· Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
I think policies regarding minimum wage provisions, although not intended to be health policies, would play an important role in reducing health disparities.
· Describe why an evaluation of that policy is informative (e.g., determining effects of the policy, or primarily a test of hypothesized mediators).
Evaluation of these policies is important because they increase the income level of the individuals and/or their families and therefore may give them access to more nutritional food and gyms/recreational centres. These policies also increase their financial security and reduce their psychological stress, which may lead to decreased smoking and better mental health outcomes.
· Specify the outcomes and populations you think most affected or least affected by the policy.
I think the population that would be the most affected by the policy would be those in the low socioeconomic strata who earn minimum wage, especially those who are the main providers for their families. The populations least affected by the policy would be the those who have high or middle socioeconomic status, who do not earn minimum wage. Among those affected, outcomes such as obesity, diabetes, mortality, smoking and stress levels could be studied.
· Propose a study design to evaluate the policy.
A longitudinal cohort study comparing the change in BMI (to assess obesity) among low-wage earners before and after the implementation of the minimum wage policy could be conducted. Alternatively, since minimum wage levels vary across states (i.e. many states have minimum wage set higher than the federal level of $7.25), a more time-effective method could be to compare the obesity rates between low-wage earners in states that have a minimum wage at the federal level only (eg. South Carolina) and low-wage earners in states that have implemented policies to increase minimum wage (eg. California at $11), but the issue of variability among the individuals is much higher in this type of study design.
Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.
The biggest challenge to implementing and drawing inference about the impact of minimum wage policies on health outcomes is that multiple other factors come into play regarding how this increase in income could translate to better health outcomes. For instance, the cost of living varies from state to state, whereby increasing the minimum wage in “expensive” states may still not be enough to see a substantial improvement in health outcomes and therefore their health disparities may still continue to be similar to “less expensive” states who are at federal minimum wage level. As such, it would be difficult to understand the true impact of the policy from such comparison studies. In addition, varying magnitudes of increases (eg. $1 vs. $3) may also affect health outcomes differently and the same conclusions should not be drawn for both.