Using health impact assessment to evaluate health outcomes related to gender pay equity legislation

Gender pay inequity and the lower incomes for women that result may make healthful choices in housing and nutrition difficult, reduce access to health care, increase stress, and lower social- and self-perception of women. All of these impact health, especially maternal and child health. As an upstream intervention to reduce high infant mortality rates in Detroit, our team conducted a health impact assessment of proposed pay equity legislation. Due to continued failure to pass the legislation, advocates recognized the potential benefit of the HIA process as a method to reframe the issue around health.

HIA is a flexible research and engagement methodology to predict future health impacts of proposals. We carried out the five steps of HIA: screening; scoping; assessment, which included a literature review, analysis of secondary data, and primary data collection; recommendations, and reporting. The last step of HIA, monitoring, has begun.

Scoping and assessment results indicate that passing a pay equity law will positively impact health through decreased stress, increased income, more healthful choices, improved access to health care, and increased power in the workplace. An HIA recommendation example includes: ensuring the reduction of loopholes in the bill that will target women most affected by inequity, such as women of color, low-income women, and mothers. The HIA process connected public health practitioners with non-health stakeholders and brought a health lens into the decision-making process.

Passing pay equity laws can improve health. Using HIA to impact the decision-making process brings a new health frame to the equity discussion.