The association of minimum wage change on child nutritional status in LMICs: A quasi-experimental multi-country study^*

* NP and RS were involved in the conceptualisation of the paper, analysis, interpretation and drafting. AR was involved in the processing and analysis of the minimum wage data. AD and AN were involved in establishing the methodology for this paper as well as issues related to the Demographic Health Survey. JH contributed to the conceptualisation of the paper from the start to the completion of this paper, guided the process, and is co-investigator on MACHEquity research programme, which built the data set on minimum wage. LR also contributed to the conceptualisation and is also co-investigator on MACHEquity. All authors have contributed to writing and reviewing this paper.

ABSTRACT

There is recognition that social protection policies such as raising the minimum wage can favourably impact health, but little evidence links minimum wage increases to child health outcomes. We used multi-year data (2003–2012) on national minimum wages linked to individual-level data from the Demographic and Health Surveys (DHS) from 23 low- and middle-income countries (LMICs) that had least two DHS surveys to establish pre- and post-observation periods. Over a pre- and post-interval ranging from 4 to 8 years, we examined minimum wage growth and four nutritional status outcomes among children under 5 years: stunting, wasting, underweight, and anthropometric failure. Using a differences-in-differences framework with country and time-fixed effects, a 10% increase in minimum wage growth over time was associated with a 0.5 percentage point decline in stunting (−0.054, 95% CI (−0.084,−0.025)), and a 0.3 percentage point decline in failure (−0.031, 95% CI (−0.057,−0.005)). We did not observe statistically significant associations between minimum wage growth and underweight or wasting. We found similar results for the poorest households working in non-agricultural and non-professional jobs, where minimum wage growth may have the most leverage. Modest increases in minimum wage over a 4- to 8-year period might be effective in reducing child undernutrition in LMICs.

KEYWORDS:

• Minimum wage
• child
• undernutrition
• social protection policy
• stunting
• anthropometric failure

Acknowledgements

NP, Corresponding Author, affirms that the manuscript is an honest, accurate, and transparent account of the study being reported. No important aspects of the study have been omitted; there are no discrepancies from the study as planned.

The UCLA Office of Human Research Protection Program (UCLA OHRPP) determined this study, which uses secondary data analysis, did not meet the definition of human subjects research, defined by federal regulations for human subject protections (45 CFR 46.102(d) - http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.html#46.102). Therefore, neither certification of exemption from IRB review nor IRB approval of the study was required.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Ninez Ponce http://orcid.org/0000-0001-5151-6718

Riti Shimkhada http://orcid.org/0000-0002-5177-4853

Notes

* NP and RS were involved in the conceptualisation of the paper, analysis, interpretation and drafting. AR was involved in the processing and analysis of the minimum wage data. AD and AN were involved in establishing the methodology for this paper as well as issues related to the Demographic Health Survey. JH contributed to the conceptualisation of the paper from the start to the completion of this paper, guided the process, and is co-investigator on MACHEquity research programme, which built the data set on minimum wage. LR also contributed to the conceptualisation and is also co-investigator on MACHEquity. All authors have contributed to writing and reviewing this paper.

Additional information

Funding

Funding was received from the Canadian Institutes of Health Research (award ROH-115209, ‘Examining the Impact of Social Policies on Health Equity’) and the Bill and Melinda Gates Foundation [Grant OPP1107826 ‘Progress for Women and Girls; Gains and Gaps in Policies and Laws Promoting the Beijing Platform for Action’]. Additional support was received from the Canada Foundation for Innovation and the Hewlett Foundation [Grant 2016-3840 ‘Gender Equality and Economic Empowerment in 2030: A Data-Driven Approach to Advancing Evidence-Based Steps Critical to Achieving SDG5’] for the development of the policy database.