From Vision to Action: Implementing a Living Wage in the Monadnock Region

Ask most people to name the factor that has the greatest influence on their health, and they are likely to answer “their doctor.”

Though important, those living in the Greater Monadnock Region of New Hampshire have recognized that excellent medical care and universal healthcare coverage are insufficient by themselves to significantly improve an individual’s or a community’s overall health. In fact, public health experts and social scientists estimate that healthcare services alone account for just 10-20% of health outcomes. 

Since the 1990’s, researchers have proposed that it is really a combination of biologic, lifestyle, social, socioeconomic, and environmental factors that together shape individual and population health.

A subset of influences such as culture, education, employment, housing, and socioeconomic status are termed the “social determinants of health” - and these oft overlooked factors account for 80% of health outcomes.

Data reveal that our environment impacts our health more than our health care system.

Money obviously doesn’t buy health. 

Rather, sufficient income provides the means to obtain the material resources necessary for health and also to pursue the opportunities and positive social interactions that support healthier choices and lifestyles. Research demonstrates that higher income relates to more control over one’s life circumstances and less disease-causing toxic stress.

Lower incomes are correlated to: Poorer quality food, lower quality housing, lower quality childcare, less reliable transportation, less access to healthcare, fewer educational opportunities, higher chronic social and financial stress, less positive social support, and less ability to control one’s life circumstances. 

Chronic levels of unhealthy stress have lasting physical consequences attributed to unhealthy levels of cortisol and other stress hormones. Life course theory suggests that a lifetime of stress and unhealthy lifestyle choices accumulate to negatively impact health, even in the face of later positive gains in social standing. 

Residents of the Monadnock Region saw this as a red flag, and wanted to look into the extent of this income/wage gap  in the community.

There is a strong correlation between income and health.

In the US, high-income counties tend to live longer, while low-income counties tend to have reduced lifespans. 

In the Monadnock Region, 29% of households make less than $25,000 per year, or $12/hr.

The realization of income disparities in the community presented a huge challenge; however, it was also seen as an opportunity to bring community leaders together to make a powerful impact.

The Vision: 

Living Wage. Healthy Community. Working Together.

The Monadnock Living Wage Work Group (LWWG), a coalition of business, health, faith, social service, government, non-profit, and education leaders, has identified the wage/income gap as a key opportunity for working together to make the Monadnock region a healthier place to live, learn, work, play, and heal. Towards that end, a common vision for the region emerged where every permanent part-time and full-time employee in every sector earns a living wage for their work, optimizing their income, education and social potential, and resulting in stronger economic development, improved health outcomes, and reduced health care costs.
The group worked together to develop models for Living and Healthy Wages based on a variety of expense items, as well as accounting for inflation. Models were developed for a single woman (age 35) and for a single adult with one child (age 4). 


The LWWG is working to increase the number of employees who will earn at least a living wage (or living wage equivalent) by 2020.

o By May 2016, the LWWG will identify and publicly recognize at least 5 employers committed to adopt and implement the living wage of $15/hr ($13.62/hr if employer contributes to health insurance) 

o By December 31, 2020, the LWWG will gain commitment from at least 50 employers in the region to implement a plan to achieve the living wage vision

Generating Buy-In

The LWWG spent a substantial amount of time researching the benefits of adopting living wages for employees. Their recruitment efforts were focused around highlighting a few crucial points:

• Improving the health of employees and reduce related medical costs
• Raising wages benefits both employers and employees, contributing to success and growth
• When wages increase so does productivity and quality, leading to better customer service and reduced need for employer supervision and its associated costs
• Has a positive impact on employee recruitment and retention
• Creating a positive brand perception for employees, clients and partners alike
• Stimulating the local economy

Failing Forward: 

The Living Wage Launch

At the start of the Living Wage Initiative, there were 7 organizations in the community that embraced the challenge and made the pledge.

However, the momentum was lost soon thereafter.

Though recruitment for organizations to adopt the program was ongoing, there were no new organizations stepping forward to make the commitment between May 2016 and April 2017. 

Instead of viewing this as a failure, the LWWG brainstormed ways in which they could engage employers and highlight the benefits it has to their organizations and their employees, as well as re-energizing public will.

Businesses in Downtown Keene, NH

Audacious Goal?

After one year, no more than the initial 7 organizations pledged to provide a living wage by 2020.

A glimmer of hope:

Emerging Solutions

Members of the LWWG were committed to their community and their cause. Tireless efforts led to the emergence of a revitalized approach to secure a Living Wage for everyone in the Greater Monadnock Region.

1. Re-engineering the Coalition

At the May 19, 2016 LWWG Meeting it was decided to divide into 4 sub-groups to work on different elements of the LW Campaign.     These included:

    i) Education/Awareness/Communication – Events, Facebook, FAQs, and a free standing website

    ii) Organizational Support and Business Recruitment

    iii) Advocacy- State/Region and Resource Identification

    iv) Calculation, Measurement, and Evaluation

2. Engaged Campaign Brand Consultants

The most successful campaigns all have one thing: a visible brand. On that note, an outside consultant was hired to create a powerful brand that local organizations would want to be associated with - including an eye-catching logo. Further, they have proposed the idea of creating a website to streamline information, raise awareness, and promote signing onto the campaign. In short, greater recognition will lead to greater engagement.

3. Engaged Community Members to Raise Awareness

No one knows better what the community needs than community members themselves. Efforts were made with local students at Keene State College to re-engage community members by offering novel "Deliberative Dialogue" sessions with a customized issue guide to discuss all of the options available to obtain a living wage, as well as discussing the possible consequences associated with inactivity on the initiative.

4. Receipt of Robert Wood Johnson Foundation Grant

With a lot of effort, and a touch of luck, the Living Wage Initiative was recently awarded funds from the Robert Wood Johnson Foundation to bring this issue into the spotlight state-wide. Partnering with Antioch University of New England, the LWWG will provide guidance and support to other New Hampshire communities who are ready to make obtaining a living wage the norm.


The cumulative effect of these four new additions to the campaign have great promise, and the Monadnock Region is finally prepared to tackle this initiative that could even the playing field of health disparities in Southwest New Hampshire.

No business which depends for existence on paying less than living wages to its workers has any right to continue in this country... by living wages, I mean more than the bare subsistence level - I mean the wages of a decent living.

—Franklin D. Roosevelt