AJPH April 2016 Highlights

Date: Apr 14 2016

AJPH Research: Effects of raising the minimum wage in NYC, medical debt among older adults, improving school food quality

CONTACT: For copies of articles or full table of contents of an issue, contact Mandi Yohn at via email or at 202-777-2509.

American Journal of Public Health highlights:

1. Higher minimum wage in New York City could substantially reduce premature deaths

2. Older African Americans have more medical debt than older whites

3. Majority of food and beverages meet nutrition standards in Massachusetts middle and high schools

Higher minimum wage in New York City could substantially reduce premature deaths

Raising the minimum wage to $15 per hour in New York City could have averted up to 5,500 premature deaths between 2008 and 2012, according to a new study in the American Journal of Public Health.

Researchers with the New York City Department of Health and Mental Hygiene used the 2008-2012 American Community Survey to assess how the proportion of low-income residents in each New York City neighborhood might change with a hypothetical $15 minimum wage. Then, based on data on the deaths of New Yorkers, they determined the potential reductions in the levels of premature mortality as predicted by the changes in the proportions of low income residents resulting from a hypothetical $15 minimum wage.  

Analysis suggested that a minimum wage increase to $15 per hour would have reduced premature deaths by as many as 5,500 deaths over five years. Even if wage increases led to modest job losses, as many as 2,800 deaths could have been averted in this period. Further, with a $15 minimum wage more than 1 million low-income residents might see an average $10,000 per year boost in family income and about 400,000 could move up from below 200 percent of the federal poverty level.

“As research on income and health consistently demonstrates that lower income and poverty are associated with worse health outcomes and earlier death, the recent national advocacy across the United States to raise the minimum wage as a way of improving the income of the working poor could also have important health consequences,” the authors explain. “Recent legislation has established a $15 per hour minimum wage in several states and municipalities. This analysis adds to a growing body of work by health departments to resurrect the centrality of minimum wages to population health.”

[“Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15.” Contact: Tsu-Yu Tsao, PhD, Office of Policy, Planning and Strategic Data Use, New York City Department of Health and Mental Hygiene, New York, New York.]

Older African Americans have more medical debt than older whites

According to new research in the American Journal of Public Health, older African American adults incur substantially more medical debt compared to older whites.

Researchers examined nationally representative data from the 2007 and 2010 U.S. Health Tracking Household Survey — which collected information on access to care, health care experiences, health expenses and bills, insurance coverage, health status and socioeconomic characteristics — and created population-based estimates of medical debt attributable to economic and health factors. The sample included non-Hispanic whites and African Americans ages 65 and older.

Results showed that African American adults were more than 2 times more likely to have medical debt than whites. Health status, income and insurance accounted for more than 40 percent of the racial and ethnic disparity in debt. African Americans were also more likely to be contacted by a collection agency and to borrow money because of medical debt, while whites were more likely to use savings to pay off medical bills.

“As out-of-pocket expenses continue to rise and older adults face the prospect of shrinking income, medical debt represents a major threat to the economic security of older African Americans,” the authors explain. “Understanding the racial and ethnic disparities in medical debt and financial consequences may inform policy on health care affordability for a large and growing proportion of our aging population.”

[“Medical Debt and Related Financial Consequences Among Older African American and White Adults.” Contact: Jacqueline Wiltshire, PhD, Department of Health Policy and Management, University of South Florida College of Public Health, Tampa, Florida.]

Majority of food and beverages meet nutrition standards in Massachusetts middle and high schools

According to a new study in the American Journal of Public Health, the majority of competitive foods and beverages — items sold in à la carte lines, vending machines and school stores that “compete” with standard school meals — in Massachusetts middle and high schools are now compliant with state nutrition standards. The improvement follows implementation of a statewide nutrition law in 2012.

Researchers collected data through direct observation of competitive foods and beverages in 36 Massachusetts school districts and seven control state districts to determine availability and compliance with the law at baseline, one year and two years after it was implemented. They examined trends in availability of prepackaged foods and beverages and their alignment with new state nutrition standards over time.

Results showed that by 2014, 60 percent of competitive foods and 79 percent of competitive beverages were compliant with the nutrition law. Models showed an overall 46 percentage point increase in schools’ alignment with updated standards from 2012 to 2014 for both foods and beverages. While the law’s implementation resulted in major improvements in the availability and nutritional quality of competitive foods and beverages, schools have still not reached the goal of 100 percent compliance.

“This Massachusetts law closely mirrors the U.S. Department of Agriculture Smart Snacks in School standards, which set federal standards for competitive foods and beverages. Nationally, schools are provided with compliance tools and additional technical assistance by USDA to help meet new standards, as well as a longer phased-in implementation period,” the authors explain. “This data suggests that implementing policies with strict nutrition criteria are feasible, and schools may experience both challenges and major improvements in compliance with new standards over time.”

[“Impact of Nutrition Standards on Competitive Food Quality in Massachusetts Middle and High Schools,” Contact: Mary Gorski, ScM, Interfaculty Initiative in Health Policy, Harvard University, Cambridge, Massachusetts.]

Find a full list of research papers published online on April 14, 2016, at 4 p.m. EDT below:

  • Demographic, Insurance, and Health Characteristics of Newly Enrolled HIV-Positive Patients After Implementation of the Affordable Care Act in California
  • Racial and Social Disparities in Bystander Support During Medical Emergencies on US Streets
  • Diffusion of Pharmacy-Based Influenza Vaccination Over Time in the United States
  • Diffusion of an Evidence-Based Smoking Cessation Intervention Through Facebook: A Randomized Controlled Trial
  • Social Support, Sexual Violence, and Transactional Sex Among Female Transnational Migrants to South Africa
  • Educational Interventions to Promote Healthy Nutrition and Physical Activity Among Older Chinese Americans: A Cluster-Randomized Trial
  • Efficacy of a Computerized Intervention on HIV and Intimate Partner Violence Among Substance-Using Women in Community Corrections: A Randomized Controlled Trial
  • Trends Over 4 Decades in Disability-Free Life Expectancy in the United States
  • Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom
  • Birth Cohorts Analysis of Adolescent Cigarette Smoking and Subsequent Marijuana and Cocaine Use
  • A Novel Indicator of Life-Course Smoking Prevalence in the United States Combining Popularity, Duration, Quantity, and Quality of Smoking
  • Sexual Risk Behaviors and Substance Use Among Men Sexually Victimized by Women
  • Medical Debt and Related Financial Consequences Among Older African American and White Adults
  • Impact of Nutrition Standards on Competitive Food Quality in Massachusetts Middle and High Schools
  • Impact of Text Message Reminders on Caregivers’ Adherence to a Home Fortification Program Against Child Anemia in Rural Western China: A Cluster-Randomized Controlled Trial
  • Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly
  • Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15

The articles above will be published online April 14, 2016, at 4 p.m. EDT by the American Journal of Public Health under “First Look.” “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, and is available at www.ajph.org.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Mandi Yohn at APHA, 202-777-2509, or email her. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions department. If you are not a member of the press, a member of APHA or a subscriber, online single issue access is $30 and online single article access is $22 at www.ajph.org or for direct customer service, call 202-777-2516, or email.

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The American Journal of Public Health is the monthly journal of the American Public Health Association. APHA champions the health of all people and all communities by strengthening the profession of public health, sharing the latest research and information, promoting best practices and advocating for public health issue and policies grounded in research. More information is available at www.apha.org.