Healthcare Assignment Paper on Public Health Policy

Public Health Policy

Part 1: Policy Assessment

A policy presented by the American Public Health Association in 2016 advocates for the improvement of public health by raising the minimum wage. The policy is founded on the background that health is a key determinant of economic growth. At the same time, the income level determines the access to quality healthcare facilities and services. The ability to access healthcare at individual level is strongly linked to access to finances. As the level of income reduces, the amount of disposable income reduces and with it goes the purchasing power of the citizens. The American Public Health Association (2016) describes the role that the federal and state governments have played this far in ensuring there is access to healthcare and concludes that a lot still has to be done in boosting the income of the citizens and subsequently enhancing access to healthcare facilities and services.

Various agencies have discussed the role of income on the healthcare indicator. For instance, poor health outcomes are linked to poverty, with reports that more than 13.5% of the U.S. population lives below or at the federal poverty level (Proctor, Semega, & Killar, 2016). At the same time, such low wage earners are in most cases the bread winners in their different families. The low earnings affect the health outcomes through causing the diminishing of purchasing power, working in jobs whereby they are not accorded sick leaves; having to deal with increased Consumer Price Index (CPI) and difficulty in accessing affordable and proper housing for their families (Landefeld et al., 2014). Such factors foster the growth of poor health outcomes, which cannot be addressed sustainably unless there is collaboration between different stakeholders. The stakeholders that may be involved in the implementation of the policy are many depending on the income provided by the public sector and the private businesses.

The state government is one of the public agencies affected by the minimum wage increase policy for improved public health. The federal and state governments play an important role when it comes to the implementation of the policy. The federal government provides a minimum wage for the entire country, while the state governments provide guidelines for the minimum wage in the different states. In the states where the minimum wage is lower than the federal minimum wage, it is expected that the rates of hourly pay would be limited compared to the other states. For instance, McBride (2014) describes the ban against minimum wage rise above federal level by the Oklahoma governor. Similarly, different rates are given by the U.S. department of Labor for different counties. If countries such as Kansas which have minimum wage rates lower than federal minimum wage level could improve their minimum wage, then the county would have more people gaining access to better healthcare (DeNavas- Walt & Proctor, 2014).

In line with the arguments of Mishel and Eisenbreg (2015), wage stagnation is one of the key economic challenges in the U.S. in the contemporary times. The U.S. department of Health and Human Services (2017) also reiterates that access to quality healthcare faces a barrier in the form of low wages due to lack of health insurance covers for the low wage earners, high costs of medical services and lack of access to the requisite health services. Because of such factors, the low-income earners often face unmet needs in the healthcare sector, delays in receiving the services of healthcare providers, and lack of preventive practices (Reich, Jacobs, & Bernhardt, 2014). The employers can change this by increasing the minimum wages of the workers or avoiding wage stagnation in the face of increasing CPI. They could also increase the benefits offered to low-income earners through practices such as providing sick-off opportunities, providing health insurance, and recommending cheap healthcare facilities (Hall & Cooper, 2012). Other players can also be deemed important in the subject of the minimum wage policy. For instance, the U.S. Department of Transportation (n.d) argues that housing and transportation are interrelated such that as people move further from the central business districts, they get more low-cost housing. However, what they save from the low-cost housing is consumed in the transportation costs.

Various entities including the national healthcare providers and organizations such as the CDC and the NHS can also be considered to be key stakeholders in the accomplishment of the policy. The American Public Health association (2016) provided one of its recommendations on the minimum wage increase as a way to improve health quality as the increment of funding to the agencies that support medical care provision to the low-income earners. According to the association, the CDC, NHS and other agencies if funded appropriately, and if they use the same agency to fund the healthcare cases across the country among the low-income earners, the impacts of the low income would be reduced significantly. The prerogative then lies with the different agencies to provide sustainable operation models to ensure that the funds provided are utilized efficiently to provide help to those who would not afford quality healthcare services in any other way. The capacity of the CDC to do this is undoubted as they also share the concern that is on funding (Baron et al., 2013). While the governments and healthcare providers present the business interests of the stakeholders, the patients, different funding agencies, and the American Public Health association present advocacy groups towards the implementation of the policy. The importance of this categorization is that it provides a leeway into how to approach the policy issue based on the expected intentions of the different players in the industry.

