scholarly journals A Longitudinal Investigation of the Impact of Operational Deployment on the Psychological Wellbeing of New Zealand Defence Force Service Personnel

2021 ◽  
Author(s):  
◽  
Kelsey Laura Morrison
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
New Zealand ◽  
Military Personnel ◽  
The United States ◽  
Path Model ◽  
Psychological Wellbeing ◽  
Ptsd Symptoms ◽  
Service Personnel ◽  
The Impact

<p>The deleterious impact of combat on psychological wellbeing has been documented as early as 490 B.C. by Greek historians (Bentley, 2005), and researchers continue to delve into this phenomenon today. Published literature in this field largely emanates from the United States and United Kingdom, whilst research from New Zealand is largely absent. The current study seeks to fill this gap with an investigation of the impact of overseas deployment on the psychological wellbeing of New Zealand Defence Force (NZDF) military personnel. This study utilised data from 1410 NZDF military personnel who operationally deployed between 1 July 2015 and 31 October 2016 and completed two questionnaires: (1) immediately following deployment, and (2) six months after returning home. Regression, moderation, mediation, and path model analyses were used to analyse the data. Several key findings were obtained. Firstly, combat stressors, as expected, predicted posttraumatic stress disorder (PTSD) symptoms but surprisingly not psychological distress. PTSD, as expected, predicted distress. Secondly, moderation analysis revealed that experiencing medium to high levels of non-combat stressors in addition to combat stressors was likely to result in exacerbated levels of PTSD symptoms. Thirdly, demographic characteristics such as being in the Navy, being female, and not being in a relationship were all identified risk factors for poorer psychological outcomes (PTSD symptoms and psychological distress), whereas neither ethnicity nor prior deployment experience functioned as risk factors. Lastly, mediation analysis revealed that PTSD partially explained the relationship between combat events and posttraumatic growth, suggesting that PTSD symptomology may prompt military personnel to appraise outcomes from their deployment, and subsequently experience personal growth. Implications of the current research lay in the potential for improvements to be made to the education, training, and support offered by the NZDF to their service personnel.</p>

scholarly journals A Longitudinal Investigation of the Impact of Operational Deployment on the Psychological Wellbeing of New Zealand Defence Force Service Personnel

2021 ◽  
Author(s):  
◽  
Kelsey Laura Morrison
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
New Zealand ◽  
Military Personnel ◽  
The United States ◽  
Path Model ◽  
Psychological Wellbeing ◽  
Ptsd Symptoms ◽  
Service Personnel ◽  
The Impact

<p>The deleterious impact of combat on psychological wellbeing has been documented as early as 490 B.C. by Greek historians (Bentley, 2005), and researchers continue to delve into this phenomenon today. Published literature in this field largely emanates from the United States and United Kingdom, whilst research from New Zealand is largely absent. The current study seeks to fill this gap with an investigation of the impact of overseas deployment on the psychological wellbeing of New Zealand Defence Force (NZDF) military personnel. This study utilised data from 1410 NZDF military personnel who operationally deployed between 1 July 2015 and 31 October 2016 and completed two questionnaires: (1) immediately following deployment, and (2) six months after returning home. Regression, moderation, mediation, and path model analyses were used to analyse the data. Several key findings were obtained. Firstly, combat stressors, as expected, predicted posttraumatic stress disorder (PTSD) symptoms but surprisingly not psychological distress. PTSD, as expected, predicted distress. Secondly, moderation analysis revealed that experiencing medium to high levels of non-combat stressors in addition to combat stressors was likely to result in exacerbated levels of PTSD symptoms. Thirdly, demographic characteristics such as being in the Navy, being female, and not being in a relationship were all identified risk factors for poorer psychological outcomes (PTSD symptoms and psychological distress), whereas neither ethnicity nor prior deployment experience functioned as risk factors. Lastly, mediation analysis revealed that PTSD partially explained the relationship between combat events and posttraumatic growth, suggesting that PTSD symptomology may prompt military personnel to appraise outcomes from their deployment, and subsequently experience personal growth. Implications of the current research lay in the potential for improvements to be made to the education, training, and support offered by the NZDF to their service personnel.</p>

scholarly journals Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study

2015 ◽  
Vol 25 (4) ◽  
pp. 393-402 ◽  
Author(s):  
M. Waller ◽  
F. J. Charlson ◽  
R. E. E. Ireland ◽  
H. A. Whiteford ◽  
A. J. Dobson
Keyword(s):  
Psychological Distress ◽  
Military Personnel ◽  
Time Course ◽  
Mental Health Problems ◽  
Stressful Events ◽  
Stressful Event ◽  
Ptsd Symptoms ◽  
C 50 ◽  
Distress Scale ◽  
The Impact

