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Rajiv Bhatia, MD, MPH and Mitchell Katz, MD

The authors are with the San Francisco Department of Public Health and the Department of Medicine, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Rajiv Bhatia, MD, MPH, San Francisco Department of Public Health, 1390 Market St, Suite 822, San Francisco, CA 94102 (e-mail: rajiv_bhatia{at}dph.sf.ca.us).

Objectives. This study estimated the magnitude of health improvements resulting from a proposed living wage ordinance in San Francisco.

Methods. Published observational models of the relationship of income to health were applied to predict improvements in health outcomes associated with proposed wage increases in San Francisco.

Results. With adoption of a living wage of $11.00 per hour, we predict decreases in premature death from all causes for adults aged 24 to 44 years working full-time in families whose current annual income is $20 000 (for men, relative hazard [RH] = 0.94, 95% confidence interval [CI] = 0.92, 0.97; for women, RH = 0.96, 95% CI = 0.95, 0.98). Improvements in subjectively rated health and reductions in the number of days sick in bed, in limitations of work and activities of daily living, and in depressive symptoms were also predicted, as were increases in daily alcohol consumption. For the offspring of full-time workers currently earning $20 000, a living wage predicts an increase of 0.25 years (95% CI = 0.20, 0.30) of completed education, increased odds of completing high school (odds ratio = 1.34, 95% CI = 1.20, 1.49), and a reduced risk of early childbirth (RH = 0.78, 95% CI = 0.69, 0.86).

Conclusions. A living wage in San Francisco is associated with substantial health improvement.

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