Most of the stakeholders have not provided their stance on the policy issue under discussion. However, the policy statement issued by the American Public Health Association states the roles of different stakeholders with respect to the policy in question. The American Public Health Association (2016) explains that expanding the minimum wage could be one of the most beneficial strategies in the public health sector. The rationale behind this argument is that increasing the minimum wage expands access to resources, enhances purchasing power of the patients and increases access to safe as well as affordable housing, transportation and safe neighborhoods (Klein & Rones, 2015). It also enhances the educational attainment of the workers and their family members. Komro et al. (2016) assert that the minimum wage limits in the country affect child mortality rates as well as birth weight. This is due to several factors similar to those described by the American Public Health Association. Based on this, the argument presented by the latter that expanding the minimum wage would enhance health outcomes is valid as supported by Leigh (2016). Consequently, the position of the APHA with regards to using a variety of programs to foster access to healthcare among the low-income earners is also valid.

Some of the programs recommended such as providing conditional cash transfers to the low income earners, have been confirmed effective in the U.S. For instance, Dechausey, Miller and Quiroz- Becerra (2014) opine that the cash transfer program is successful, based on the evaluation strategies implemented on the same. Other programs include guaranteed annual incomes as provided for in the Canadian law and earned income tax reductions for the low wage earners (Raphael, 2016).


Part 2: Letter to Policy Maker

Student’s Name

Postal Address

Phone Number




Governor Sam Brownback

Kansas County Government

Dear Mr. Governor,


The American Public Health Association recently published a policy statement on improving health outcomes through increase in the minimum wage level. As a concerned citizen, I would like to communicate my position on the same policy as I feel it would be a good starting point to enhance our county’s productivity sustainably. My concern arises from the fact that Kansas County is one of the few counties still offering a minimum wage below $ 8.00 per hour.

As a county, I believe we can benefit a lot from increasing the minimum wage. For instance, some of the outcomes associated with the low minimum wage can be avoided if we have the resources and decide to implement this policy. Although there are disparities in the social status of the citizens, it should not reflect on access to healthcare services. With the low minimum wage, however, research indicates that there are increasing disparities between the rich and the poor in terms of access to healthcare (Ubri & Artiga, 2016). These disparities are a source of concern since most of those who earn low wages are bread winners, and given that they cannot access healthcare services, it goes without doubt that their families are also limited in terms of access to healthcare (Osypuk et al., 2014). Children born of low earning parents are at higher risk of postnatal death as well as low birth weight (Komro et al., 2016). The county government can help in preventing child deaths and improving productivity.

Kansas County prides itself in its productive economic sector. However, the question we really need to ask is whether the citizens are comfortable. Research has indicated that low income not only limits access to healthcare facilities but also affects the victims psychologically (Flint, Cummins, & Wills, 2014). Stress and economic pressures weigh down on the low-income earners on a daily basis. The impacts of low income imply that the workers have to find ways of minimizing the living expenses, the most common being finding affordable housing (Kneebone & Holmes, 2015). In the recent years, urban development has been such that more affordable housing units are situated further away from metropolitan areas. On the one hand, the low earners spend less on housing, while on the other hand, the amount saved in housing is spent on transportation costs. It is on such premises that we should ask whether the minimum wage is really enough for the populace. The poor cannot afford nutritious diets as they have to prioritize other expenses as reported by Newell et al. (2014).

