Exploring the Effects of Wage on the Culture of Health in Early Childhood Education Centers

Investigators are evaluating how wage and wage changes might affect the culture of health in early childhood education (ECE) settings —a setting typically characterized by low wages. The researchers are examining how changes to state and city minimum wages affect the health of ECE providers, and how ECE provider health relates to the quality and healthfulness of the ECE environment. The study is designed to compare minimum wage changes over time in Seattle, WA, and South King County, WA, to the control city, Austin, TX. Results will provide insights about how labor regulations relate to health and health-promoting behaviors, particularly minimum wage, and a better understanding of how investing in ECE and the ECE workforce might influence the health of the next generation.


Using baseline data from an ongoing study, Exploring the Effects of Wage on the Culture of Health in Early Childhood Education Centers, Jennifer Otten of the University of Washington and coauthors found that ECE teachers earned low wages, experienced poor mental well-being, and lacked access to enough food for an active and healthy life. Lower wage teachers were more likely to work at centers that did not offer health insurance, paid sick leave, or parental or family leave. Study authors suggest health and equity-related outcomes could be improved by helping centers provide more support and flexibility to teachers (for example, offsetting workers’ benefit costs or reducing teacher-to-child ratios to reduce stress).

In a follow up study, researchers found that for the early child care and education teachers, very low and low food insecurities were associated with higher odds of depression when compared to being food secure. Study findings shed light on potential opportunities to help improve the situation. Policies and center-level interventions that address both food insecurity and depression in the ECE workforce may be warranted, in order to protect and improve the health of this valuable, yet vulnerable, segment of the U.S. workforce. Potential policy-level strategies in the U.S. could include incorporating ECE workers as recipients of the federally reimbursed nutritious meals and snacks already served on-site to children via the Child and Adult Care Food Program or adopting legislation or provisions that improve financial security for ECE workers (e.g., tax credits, raised minimum wage). Centers could also provide workers with resources and connections to nutrition education and food assistance programs, as misunderstandings and uncertainty around eligibility for food stamp benefits are fairly common, and population-specific outreach and education around food assistance participation eligibility may encourage participation. Finally, centers could include routine staff training on mental health and emotional well-being, coping skills, and stress management.

Outcomes & Methodology

ECE Project diagram

Natural experiment

Children in PE class stretching their arms into the air
Grantee and Partner organizations
Grant status
In Progress
Principal investigators
Jennifer Otten, PhD, RD
Start date
Award amount
36 months

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