Article

Study Identifies Inverse Relationship Between Minimum Wage, HIV Diagnoses Among Black Men, Women

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Metropolitan areas with a minimum wage that was $1 higher at baseline had a 27.12% lower rate of newly diagnosed HIV cases among black residents.

Studying the impact of minimum wage laws on public health outcomes, researchers have determined that there is an inverse relationship between baseline state minimum wages and rates of newly diagnosed HIV cases among heterosexual black residents in metropolitan areas.

While black people represent 12% of US residents, they account for approximately 40% of people living with HIV. And while black men who have sex with men account for the majority of these HIV diagnoses, 34% of infections diagnosed in 2015 among black residents were attributed to heterosexual contact. According to CDC data, if these trends persist, about 1 in 20 black men and 1 in 48 black women will contract HIV in their lifetime.

“Researchers using a social-economic framework to investigate determinants of HIV-related outcomes have shown that individual behaviors cannot fully account for greater vulnerabilities to HIV experienced by heterosexual black adults and adolescents,” wrote the study researchers. “Rather, the social, economic, and political contexts in which people are born, live, and work shape the disparate distribution of HIV across racial/ethnic groups.”

To date, research on the impact of minimum wage increases and health has produced mixed conclusions, with most studies showing improvements, some suggesting adverse impacts, and others showing either insignificant or mixed effects on various health indicators among different study populations. However, no study has assessed the impact on HIV outcomes.

Filling this gap, researchers examined the relationship between state minimum wage laws and rates of HIV diagnoses among heterosexual black residents of 73 US metropolitan areas from 2008 to 2015. They used hierarchical linear modeling to determine whether state-level variations in minimum wage laws, adjusted for cost-of-living and inflation, were associated with these new diagnoses.

In 2007, the metropolitan area median minimum wage, adjusted for cost of living and inflation, was $7.01. That year, 16 metropolitan areas had an adjusted minimum wage below the federal level and 57 had a minimum wage above the federal minimum of $6.24. In 2014, 28 metropolitan areas had an adjusted minimum wage below the federal level and 45 had an adjusted minimum wage of above the federal minimum of $7.29.

In 2008, the median rate of newly diagnosed cases of HIV among black heterosexuals was 2.46 per 10,000 adults, and the median change in diagnoses over time was —1.06/10,000.

According to the researchers, there was an inverse, substantively significant association between baseline minimum wage and initial rates of HIV diagnoses among the patient population, with metropolitan areas in states with a minimum wage that was 1 standard deviation higher at baseline having rates of newly diagnosed HIV 0.42 lower.

Using a back transformation to calculate percent change in new HIV diagnoses per dollar change in minimum wage, the researchers found that the rate of newly diagnosed cases was 27.12% lower in metropolitan areas with a $1 higher minimum wage at baseline.

They also explored possible mediators to guide future analyses of pathways linking minimum wage and HIV. “We found that income inequality might mediate the relationship between minimum wage and rate of HIV diagnoses, but poverty rates among black households, unemployment rates among black adults, percent of residents on SNAP, and incarceration rates did not appear to do so,” they explained.

Reference:

Cloud D, Beane S, Adimora A, et al. State minimum wage laws and newly diagnosed cases of HIV among heterosexual black residents of US metropolitan areas [published online November 28, 2018]. SSM Popul Health. doi: 10.1016/j.ssmph.2018.100327.

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