This, therefore, is a call to consider others Mr. Governor. As the CPI increases on a daily basis, it is impossible to enhance the lives of citizens based on a low minimum wage. Not only does the minimum wage limit the capacity of the poor to access resources but it also increases the rift between the poor and the rich (Mishel, 2013). Kindly help the American Public Health Association to advocate for better pay of workers through their policy, if not for the entire country then for your people. You have seen what a low minimum wage can do; improving the minimum wage will enhance our health indicator and subsequently the county economy (Wilkinson & Marmot, 2003).

Yours faithfully,


Student Name



American Public Health Association. (2016, November 1). Improving health by increasing the

minimum wage. American Public Health Association.

Baron, S. L., Steege, A. L., Marsh, S. M., Menéndez, C. C., & Myers, J. R. (2013). CDC health

disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly

            Report, 62(3):35–40.

Dechausay, N., Miller, C., & Quiroz- Becerra, M. (2014). Implementing a conditional cash

transfer program in two American cities. MDRC. Retrieved from

DeNavas-Walt, C., & Proctor, B. D. (2014). Income and poverty in the United States. Current

            Population Reports. Retrieved from

Flint, E., Cummins, S., & Wills, J. (2014). Investigating the effect of the London living wage on

the psychological wellbeing of low-wage service sector employees: a feasibility study.

Journal of Public Health, 36:187–193.

Hall, D., & Cooper, D. (2012, August 14). How raising the federal minimum wage would help

working families and give the economy a boost. Economic Policy Institute. Retrieved


Ubri, P., & Artiga, S. (2016, August 12). Disparities in health and health care: five key questions

and answers. Henry J. Kaiser Family Foundation. Retrieved from


Klein, B. W., & Rones, P. L. (2015). A profile of the working poor, 2013. US Bureau of Labor

            Statistics. Retrieved from


Komro, K. A., Livingston, M. D., Markowitz, S., & Wagenaar, A. C. (2016). The effect of an

increased minimum wage on infant mortality and birth weight. American Journal of

            Public Health, 106(8):1514–6.

Kneebone, E., & Holmes, N. (2015, March 24). The growing distance between people and jobs

in metropolitan America. The Brookings Institute.

Landefeld, J. C., et al. (2014). The association between a living wage and subjective social status

and self-rated health: a quasi-experimental study in the Dominican Republic. Social

            Science and Medicine, 121:91–97.

Leigh, J. P. (2016). Could raising the minimum wage improve the public’s health? American

            Journal Public Health, 106:1355–1356.

McBride, B. E. (2014). Oklahoma governor signs minimum wage hike ban. Associated Press.

Mishel, L. (2013). Declining value of the federal minimum wage is a major factor driving

inequality. Economic Policy Institute, Issue Brief 351.

Mishel, L. & Eisenbrey, R. (2015, March 19). How to raise wages: policies that work and

policies that don’t. Economic Policy Institute.

Newell, F. D., Williams, P. L., & Watt, C. G. (2014). Is the minimum enough? Affordability of a

nutritious diet for minimum wage earners in Nova Scotia (2002–2012). Canadian

            Journal of Public Health, 105(3):158–165.

Osypuk, T. L., Joshi, P., Geronimo, K., & Acevedo-Garcia, D. (2014). Do social and economic

policies influence health? A review. Current Epidemiological Report, 1:149–164. Proctor, B. D., Semega, J. L., Kollar, M. A. (2016). Income and Poverty in the United States:

  1. Washington, DC: US Government Printing Office. Retrieved from

Raphael, D. (2016). Social determinants of health: Canadian Perspectives. Canadian Scholars


Reich, M., Jacobs, K., & Bernhardt, A. (2014). Local Minimum Wage Laws: Impacts on

Workers, Families and Businesses. ILRE Working Paper.

U.S. Department of Health and Human Services. Determinants of health: Healthy People 2020.

U.S. Department of Labor. (2017). Minimum wage laws in the states. Retrieved from

U.S. Department of Transportation. (n.d). Transportation and housing costs. Retrieved from

Wilkinson, R., & Marmot, M. (2003). Social determinants of health: The solid facts. World

Health Organization.