Effect of EITC on Biological Markers of Aging, Health and Mortality

Study Overview
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Brief Summary
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Paycheck Plus (PP) is a randomized controlled experiment (RCT) that explores the health and longevity effects associated with increasing the Earned Income Tax Credit (EITC). EITC is a national program that provides tax credits to low-income, disproportionately minority workers who file taxes. EITC is politically popular, having received bipartisan support. The EITC, along with state supplemental programs, have 7 million American families out of poverty. The investigators' preliminary data analyses show that the EITC has had large population health impacts, reversing declines in self rated health and survival among the poorest Americans.

Detailed Description
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Poverty disproportionately impacts minority and rural populations and is very strongly correlated with poor health over the life cycle, and has been hypothesized to lead to a shorter, less healthy aging process. Poverty is associated with a greater burden of disease than smoking and obesity combined and accounts for the bulk of health disparities by race. It is widely believed that an antipoverty policy, such as Earned Income Tax Credit (EITC), could improve healthy aging among working-age low-income adults over the life cycle. It does so by increasing material hardship and psychological stress, two risk factors that are strongly correlated with biological markers of premature aging (e.g., shorter telomeres, higher cholesterol levels, and higher blood pressure).

Official Title
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An Experimental Investigation Into the Impact of Socioeconomic Context on Biological Markers of Aging, Health and Mortality

Conditions
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Poverty, Tax Policy

Intervention / Treatment
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* Other: Paycheck Plus


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a US resident Filed taxes Earned <$30,000 in the previous year Aged 21-64 Have a Social Security number Exclusion Criteria: Eligible for Supplemental Security Income or Social Security Disability Insurance Married Have dependent children

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Controlled Trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental<br>Paycheck Plus: Participants will receive four times the standard Earned Income Tax Credit after filing their annual taxes | Other: Paycheck Plus<br>* A four-fold increase in the Earned Income Tax Credit<br>|
| No Intervention: Control<br>Control participants will receive the standard Earned Income Tax Credit after filing their annual taxes | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Score on the Patient Health Questionnaire-9 (PHQ-9) | Depression will be measured using the subject's score on the PHQ-9. | 4 Years | 
| EuroQol 5D5L | Health-related quality of life | 4 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Body Mass Index (BMI) | A measure of obesity | 2 Years | 
| Telomere length | Telomere length is a measure of biological age | 4 years | 
| Mortality | We will link records to National Death Index for future study | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Earned Income Tax Credit (EITC), Tax Credit, Paycheck Plus