Antipoverty policies may hold promise as tools to improve health and reduce mortality rates among low-income Americans. We examined the health effects of the New York City Paycheck Plus randomized controlled trial. Paycheck Plus tests the impact of a potential fourfold increase in the Earned Income Tax Credit for low-income Americans without dependent children. Starting in 2015, Paycheck Plus offered 5,968 study participants a credit of up to $2,000 at tax time (treatment) or the standard credit of about $500 (control). Health-related quality of life and other outcomes for a representative subset of these participants (n = 3,289) were compared to those of a control group thirty-two months after randomization. The intervention had a modest positive effect on employment and earnings, particularly among women. It had no effect on health-related quality of life for the overall sample, but women realized significant improvements.

Anti-poverty policies have the potential to improve mental health. We conducted a randomized trial to investigate whether a fourfold increase in the Earned Income Tax Credit for low-income Americans without dependent children would reduce psychological distress relative to the current federal credit (Paycheck Plus, New York City site). Between 2013 and 2014, 5,968 participants were recruited; 2,997 were randomly assigned to the treatment group and 2,971 were assigned to the control group. Survey data were collected 32 months post-randomization (N=4,749). Eligibility for the program increased employment by 1.9 percentage points and after-bonus earnings by 6% ($635 per year) on average over the three years. Treatment was associated with a marginally statistically-significant decline in psychological distress relative to the control group (-0.30 points; 95% CI, -0.63 to 0.03; p=0.076). Women in the treated group experienced a half-a-point reduction in psychological distress (-0.55; 95% CI, -0.97 to -0.13; p=0.032) and noncustodial parents reported a 1.36 point reduction (95% CI, -2.24 to -0.49; p = 0.011) in psychological distress. An expansion of a large anti-poverty program to individuals without dependent children reduced psychological distress for women and noncustodial parents – the groups who benefitted the most in terms of increased after-bonus earnings.