by September 10, 2024—Throughout the fall, Harvard Chan faculty will share evidence-based recommendations on pressing public health challenges facing the next U.S. administration. Rita Hamad, associate professor of social and behavioral sciences and director of the Social Policies for Health Equity Research (SPHERE) Center, offered her thoughts on how child poverty leads to poor health, recent policies that have shown promise in alleviating the challenge, and opportunities to lift more children out of poverty.
Q: Why is child poverty such an urgent public health problem?
A: We have decades of research, both in public health and economics, showing how poverty is associated with poor health across children’s lives. The strength of the evidence is simply overwhelming.
For example, pregnant women living in poverty have less access to health care, healthy food, and other important health benefits. Research tells us that when their children are born, those children end up being less healthy.
After birth, children living in poverty are more likely to endure less safe, less clean neighborhoods, and lack access to quality health care and nutrition. These deficiencies make it harder to do well in school, get good jobs, and so on. The hardships these children experience are partly due to the intergenerational transmission of poverty, and as a result, the cycle is likely to continue for their own children.
Q: What are the biggest challenges for the next government in terms of child poverty?
A: The biggest issue is how alarmingly common child poverty is. One in eight American children lives in poverty, about 12 percent of all children. The next administration is going to have to address that, because it’s a real outlier compared to our peers, other high-income countries. These child poverty numbers not only pose a challenge today, they create future challenges for society as a whole. Children who grow up in poverty are less likely to participate in the workforce, more likely to need government assistance, and more likely to be involved in the criminal justice system. So reducing child poverty is not only fair to support these children, it’s essential to have an educated and informed public that can contribute to society.
Importantly, the child poverty rate fell to 5% in 2021, the lowest ever, thanks in large part to pandemic-era safety net programs. But then those programs expired, and that rate doubled from 2021 to 2022. The positive thing is that we have tools that can make a real difference in child poverty if we can muster the political will.
Q: What are your main policy recommendations to tackle child poverty?
A: One of the best tools in our toolbox to combat child poverty is the Child Tax Credit (CTC). This tax credit has existed for more than two decades as a benefit primarily for middle- and high-income families, but during the pandemic it was significantly expanded, extending benefits to poorer families, even those with zero income. That meant that unemployed parents received benefits, and the size of the benefit was largest, specifically for the lowest-income families. The delivery mechanism of the CTC also changed: instead of a lump sum paid out upon filing a tax return, the IRS now distributes the payments monthly to people who had recently filed taxes.
These were significant policy innovations, and they really worked! As I said above, child poverty rates were nearly halved in 2021. Unfortunately, Congress authorized only short-term funding, and the expansion expired at the end of that year. When the benefits ended, we saw a reversal of the significant progress.
Another tool we have at our disposal is the Earned Income Tax Credit (EITC), the largest U.S. anti-poverty program for families with children. The EITC lifts millions of families out of poverty each year, but like the original CTC, it does not provide benefits to those without income. This means that families who are struggling the most and children who potentially need it the most are being left behind.
In addition to expanding these tax breaks, we also need to raise the minimum wage. The minimum wage in America is $7.25 and has remained the same since 2009, despite rising costs of living and inflation. That means that some Americans are trying to get by and raise their children on $7.25 an hour, which works out to about $15,000 a year. Just imagine a household, especially a single-parent household, raising children on that amount. It’s just not feasible.
Finally, it’s important to acknowledge one fundamental challenge with our safety net system: It’s made up of many different programs, each with slightly different, complex eligibility requirements and confusing applications. It’s too much to ask families already struggling with poverty to navigate this fragmented system. Millions of families are missing out on critical benefits — and their children are stuck in poverty — simply because they can’t navigate these complicated bureaucratic hurdles. The new administration needs to undertake a major overhaul to simplify the system for these families.
Q: What evidence supports these recommendations?
A: With the CTC, the early evidence was the sharp decline in child poverty during the credit expansion. Given the extensive research showing how exposure to childhood poverty can lead to long-term health problems and even stunt brain development, reducing poverty will improve health. For example, a study by my team found that expanding the CTC reduced anxiety and depression among low-income parents, which may also have benefits for children’s mental health.
My team also found evidence that the EITC is associated with positive health benefits, including birth outcomes, child development, and closing racial health disparities. These are benefits that last a lifetime and are worth pursuing.
On the minimum wage front, health economist George Wehby and his team at the University of Iowa compared states that have adopted higher minimum wages with states that have stuck with the lower federal standard. Their studies and those of others have found that raising the minimum wage is good for children’s health.
My team has also shown how the most marginalized families, such as those with the lowest incomes or those who do not speak English, are the least likely to receive the poverty reduction benefits they qualify for. New policy approaches are needed to address this unfair and inefficient policy failure.
Q: What do you hope can be achieved over the next four years to tackle child poverty?
A: In the middle of a global pandemic, we were able to pass legislation that significantly reduced child poverty in our country. We did it then, and we can do it again. If the next administration could pass some of these policies, it would lead to dramatic improvements in child poverty.
That would give all children the chance to live healthy lives and be productive members of society. And it is morally right to support children who could not choose the household they were born into. Four years from now, I would like to say that our country has finally tackled child poverty in ways that other countries began to think about decades ago.
—Jeff Sobotko
Photos: iStock/kieferpix; thanks to Rita Hamad