Aims.Understanding the time-course of post-traumatic stress disorder (PTSD), and the underlying events, may help to identify those most at risk, and anticipate the number of individuals likely to be diagnosed after exposure to traumatic events.Method.Data from two health surveys were combined to create a cohort of 1119 Australian military personnel who deployed to the Middle East between 2000 and 2009. Changes in PTSD Checklist Civilian Version (PCL-C) scores and the reporting of stressful events between the two self-reported surveys were assessed. Logistic regression was used to examine the association between the number of stressful events reported and PTSD symptoms, and assess whether those who reported new stressful events between the two surveys, were also more likely to report older events. We also assessed, using linear regression, whether higher scores on the Kessler Psychological Distress Scale or the Alcohol Use Disorder Identification Test were associated with subsequent increases in the PCL-C in those who had experienced a stressful event, but who initially had few PTSD symptoms.Results.Overall, the mean PCL-C scores in the two surveys were similar, and 78% of responders stayed in the same PCL-C category. Only a small percentage moved from having few symptoms of PTSD (PCL-C < 30) in Survey 1 to meeting the criteria for PTSD (PCL-C ≥ 50) at Survey 2 (1% of all responders, 16% of those with PCL-C ≥ 50 at Survey 2). Personnel who reported more stressful lifetime events were more likely to score higher on the PCL-C. Only 51% reported the same stressful event on both surveys. People who reported events occurring between the two surveys were more likely to record events from before the first survey which they had not previously mentioned (OR 1.48, 95% CI (1.17, 1.88),p< 0.001), than those who did not. In people who initially had few PTSD symptoms, a higher level of psychological distress, was significantly associated with higher PCL-C scores a few years later.Conclusions.The reporting of stressful events varied over time indicating that while the impact of some stressors endure, others may increase or decline in importance. When screening for PTSD, it is important to consider both traumatic experiences on deployment and other stressful life events, as well as other mental health problems among military personnel, even if individuals do not exhibit symptoms of PTSD on an initial assessment.

scholarly journals Psychological Distress and Post-Traumatic Symptomatology among Dental Healthcare Workers in Russia: Results of a Pilot Study

2021 ◽  
Vol 18 (2) ◽  
pp. 708 ◽  
Author(s):  
Maria Sarapultseva ◽  
Alena Zolotareva ◽  
Igor Kritsky ◽  
Natal’ya Nasretdinova ◽  
Alexey Sarapultsev
Keyword(s):  
Psychological Distress ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Clinical Symptoms ◽  
Stress Disorders ◽  
Self Report ◽  
Ptsd Symptoms ◽  
Event Scale ◽  
Post Traumatic ◽  
The Impact

The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3–24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1–29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.

Factors Contributing to Violence Against Children: Insights From a Multi-informant Study Among Family-Triads From Three East-African Refugee Camps

2021 ◽  
pp. 088626052110139
Author(s):  
Tobias Hecker ◽  
Edna Kyaruzi ◽  
Julia Borchardt ◽  
Florian Scharpf
Keyword(s):  
Risk Factors ◽  
Household Income ◽  
Path Model ◽  
Refugee Children ◽  
Refugee Camps ◽  
Childhood Victimization ◽  
Ptsd Symptoms ◽  
Parental Violence ◽  
Psychosocial Impairment ◽  
Violence Against Children

