Return on investment from co-locating tax assistance for low-income persons at clinical sites

Poverty is associated with higher morbidity and mortality across a range of diseases. However, it is difficult for clinicians to address poverty, even compared with other social determinants, such as food or transportation, because of resource constraints and questions about the appropriate role of health systems. One potential approach for financial support is increasing access to federal programs like the Earned Income Tax Credit (EITC). The EITC, which can total 30% of a family’s annual income, has been linked to improvements in infant and maternal health, including increased birth weight, improved nutrition, and decreased maternal depression rates. Evidence suggests that this tax credit is underclaimed by qualifying families. To increase awareness of and broaden access to tax credits like the EITC, tax assistance was co-located at clinical sites in New York City. We assessed the return on investment of this intervention.