wow-inequalities/02-data/intermediate/wos_sample/bed2f1dc7ae79dcc594f6b48b77b1c71-pega-frank-and-cart/info.yaml

abstract: 'Background

  By improving two social determinants of health (poverty and

  unemployment) in low-and middle-income families on or at risk of

  welfare, in-work tax credit for families (IWTC) interventions could

  impact health status and outcomes in adults.

  Objectives

  To assess the effects of IWTCs on health outcomes in working-age adults

  (18 to 64 years).

  Search methods

  We searched 16 electronic academic databases, including the Cochrane

  Public Health Group Specialised Register, Cochrane Database of

  Systematic Reviews (The Cochrane Library 2012, Issue 7), MEDLINE and

  EMBASE, as well as six grey literature databases between July and

  September 2012 for records published between January 1980 and July 2012.

  We also searched key organisational websites, handsearched reference

  lists of included records and relevant journals, and contacted academic

  experts.

  Selection criteria

  We included randomised and quasi-randomised controlled trials and

  cohort, controlled before-and-after (CBA) and interrupted time series

  (ITS) studies of IWTCs in working-age adults. Included primary outcomes

  were: self rated general health; mental health/psychological distress;

  mental illness; overweight/obesity; alcohol use and tobacco use.

  Data collection and analysis

  Two review authors independently extracted data and assessed the risk of

  bias in included studies. We contacted study authors to obtain missing

  information.

  Main results

  Five studies (one CBA and four ITS) comprising a total of 5,677,383

  participants (all women) fulfilled the inclusion criteria and were

  synthesised narratively. The in-work tax credit intervention assessed in

  all included studies is the permanent Earned Income Tax Credit in the

  United States, established in 1975. This intervention distributed nearly

  USD 62 billion to over 27 million individuals in 2011, and its

  administration costs were less than one per cent of its total costs. All

  included studies carried a high risk of bias (especially from

  confounding and insufficient control for underlying time trends). Due to

  the small number of (observational) studies and their high risk of bias,

  we judged this body of evidence to have very low overall quality.

  One study found that IWTC had no detectable effect on self rated general

  health and mental health/psychological distress five years after its

  implementation (i.e. a considerable change in the generosity of the

  permanent IWTC) and on overweight/obesity eight years after

  implementation. One study found no effect of IWTC on tobacco use five

  years after implementation, one a moderate reduction in tobacco use one

  year after implementation (odds ratio 0.95, 95\% confidence interval

  (CI) 0.94 to 0.96), and one differential effects, with no effect in

  African-Americans and a large reduction in European-Americans two years

  after implementation (risk difference -11.1\%, 95\% CI -20.9\% to

  -1.3\%). No evidence was available for the effect of IWTC on mental

  illness and alcohol use. No adverse effects of IWTC were identified. One

  study also found no detectable effect of IWTC on the number of bad

  physical health days and of risky biomarkers for inflammation,

  cardiovascular disease and metabolic conditions eight years after

  implementation.

  One study found that IWTC had a large, positive effect on income from

  wages or salaries one year after implementation. Two studies found no

  effect on employment two and five years after implementation, whereas

  two found a moderate increase five and eight years after implementation

  and one a large increase in employment due to IWTC one year after

  implementation.

  No differences in outcomes between groups with different educational

  status were found for self rated health and mental health/psychological

  distress. In one study European-American women with lower levels of

  education were more likely to reduce tobacco use, while tobacco use did

  not change among African-American women with lower levels of education.

  However, no differences in tobacco use by educational status were

  observed in a second study. Two studies found that the intervention may

  have reduced inequity with respect to employment, where women with less

  education were more likely to move into employment (although one did not

  establish whether this difference was statistically significant), while

  two studies found no such difference and no studies found differences by

  ethnic group on employment rates.

  Authors'' conclusions

  In summary, the small and methodologically limited existing body of

  evidence with a high risk of bias provides no evidence for an effect of

  in-work tax credit for families interventions on health status (except

  for mixed evidence for tobacco smoking) in adults.'
affiliation: 'Pega, F (Corresponding Author), Univ Otago, Dept Publ Hlth, Wellington,
  New Zealand.

  Pega, Frank; Carter, Kristie; Blakely, Tony, Univ Otago, Dept Publ Hlth, Wellington,
  New Zealand.

  Pega, Frank, Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA.

  Lucas, Patricia J., Univ Bristol, Sch Policy Studies, Bristol, Avon, England.'
article-number: CD009963
author: Pega, Frank and Carter, Kristie and Blakely, Tony and Lucas, Patricia J.
author-email: frank.pega@otago.ac.nz
author_list:
- family: Pega
  given: Frank
- family: Carter
  given: Kristie
- family: Blakely
  given: Tony
- family: Lucas
  given: Patricia J.
da: '2023-09-28'
doi: 10.1002/14651858.CD009963.pub2
eissn: 1361-6137
files: []
issn: 1469-493X
journal: COCHRANE DATABASE OF SYSTEMATIC REVIEWS
keywords-plus: 'SOCIAL-POLICY PROGRAMS; EMPLOYMENT CONDITIONS; INCOME; WELFARE;

  UNEMPLOYMENT; POVERTY; INEQUALITIES; BENEFITS; MOTHERS; PEOPLE'
language: English
number: '8'
number-of-cited-references: '88'
orcid-numbers: 'Blakely, Tony/0000-0002-6995-4369

  Lucas, Patricia Jane/0000-0002-0469-8085'
papis_id: 13d7a5334bb8d20be3c15a30386305a0
ref: Pega2013inworktax
researcherid-numbers: 'Lucas, Patricia/HNJ-0065-2023

  '
tags:
- review
times-cited: '40'
title: In-work tax credits for families and their impact on health status in adults
type: article
unique-id: WOS:000323928900036
usage-count-last-180-days: '1'
usage-count-since-2013: '6'
web-of-science-categories: Medicine, General \& Internal
year: '2013'