Parental violence poses a considerable, yet mitigable risk for the mental health and well-being of refugee children living in resource-poor refugee camps. However, little is known about potential risk factors for parental violence in these settings. Using an ecological systems perspective and a multi-informant approach, we investigated ontogenic (parental childhood experiences of violence), microsystem (parents’ and children’s psychopathology) and exosystem (families’ monthly household income) risk factors for child-directed parental violence in a sample of 226 Burundian families living in refugee camps in Tanzania. Data were collected through individual structured clinical interviews with mothers, fathers, and children. In the child-report path model [ χ2 (6) = 7.752, p = .257, comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.036 ( p = .562)], children’s posttraumatic stress disorder (PTSD) symptoms, externalizing symptoms and paternal PTSD symptoms were positively associated with violence by both parents. Maternal psychosocial impairment was positively associated with child-reported paternal violence. In the parent-report path model [ χ2 (6) = 7.789, p = .254, CFI = 0.97, RMSEA = 0.036 ( p = .535)], children’s externalizing problems as well as a lower monthly household income were positively related to maternal violence. Each parent’s childhood victimization was positively linked to their use of violence against children. Maternal psychosocial impairment and paternal alcohol abuse were positively associated with paternal violence. Child and paternal psychopathology, maternal psychosocial impairment, parents’ childhood victimization, and families’ socioeconomic status may be important targets for prevention and intervention approaches aiming to reduce parental violence against refugee children living in camps.

scholarly journals A scoping review of female drowning: an underexplored issue in five high-income countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kym Roberts ◽  
Ogilvie Thom ◽  
Susan Devine ◽  
Peter A. Leggat ◽  
Amy E. Peden ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
United Kingdom ◽  
New Zealand ◽  
Clinical Outcomes ◽  
Scoping Review ◽  
The United States ◽  
Clinical Treatment ◽  
High Income ◽  
Public Health Issue

Abstract Background Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning. Methods A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines. Results The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females). Conclusion Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning.

304 The relationship between basic personality, subjective sleep duration, and psychological distress during a military deployment

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A121-A121
Author(s):  
Walter Sowden ◽  
Alexxa Bessey ◽  
Julie Merrill ◽  
Ashlee Mckeon ◽  
Jake Choynowski ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Personality Traits ◽  
Sleep Duration ◽  
Big Five ◽  
Military Personnel ◽  
The United States ◽  
Post Traumatic Stress ◽  
Medicine Research ◽  
Subjective Sleep ◽  
The Relationship

Abstract Introduction Extended, overseas operations (deployments) increase the likelihood that military personnel will experience psychological distress. Reduced sleep during deployments is a key correlate of psychological distress. Thus, it is imperative to identify mechanisms that adaptively modulate the relationship between insufficient sleep and psychological distress. Research has recently connected basic personality traits (i.e., the Big Five: extraversion, agreeableness, conscientiousness, neuroticism, and openness) to more sleep. The current project aimed to examine the relationship between basic personality traits, subjective sleep duration (SSD), and psychological distress during an operational deployment. Methods 488 soldiers took surveys both prior to and half-way through a nine-month deployment. The pre-deployment survey included the Big Five Index, and three standardized measures of psychological distress commonly used to screen military personnel for anxiety (Generalized Anxiety Disorder; GAD-7), depression (Patient Health Questionnaire; PHQ-8), and post-traumatic stress (Posttraumatic Symptom Disorder Checklist; PCL-4). The mid-deployment survey included an item from the Pittsburgh Sleep Quality Index measuring SSD and the same psychological distress measures from the pre-deployment survey. General linear models were used to test the interaction between SSD and each basic personality trait on each measure of psychological distress at mid-deployment while accounting for psychological distress at pre-deployment. Results Of the Big Five, conscientiousness was the only trait to significantly moderate the relationship between SSD and anxiety, t = 2.11, p = .035, where higher conscientiousness weakened the relationship. Further only agreeableness attenuated the relationship between depression and SSD, t = 2.10, p = .036. Interestingly, the only Big Five trait that moderated the relationship between SSD and PTS was openness, insomuch that openness strengthened the relationship, t = -1.92, p = .055. Conclusion The relationship between SSD and psychological distress was uniquely impacted by different personality traits. These results reinforce the age-old concept that behavior is the product of a complex, nuanced, and puzzling interaction between the individual and the environment. The current research motivates further research into personality as an adaptive mechanism for optimizing military wellbeing. Support (if any) Support for this study came from the Military Operational Medicine Research Program (MOMRP) of the United States Army Medical Research and Development Command (USAMRDC).

scholarly journals Impact of family social support on psychological wellbeing of infertile women attending Yusuf Dantsoho Memorial Hospital, Kaduna, Nigeria

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Abubakar R ◽  
Zubairu HD ◽  
Yohanna S
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Well Being ◽  
Social Consequences ◽  
Psychological Wellbeing ◽  
Memorial Hospital ◽  
Infertile Women ◽  
Family Social Support ◽  
Wide Range ◽  
The Impact

