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Antipoverty policies have the potential to improve mental health. We conducted a randomized trial (Paycheck Plus Health Study Randomized Controlled Trial, New York, New York) to investigate whether a 4-fold increase in the Earned Income Tax Credit for low-income Americans without dependent children would reduce psychological distress relative to the current federal credit. Between 2013 and 2014, a total of 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 postrandomization (n  = 4,749). Eligibility for the program increased employment by 1.9 percentage points and after-bonus earnings by 6% ($635/year), on average, over the 3 years of the study. Treatment was associated with a marginally statistically significant decline in psychological distress, as measured by the 6-item Kessler Psychological Distress Scale, relative to the control group (score change = −0.30 points, 95% confidence interval (CI): −0.63, 0.03; P  = 0.072). Women in the treated group experienced a half-point reduction in psychological distress (score change = −0.55 points, 95% CI: −0.97, −0.13; P  = 0.032), and noncustodial parents had a 1.36-point reduction (95% CI: −2.24, −0.49; P  = 0.011). Expansion of a large antipoverty program to individuals without dependent children reduced psychological distress for women and noncustodial parents—the groups that benefitted the most in terms of increased after-bonus earnings. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]