粮食安全，减少购买更健康食品的成本限制。然而，现有研究 将工资和体重联系起来的设计缺陷限制了因果推理和识别因果关系的能力 机制等本研究采用前瞻性准实验设计，具有较强的反事实性 条件，是下一步测试是否以及如何提高最低工资导致改善 低收入工人中与肥胖相关的结果。在整个4.5年的执行过程中， 明尼阿波利斯最低工资条例，我们将遵循低工资工人（那些收入低于 在一个自然实验中，使用差异中的差异设计来比较一组 在明尼阿波利斯的一组低工资工人（n = 400）和一个类似的工人中， 匹配对照社区（n = 400），罗利，NC。控制城市有全州范围的优先购买法， 禁止提高当地最低工资。将在基线（T0）和之后收集所有个体的测量值 到2022年6月的5次工资递增（T1-T5）。这项研究旨在测试在变化的差异， 两种情况下个体之间的体重指数（BMI，主要结局）， 人体测量身高体重。我们还将测试这两种情况下变化的差异 一系列与营养相关的结果，包括购买更健康和不太健康的食物（通过 粮食购买收据），粮食不安全（由6项美国农业部措施衡量），以及参与 政府粮食援助方案（通过参与者调查衡量）。最后，我们将测试其他行为 以及工资可能影响肥胖的心理社会机制，并探讨 与家庭健康相关的费用。最低工资法是一种潜在的上游方法， 预防肥胖，这些政策可能是唯一的定位，以减少健康差距，因为他们 对健康状况不佳风险最高的人群（低收入、高种族/少数民族）进行干预。这 自然实验提供了一个时间敏感的机会，以测试政策效果，并有助于罕见的健康导向 这是围绕经济政策影响的国家话语的视角。

Minimum wage laws are increasingly being recognized as a possible policy lever for improving population health and health equity, with the potential for implementation at the local, state, and national levels. On June 30, 2017, Minneapolis, Minnesota became the 40th local jurisdiction to set the minimum wage above the state level. The city will incrementally increase the minimum wage to $15 an hour by July 1, 2022 for all firms with greater than 100 employees; minimum wage in smaller firms will increase to $13.50 during this time period. The ordinance is expected to increase wages among the 71,000 workers likely to be affected, who are disproportionately non-Hispanic black and Hispanic workers. The available evidence suggests that minimum wage laws may be associated with a range of health outcomes. This includes obesity, as increasing wages can improve food security and reduce cost constraints for purchasing healthier foods. However, existing studies linking wages and weight have design weaknesses that limit causal inference and the ability to identify causal mechanisms. This study, which has a prospective quasi-experimental design with a strong counterfactual condition, is the next step for testing whether and how an increase in minimum wage results in improved obesity-related outcomes among low-wage workers. Throughout the 4.5-year implementation of the Minneapolis minimum wage ordinance, we will follow a cohort of low-wage workers (those earning less than $10 an hour at baseline) in a natural experiment, using a difference-in-difference design to compare a panel of obesity-related measures in a cohort of low-wage workers in Minneapolis (n = 400) and similar workers in a matched control community (n = 400), Raleigh, NC. The control city has a statewide preemption law which prohibits local minimum wage increases. Measures for all individuals will be collected at baseline (T0) and after 5 incremental wage increases (T1-T5) through June 2022. The study aims to test the difference in change in body mass index (BMI, the primary outcome) between individuals in the two conditions, as assessed by anthropometric height-weight measurements. We will also test the difference in change in the two conditions for a range of nutrition-related outcomes, including purchases of healthier and less healthy foods (measured by food purchase receipts), food insecurity (measured by a 6-item USDA measure), and participation in government food assistance programs (measured by participant survey). Finally, we will test other behavioral and psychosocial mechanisms through which wages might affect obesity, and explore spending changes in household health-related expenses over time. Minimum wage laws are a potential upstream approach to prevent obesity, and these policies may be uniquely positioned to reduce health disparities because they intervene on a population (lower-income, high racial/ethnic minority) at the highest risk for poor health. This natural experiment offers a time-sensitive opportunity to test policy effects and contribute a rare health-oriented perspective to the national discourse around the effects of an economic policy.