Earlier this month, Genesis Health Consulting had the opportunity to attend the Pediatric Academic Societies (PAS) Annual Meeting. The PAS meeting brings together pediatricians, researchers, health care providers, and other academicians to “improve the health and well-being of children." One plenary that particularly stood out to us was on the National Academies of Sciences (NAS) report, A Roadmap to Reducing Child Poverty, which introduces the goal of reducing child poverty by 50% in ten years.
The report uses 2015 data on the Supplemental Poverty Measure to define child poverty. Using this measure, the poverty line for a two-parent, two-child home who are renters or are homeowners with a mortgage, is drawn at around $26,000 per year, or $2,167 per month. For context, a typical piece of budget advice recommends 25 - 35% of monthly income be set aside for housing. For this family, that is $542 - $758 per month. The median apartment cost of a one-bedroom unit in 50 cities across the United States is $1,234 (or 57% of this family's budget). And that is just housing. Another piece of typical budget advice is that 10 - 15% of your monthly income be put towards food; which, for this family, would be $217 - $325 per month. Recent numbers from the US Department of Agriculture show that the average cost of feeding a family of four was $557 - $1089 per month, depending on if the family used a “thrifty” or “liberal” food plan. If we conservatively use the “thrifty” plan, 83% of this family's budget would be utilized for only food and housing costs. Utilities, insurance, health care, education, transportation, clothing, and other bills will all need to be paid with the remaining $375.
According to the NAS report, currently 9.6 million children live in households with incomes at or below that $26,000 child poverty line. This is roughly equivalent to the total population of the state of Michigan, the 10th most populous state in the United States. Even more disturbing, 2.1 million of those children (or >20%) live in “deep poverty,” meaning they are living at or below a $13,000 annual household income. This is roughly equivalent to the total population of the state of New Mexico, the 36th most populous state in the United States.
Research has consistently demonstrated the negative health effects of poverty on children directly throughout their life course, from low birthweight, prematurity and infant mortality to language development, social development, and chronic illness, among others. Children also experience the negative health effects of poverty indirectly through their parents, families and caregivers through effects that poverty has on parenting and toxic stress. The effects of poverty can also be felt on a societal level as life expectancy, employment rates and productivity are all attenuated among high poverty populations, while incarceration rates, crime and health care utilization all increase.
In light of all of this, it seems both daring and necessary to posit that child poverty rates must be cut in half in the next ten years. But, how?
The committee convened to develop what ultimately become the NAS Roadmap to Reducing Child Poverty initially identified 20 evidence-based program and policy options to reduce child poverty. It is important to note that analyses of these programs and policies revealed that no single option would get to the goal of a 50% reduction. The committee then examined packages of program and policy options and ultimately found that two packages, that if implemented in contexts that support them, would meet the goal of reducing the child poverty rate by 50%:
The first package calls for expanding the earned-income and child care tax credits, as well as expanding housing vouchers and SNAP benefits yielding a 50.7% reduction in child poverty within 10 years;
The second package calls for expanding the earned-income and child care tax credits, beginning a child allowance (extension of federal child tax credit delivered monthly) and child support assurance program (sets guaranteed minimum child support amounts per child per month), and eliminating the 1996 immigrant eligibility restrictions to yield a 52.3% reduction in child poverty.
We have written several blog posts on the importance of early investments in child development (i.e., The Heckman Equation), social determinants of health, the importance of family to child development, federal policies to improve access to health care for kids, and the unintended consequences of an isolated approach to health care. Poverty is the underlying root case of many of the negative outcomes the health care system sees, and thus calls for a fully upstream approach must include addressing poverty. Our mission at Genesis Health Consulting is to create meaningful, positive, sustainable improvements in kids’ health. Reducing poverty and supporting those packages outlined by the NAS Roadmap is an opportunity for all of us who are united to improve the health and well-being of children.
Genesis Health Consulting has deep expertise in developing and implementing upstream strategies and service delivery models to measurably and sustainably improve child health and well-being. Please email us at info@genesishealthconsulting.com to learn how we can help you achieve your goals.