Infertility could be a life crisis with a wide range of socio-cultural and emotional problems. These social consequences are usually not voluntarily disclosed by the affected women and consequently do not receive adequate attention so the women continue to suffer in silence. The study aimed to determine the impact of family social support on psychological well-being of infertile women attending Yusuf Dantsoho Memorial Hospital (YDMH), Kaduna. The study was a cross sectional study conducted at the YDMH, T/Wada, Kaduna. Two hundred and fifty-four women who presented to the gynecology clinic during the study period and consented to participate in the study were recruited consecutively. Data on socio-demographics and family social support were determined using a self-structured questionnaire. Psychological wellbeing was assessed using a General Health Questioner. Data was analyzed using EPI-INFO statistical package. Majority of the participants were Northerners (70.1%), Muslims (91.7%), and Unemployed (52.8%) with an average monthly income of less than N 20,000 (73.6%). Most were within the age group of 25–30 years (40.2%) and from monogamous families (70.1%) with most families having 0–5 children (89.4%). 67.7% of the participants had adequate social support from their husbands as against 32.3% who had inadequate support (such as availability of financial, support encouragement, concern and sense of social belonging). Only 33.5% had adequate social support from their in-laws while majority of them (66.5%) had inadequate social support. A total of 203 (79.9%) of the participants had psychological distress (self-administered questioner) while 51 (20.1%) had no psychological distress. Husbands and in-laws support were significantly related to psychological wellbeing of the infertile women. Adequate social support provided by family members reduces stress, improves psychological wellbeing and quality of life of infertile women.

Abstract TP196: New Zealand Workforce Stroke Incidence: Urban and Rural Risk Factor Evaluation

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Hope E Buell ◽  
Patricia Metcalf ◽  
Daniel Exeter
Keyword(s):  
Risk Factors ◽  
New Zealand ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Smoking Status ◽  
Prior History ◽  
Stroke Incidence ◽  
Stroke Outcomes ◽  
The Impact

This analysis aims to assess the impact of urban and rural risk factors on a model of stroke incidence in a New Zealand workforce population. The New Zealand study consisted of 4,926 subjects prospectively enrolled at 46 worksites. The subjects were aged 40-78 years at baseline and had no prior history of stroke. This prospective study defines stroke events experienced by the study subjects during follow-up between 1988 and 2012 based on hospital admission coding. Proportional hazards regression models were fit using baseline characteristics. The difference in stroke outcomes for urban and rural worksites was also evaluated. Results demonstrate that baseline demographic, physical exam, and behavioural measures impact stroke outcomes. While the baseline distribution of stroke risk factors such as Pacific Island ethnicity, smoking status, and increased blood pressure indicates a potentially higher risk of stroke in the rural population, the proportional hazards model does not identify increased stroke risk for rural workers. Additional analysis of the diet, exercise and Quality of Life measures for these subjects may provide further information into the stroke risk profiles of individuals working in different locales.

Abstract 17019: Obesity and Cardiovascular Health in Young American Adults

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sarabjeet S Suri ◽  
Vibhu Parcha ◽  
Rajat Kalra ◽  
Garima Arora ◽  
Pankaj Arora
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Health ◽  
Piecewise Linear ◽  
The United States ◽  
Obesity Prevalence ◽  
Logistic Regression Models ◽  
Prevalence Of Obesity ◽  
Adjusted Logistic Regression ◽  
The Impact

