TY - JOUR
T1 - Impact of a private sector living wage intervention on depressive symptoms among apparel workers in the Dominican Republic
T2 - A quasi-experimental study
AU - Burmaster, Katharine B.
AU - Landefeld, John C.
AU - Rehkopf, David H.
AU - Lahiff, Maureen
AU - Sokal-Gutierrez, Karen
AU - Adler-Milstein, Sarah
AU - Fernald, Lia C.H.
PY - 2015
Y1 - 2015
N2 - Objectives: Poverty reduction interventions through cash transfers and microcredit have had mixed effects on mental health. In this quasi-experimental study, we evaluate the effect of a living wage intervention on depressive symptoms of apparel factory workers in the Dominican Republic. Setting: Two apparel factories in the Dominican Republic. Participants: The final sample consisted of 204 hourly wage workers from the intervention (99) and comparison (105) factories. Interventions: In 2010, an apparel factory began a living wage intervention including a 350% wage increase and significant workplace improvements. The wage increase was plausibly exogenous because workers were not aware of the living wage when applying for jobs and expected to be paid the usual minimum wage. These individuals were compared with workers at a similar local factory paying minimum wage, 15-16 months postintervention. Primary outcome measures: Workers' depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D). Ordinary least squares and Poisson regressions were used to evaluate treatment effect of the intervention, adjusted for covariates. Results: Intervention factory workers had fewer depressive symptoms than comparison factory workers (unadjusted mean CES-D scores: 10.6±9.3 vs 14.7±11.6, p=0.007). These results were sustained when controlling for covariates (β=.5.4, 95% CI.8.5 to.2.3, p=0.001). In adjusted analyses using the standard CES-D clinical cut-off of 16, workers at the intervention factory had a 47% reduced risk of clinically significant levels of depressive symptoms compared with workers at the comparison factory (23% vs 40%). Conclusions: Policymakers have long grappled with how best to improve mental health among populations in low-income and middle-income countries. We find that providing a living wage and workplace improvements to improve income and well-being in a disadvantaged population is associated with reduced depressive symptoms.
AB - Objectives: Poverty reduction interventions through cash transfers and microcredit have had mixed effects on mental health. In this quasi-experimental study, we evaluate the effect of a living wage intervention on depressive symptoms of apparel factory workers in the Dominican Republic. Setting: Two apparel factories in the Dominican Republic. Participants: The final sample consisted of 204 hourly wage workers from the intervention (99) and comparison (105) factories. Interventions: In 2010, an apparel factory began a living wage intervention including a 350% wage increase and significant workplace improvements. The wage increase was plausibly exogenous because workers were not aware of the living wage when applying for jobs and expected to be paid the usual minimum wage. These individuals were compared with workers at a similar local factory paying minimum wage, 15-16 months postintervention. Primary outcome measures: Workers' depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D). Ordinary least squares and Poisson regressions were used to evaluate treatment effect of the intervention, adjusted for covariates. Results: Intervention factory workers had fewer depressive symptoms than comparison factory workers (unadjusted mean CES-D scores: 10.6±9.3 vs 14.7±11.6, p=0.007). These results were sustained when controlling for covariates (β=.5.4, 95% CI.8.5 to.2.3, p=0.001). In adjusted analyses using the standard CES-D clinical cut-off of 16, workers at the intervention factory had a 47% reduced risk of clinically significant levels of depressive symptoms compared with workers at the comparison factory (23% vs 40%). Conclusions: Policymakers have long grappled with how best to improve mental health among populations in low-income and middle-income countries. We find that providing a living wage and workplace improvements to improve income and well-being in a disadvantaged population is associated with reduced depressive symptoms.
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U2 - 10.1136/bmjopen-2014-007336
DO - 10.1136/bmjopen-2014-007336
M3 - Article
C2 - 26238394
AN - SCOPUS:84941630018
VL - 5
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 8
M1 - e007336
ER -