Effect of EITC on Biological Markers of Aging, Health and Mortality (PaycheckPlus)

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

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.

Study Overview

• Status: Completed
• Conditions: Poverty; Tax Policy
• Intervention / Treatment: Other: Paycheck Plus

Detailed Description

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).

• Study Type: Interventional
• Enrollment (Actual): 1350
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Georgia
    • Atlanta, Georgia, United States, 30303
      • Westat

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. a US resident
2. Filed taxes
3. Earned <$30,000 in the previous year
4. Aged 21-64
5. Have a Social Security number

Exclusion Criteria:

1. Eligible for Supplemental Security Income or Social Security Disability Insurance
2. Married
3. Have dependent children

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

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

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Columbia University
• Collaborators: National Institute on Aging (NIA); MDRC
• Investigators: Principal Investigator: Peter Muennig, MD, Columbia University

Study record dates

Study Major Dates

• Study Start (Actual): December 20, 2016
• Primary Completion (Actual): December 31, 2021
• Study Completion (Actual): December 31, 2021

Study Registration Dates

• First Submitted: July 18, 2017
• First Submitted That Met QC Criteria: July 20, 2017
• First Posted (Actual): July 21, 2017

Study Record Updates

• Last Update Posted (Actual): April 6, 2022
• Last Update Submitted That Met QC Criteria: April 4, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: Earned Income Tax Credit (EITC); Tax Credit; Paycheck Plus
• Other Study ID Numbers: AAAQ9663 (ADD-ON); R01AG054466 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: To protect participant privacy we cannot share our data

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No