Background Social welfare policies such as the minimum wage can affect population health, though the impact may differ by the level of unemployment experienced by society at a given time.
Methods We ran difference-in-differences models using monthly data from all 50 states and Washington, DC from 1990 to 2015. We used educational attainment to define treatment and control groups. The exposure was the difference between state and federal minimum wage in US$2015, defined both by the date the state law became effective and lagged by 1 year. Models included state and year fixed effects, and additional state-level covariates to account for state-specific time-varying confounding. We assessed effect modification by the state-level unemployment rate, and estimated predicted suicide counts under different minimum wage scenarios.
Results The effect of a US$1 increase in the minimum wage ranged from a 3.4% decrease (95% CI 0.4 to 6.4) to a 5.9% decrease (95% CI 1.4 to 10.2) in the suicide rate among adults aged 18–64 years with a high school education or less. We detected significant effect modification by unemployment rate, with the largest effects of minimum wage on reducing suicides observed at higher unemployment levels.
Conclusion Minimum wage increases appear to reduce the suicide rate among those with a high school education or less, and may reduce disparities between socioeconomic groups. Effects appear greatest during periods of high unemployment.
- mental health
- social epidemiology
- health inequalities
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Contributors JAK wrote the majority of the manuscript, performed part of the analysis and performed part of the literature search. LKS-H performed part of the literature search and contributed to writing the introduction and discussion. KAK provided significant guidance on the study design and manuscript, and provided subject area expertise. MDL provided significant guidance on the study design and analysis, performed part of the analysis, contributed to writing the methods and results and prepared the data. All authors agreed on the content of the final submitted manuscript.
Funding The National Institute on Minority Health and Health Disparities, National Institutes of Health supported this work (award R01MD010241).
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available.
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