1 A Health Impact Assessment (HIA) of Gender Pay Inequity Angela Stevenson, RN, BSN Presentation for Population Health Council Meeting 11/13/12 In collaboration with: Wayne County Department of Public Health Human Impact Partners Oakland, California a

What is an “HIA”? 2 HIA is… …a research and engagement methodology used to predict the future health impacts of policies and projects in order to inform the decision-making process. HIA is… …a research and engagement methodology used to predict the future health impacts of policies and projects in order to inform the decision-making process.

HIA Processes… A typical HIA includes six steps: 1.Screening 2.Scoping 3.Assessment 4.Recommendations 5.Reporting 6.Monitoring 3

1963: Equal Pay Act passed. 2007: US - Women earn 78 cents to the male $1 and in MI - Women earn 72 cents to the male dollar. Worse for women of color, single women, mothers, women with lower education. 2009: Obama passes Lily Ledbetter Fair Pay Act and 2010: Paycheck Fairness Act proposed. Bills in MI state legislature. Background 4

Unequal pay and health Pay gaps have implications far beyond our pocketbooks… 5

Screening Has been considered a labor bill, a civil rights bill, but the impact on health for women, families, and community had not been studied and reported. The common “frames” on this bill have not worked in Michigan. Michigan women are paid less than the national average National partners (AAUW) were interested in incorporating a health lens into their advocacy. Fits in with Place Matters team interest in maternal and child health outcomes. HIA could be useful to inform elected officials, advocacy organizations and their base, and businesses. 6

Scoping 7 Determines which health impacts to evaluate Methods/Tools Identify and prioritize research questions

8 Assessment – Sources and Methods Review of peer- reviewed literature and research US Census Pay Equity HIA MI Dept. of Community Health Bureau of Labor Statistics

A glimpse of the data… Women in MI make only 73% of what men make. The average income for women in MI in 2005 was $32,600. The average income for men in MI was $46, % of women in Michigan are single mothers are the sole provider for their families. 14% of MI women are uninsured and thus have to make choices between getting health care and feeding their families. Of the working poor, 53% are uninsured. 28% of African American women in MI live below the poverty level. African American women are paid, on average, 62% of the average white male’s salary. 9

10 Assessment – Predicted Impacts Decreased stress and stress-related illness (pre-term and LBW; CVD, GI illness, musculoskeletal problems). Decreased risk of an affective disorders like depression by 60% & the risk of an anxiety disorder by 56%. Better health care coverage for women and their families, resulting in higher immunization rates and less delayed care

Findings: Equal pay policies will: result in healthier women, children, and families decrease stress and associated health issues enable poor women to increase health care access, use the emergency room less, and improve overall health. enable women to save for retirement, leading to better health outcomes for them and their dependents. 11

Recommendations Monitor existing conditions and any relevant changes Advocate for the improvement of women’s income through legislation Increase awareness of the health disparities that are perpetuated by pay inequities Conduct ongoing research related to the impact of pay inequity on health Leverage the process and results to make way for the application of future HIAs in other areas 12

13 Reporting / Outcomes o 30 Page Report and Fact Sheet o New community partners o New Voices in Pay Equity: National Equal Pay Day o Michigan Pay Equity Day o Press conference o PLACE Matters National Conference Legislator Visits o 2011 APHA Annual Meeting o CDC/NACCHO - Addressing Gender Inequities in Health and Safety working meeting o Citation in dissertation at University of North Carolina – Chapel Hill

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15 Resources Joint Center Health Policy Institute PLACE MATTERS Human Impact Partners - American Association of University Women Robert Wood Johnson Foundation - publications/find-rwjf-research/2011/06/what-shapes- health/health-impact-assessment.html publications/find-rwjf-research/2011/06/what-shapes- health/health-impact-assessment.html American Public Health Association html html MOSES -