Primary Submission Category: Non-health institutions (business, political, education systems)
State-level payday loan restrictions and preterm births in the US, 2000 to 2019: An ecological analysis
Authors: Parvati Singh Samantha Gailey Tim-Allen Bruckner
Presenting Author: Parvati Singh*
Payday loans are high-interest, short-term loans that are often used by individuals who have limited access to traditional credit. Whereas payday loans can provide immediate financial relief, the predatory nature of these loans can also correspond with increased financial strain and adverse public health consequences. Poorly-regulated payday lending practices may drain resources from communities and reduce social and economic capital. Prior research reports a positive relation between spatial exposure to payday lenders and all-cause mortality, and a decline in substance use-related mortality following state-level restrictions on payday lending.
We examine whether state-level temporal variation in payday loan restrictions (exposure) over a 20 year period (2000 to 2019) corresponds with a reduction in the rate of preterm births (<37 weeks of gestation; outcome)- a leading cause of infant mortality in the US. Between 2000 and 2019, 10 US states imposed restrictions on payday lending at varied time points. We use data on preterm birth rates provided by the CDC Wonder database (2000 to 2019) and apply staggered difference-in-difference and event study approaches to examine whether preterm birth rates decline among states that imposed payday lending restrictions (“treated group”) relative to states that never imposed any restrictions (“never treated group”). We control for state-level annual unemployment rate, median household income, and the national time-series propensity of preterm births in the US. We do not control for factors that lie on the causal path between payday loan restriction and preterm births. Analytic results indicate a decline in preterm birth rate by 0.36% (p < 0.01) within the first 3 years of payday loan restrictions, which corresponds to about 3400 fewer preterm births statistically attributable to the exposure. Our study provides preliminary, ecologic evidence that state-level payday loan restrictions may reduce preterm births in the US.