Background: Livable wage, compared to federal minimum wage, is income required to cover basic needs without outside assistance. There is limited data on the relationship between livable wage and health outcomes in adults with diabetes. This study tested the relationship between livable wage and quality of life in adults with diabetes.

Methods: MEPS data from 2011-2020 were used. Federal minimum wage was based on the federal 2022 level of $7.25. Livable wage was based on the MIT living wage calculator level of $24.16. Both were multiplied by 280 to account for 40 hours per week for 52 weeks. Outcomes were physical component score (PCS) and mental component score (MCS) of the SF-12. Dependent variable was livable wage categorized as: 1) <federal minimum=“” wage=“” (<$15,080);=“” 2)=“” <livable=“” (=livable wage (≥$50,252). Covariates included: demographics, region, education, insurance, and comorbidities. Multiple linear regression was used to test the relationship between living wage and PCS/MCS adjusting for covariates.

Results: Study sample was 20,327, representing 244,622,755 US adults with diabetes. By livable wage category, 64.1% reported wages <federal minimum=“” wage,=“” 22.6%=“” reported=“” wages=“” =livable wage. In unadjusted models, PCS and MCS were 37.5 and 48.5 for < minimum wage; 45.9 and 51.9 for =livable wage. In adjusted models, PCS and MCS were 39.3 and 48.7 for < minimum wage; 43.7 and 52.2 for =livable wage. Differences between groups were statistically significant for PCS and MCS in unadjusted models and only for PCS in fully adjusted models.

Conclusions: These findings show that livable wage is associated with significantly improved physical and mental health, yet 86% of the population are not receiving a livable wage. As the field moves forward to address structural inequalities, emphasis on economic stability via livable wage is critical to optimize patient outcomes.


J.A.Campbell: None. L.E.Egede: None.


National Institutes of Health (K24DK093699, R01DK118038, R01DK120861, K01DK131319, R01MD013826)

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