AMA adopts new policy linking poverty-level wages to health problems

CHICAGO — With one in 10 people in the United States living in poverty and with many working people unable to afford the essentials they need to stay healthy, the American Medical Association (AMA) today adopted a policy at the annual meeting of its House of Delegates affirming that poverty is detrimental to health and advocating for federal, state and local minimum wage policies that include plans to adjust wage levels in the future to keep pace with inflation.

The AMA also affirmed that minimum wage policies should be consistent with the AMA principle that the highest attainable standard of health is a fundamental human right and that optimizing the social determinants of health is an ethical obligation of civil society.

“Put simply, reducing poverty improves health,” said David H. Aizuss, MD, AMA Trustee. “The COVID-19 pandemic has created a simultaneous economic and public health crisis that has exposed and exacerbated access to care and other social inequalities. Not only has the pandemic had a disproportionate impact on minority and marginalized communities, but economic insecurity, housing insecurity and food insecurity have weighed disproportionately on communities of color and other historically marginalized populations – all of which underscores with startling relief that low-income people have poorer health outcomes Too many people are working full-time jobs – sometimes more than one job – and are unable to exceed poverty wages This needs to change.

The current federal minimum wage of $7.25 per hour translates to an annual wage of $15,080, if you work 40 hours per week for all 52 weeks of the year. Workers trying to support a family on the federal minimum wage are eligible for federal poverty assistance. Currently, full-time work at the federal minimum wage rate is insufficient for a single parent to support a single child above the federal poverty level, but in 1968 the federal minimum wage was sufficient to maintain a family of three out of poverty. Moreover, the decline in the value of the minimum wage has proven to be the primary driver of growing inequality between low-wage and middle-wage workers since the late 1970s. In contrast, a federal minimum wage of 15 dollars an hour is expected to increase the family income of 14.4 million children, nearly one-fifth of all American children.

Poverty exacerbates health inequalities because women and people from racial and ethnic groups are more likely to earn low wages. Black and Hispanic individuals and families are specifically disproportionately represented among minimum wage workers. In addition, studies have shown that populations with high and growing income inequality are associated with shorter life expectancy, higher rates of infant mortality, obesity, mental illness, homicide, and other measures in relation to populations whose distribution of income is more equitable. A large body of research on wages, incomes and health shows that policy interventions aimed at increasing the incomes of low-income populations will improve both economic measures (increased income equality and economic security) and health measures (lower mortality rates, improved health status, reduced health inequalities and reduced overall health care costs).

About 88% of minimum wage workers in the United States are over the age of 20, and the average age is 35.7. Based on 2019 data, about 48% of people earning at or below the federal minimum wage have a college education, nearly 67% are women, and about 45% work full-time. Most workers are in restaurant occupations (55%), with many others working in sales and related occupations (8.5%) or personal care and services (6.6%). About 28% of low-wage workers have children, putting many children at risk of living in poverty. The researchers estimated that there would be 2,790 fewer low birth weight births and 518 fewer post-neonatal deaths per year if all states increased the minimum wage by one dollar.

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