Background: The growing epidemic of obesity in the United States (US) is associated with cardiovascular (CV) morbidity and mortality. We evaluated the impact of the increasing obesity prevalence on the CV health of young American adults. Methods: The age-adjusted weighted prevalence of hypertension, diabetes, and hypercholesterolemia was estimated from the 2008-2018 National Health and Nutrition Examination Survey (NHANES) in American adults aged 18-44 years, stratified by the presence of obesity. The trends were evaluated using a piecewise linear regression approach. The odds for CV risk factors were estimated using multivariable-adjusted logistic regression models. Results: Among 14,919 young adults, the prevalence of obesity was 33.9% (95% CI: 32.6-35.3%). Obese young adults were more likely to be non-Hispanic Blacks and in lower socioeconomic and educational attainment strata (p<0.05 for all). Obese young adults had a greater risk of having hypertension (adjusted odds ratio [aOR]: 3.0 [95% CI: 2.7-3.4]), diabetes (aOR: 4.3 [95% CI: 3.3-5.6]), and hyperlipidemia (aOR: 1.47 [95% CI: 1.3-1.7]). Among obese, hypertension increased from 36.5% (33.9-39.1%) in 2007-2010 to 39.4% (35.6-43.1%) in 2015-2018 (p= 0.07) and diabetes increased from 4.7% (3.6-5.8%) in 2007-2010 to 7.1% (5.3-9.0%) in 2015-2018 (p=0.11). A modest increase in diabetes was seen in non-obese individuals ( Table ). Hypercholesterolemia prevalence remained unchanged from 12.6% (95% CI: 10.6-14.7%) 2007-2010 to 10.9% (95% CI: 9.0-12.8%) in 2015-2018 (p=0.27) among obese young adults. Non-obese young adults showed a decline in hypercholesterolemia from 9.5% (95% CI: 8.0-11.0%) in 2007- 2010 to 7.1% (95% CI: 5.8-8.4%) in 2015-2018 (p=0.002). Conclusions: Nearly one-in-every three young American adults have obesity, which is accompanied by a two-fold higher prevalence of CV risk factors. The CV morbidity in young adults is expected to increase with an increasing prevalence of obesity..

Essays in Labour Economics: Evidence from Voluntary and Mandatory Wage Floors in the United States and New Zealand

2021 ◽  
Author(s):  
◽  
Jaime Lancaster
Keyword(s):  
New Mexico ◽  
New Zealand ◽  
Minimum Wage ◽  
Low Income ◽  
Fixed Effects ◽  
Local Minimum ◽  
The United States ◽  
Living Wage ◽  
Earnings Growth ◽  
The Impact

<p>This thesis expands the literature on minimum and living wages by investigating local minimum wage ordinances and voluntary living wage programs. This thesis is presented as three distinct papers; the first explores a county-wide minimum wage ordinance in New Mexico, USA, while papers 2 and 3 explore New Zealand’s voluntary living wage program. In the United States, local minimum wage ordinances are growing in popularity, and research is emerging on their effects. Setting minimum wages at the local level is politically easier than enacting Federal legislation, and local minimum wages may be better targeted to local economic conditions. In my first chapter, “Local Minimum Wage Laws and Labour Market Outcomes: Evidence from New Mexico,” I use fixed effects and synthetic control analysis to uncover the effects of a local minimum wage law on the Albuquerque/Bernalillo region of New Mexico, with a focus on how provisions exempting tipped workers affect gains in earnings. My findings reveal that these provisions can lead to reductions in hourly wages for workers exempted from the minimum wage even when the labour market is not harmed overall. I find that the minimum wage ordinance did not reduce teen employment but that it served to increase the supply of teen labour leading to an increase in the teen unemployment rate.  The second and third papers in this thesis address the voluntary living wage program in New Zealand. In the first quantitative work on New Zealand’s living wage, I utilize data from Statistics New Zealand’s Integrated Data Infrastructure (IDI) to explore several facets of the living wage experience for employers and employees. In the second paper, “The New Zealand Living Wage: Earnings, Labour Costs and Turnover,” I investigate the characteristics of New Zealand living wage firms and use fixed effects to examine the impact of living wage certification on employment, worker earnings and turnover. My results provide some evidence for increases in labour costs and worker earnings following certification but find that this change is driven by changes in small firms that employ few workers. I find no evidence of a reduction in turnover.  In my final chapter, “Who Benefits from Living Wage Certification?” I investigate the distribution of benefits from the living wage based on an employees’ pre-treatment earnings, time of hire and whether or not they remained employed with the living wage firm. To do this, I utilize a worker-level panel dataset containing the full earnings history of all workers that were employed for a living wage or matched control firm between January 2014 and December 2015. I use fixed effects models containing fixed effects for worker, firm and month to compare patterns of earnings growth for workers hired before certification (‘pre-hires’) with those hired after certification (‘joiners’) and those who left their living wage job but remained in the workforce (‘leavers’). I also estimate the impact of living wage employment on the earnings of low-income workers. I find that the financial benefit of the living wage accrues almost exclusively to workers hired after certification and to low income workers. In addition, my analysis on the worker-level panel suggests that overall earnings growth in living wage firms lagged that in control firms over the observation period. This result is driven by relative declines in earnings for living wage workers in large firms and is attributed to increases in the published living wage rate that lags behind wage growth in the relevant segments of the job market.</p>

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