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Mechanisms for Advancing Public Health

Tax Incentives as a Tool to Promote Public Health

December 14, 2017


Tax incentives can be an effective legal intervention for advancing the public’s health. In this Q&A, Mathew Swinburne, Associate Director at the Network’s Eastern Region Office, discusses ways in which tax deductions are being used to address a key barrier to improving the health status of ex-offenders: the inability to secure employment because of conviction status.

Q: What health challenges do ex-offenders often face?

A: Prisoners experience incredibly high rates of mental illness, chronic disease, and infectious disease. Inmates in federal and state prisons, as well as local jails, are at an increased risk for conditions including stroke, diabetes, heart problems, asthma, tuberculosis, hepatitis, HIV/AIDS, and other STDs. When they are released, ex-offenders continue to face these health challenges.

Q: What is the connection between employment and ex-offender health?

A: One of the key barriers to improving the health status of ex-offenders is the inability to secure employment because of their conviction status. Unemployment is associated with a number of negative health results, including mental health issues like depression, and lack of medical coverage.  Also, unemployment correlates with poverty, which limits access to healthy food and housing.

Q: So how are tax incentives being used to address unemployment for ex-offenders?

A: A few ways – and at the federal and state levels. The federal Work Opportunity Tax Credit (WOTC) encourages private employers to hire individuals from chronically unemployed populations – including qualified ex-felons. My policy brief outlines how ex-felons qualify for this program and the tax benefits provided to participating employers. On the state level, there is a lot of variation in approaches – for example, Iowa offers a tax deduction of 65% of the wages paid to a qualifying ex-felon for the first year of employment; some states provide tax incentives for both full-time and part-time jobs while others only focus on full-time jobs. States also tailor their incentives by defining the specific types of ex-offenders that qualify for programs.

Q: How effective are some of the programs?

A: There isn’t a lot of research into the effectiveness of the WOTC or the states’ programs, and the results are mixed in few studies that are available. There doesn’t seem to be evidence that employers consider tax incentives in their hiring decisions. States considering this type of tax incentive program should think about how to educate employers about the benefits and how to evaluate the effectiveness of their program.

Q: What other public health issues and tax incentive policies will be you exploring?

A: I had initially examined tax incentives that promote food donations as a way to combat food insecurity and decrease food waste, which led me to look at various tax incentive programs. My colleagues at the Network’s Eastern Region Office plan to examine how tax incentives are being used to promote healthy housing, smoke-free policies, physical activity and other public health initiatives. There will be a number of additional policy briefs coming out from the Network, so keep checking in at

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.