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Family finances affect children’s minds and bodies. As a pediatrician and medical student, we see every day how poverty makes children sicker. The 2021 US bailout put an end to this harsh reality by expanding the child tax credit. But the credit expansion expired in December and 35% of families with children then said they were struggling to cover usual household expenses again, with downstream implications for children’s health.

Congress has the tools to stop this regression: expand the child tax credit and adequately fund child care.

Child tax credits, healthier children

When the child tax credit was extended last year, it increased the maximum amount of the credit, removed some income and tax requirements and allowed recipients to get monthly payments in advance. Most people use the tax credit to pay for basic needs like food, rent and utilities, so its expansion lifted 3 million children out of poverty virtually overnight and improved their health.

That’s why Beatrice*, a 55-year-old part-time cashier who earns $7,000 a year at McDonald’s and is the only one caring for her 3-year-old grandson, Avery*, celebrated by calling her closest friends the day she received a $2,400 tax refund from the US government. It was a lifesaver: she paid off her owner and bought the Spider-Man night light that Avery had been eyeing for months.

As physicians, we will be better able to help children if the child tax credit is extended. After all, the same earned income tax credit is tied to higher birth weights, K-12 academic performance, employment of single mothers, and future family earnings. And recent research shows that providing $333 a month to low-income mothers – slightly more than what the Expanded Child Tax Credit provides ($250-300 depending on age) – increases brain activity in infants. from their first birthday. In addition, extending the Child Tax Credit would advance health equity; over 70% of poor children in 2020 were children of color.

Child Care Funding, Long Term Health

Federal lawmakers must also help states expand access to affordable, high-quality child care — which has long been underfunded — to bolster the financial well-being and overall health of families. At the start of this year, more than 25% of families with young children found themselves without child care, often because it was unavailable or unaffordable.

Take for example Mariana*, a mother of two whom we met recently. Now homeless, Mariana had to choose between a childcare provider she could afford, but didn’t trust, or a certified provider she trusted, but didn’t trust. she couldn’t afford to pay. “I had no choice, actually,” she told Us.

Mariana therefore decided to stay home to care for her children instead of working, thereby losing income and, eventually, her ability to pay rent. She and the kids had to “couch surf” (crash with different people from week to week), then live in her car, and now stay in a homeless shelter, where she fears her kids will get sick and don’t fall behind in school. For Mariana, access to safe and affordable child care is the difference between a stable life and homelessness.

High-quality, subsidized child care would benefit more than 13 million children under age 6, like Mariana’s children. In fact, more than 60% of American 4-year-olds do not have access to publicly funded preschool, mostly in racial and ethnic minority communities, even though investing in high-quality preschool improves development. physical, cognitive and socio-emotional children. .

Food insecurity worsens the health and learning of more than 10% of American children, especially in rural areas and low-income communities of color. Universal pre-K programs and increased funding for free school meals would improve academic achievement, encourage early detection of developmental disabilities and other medical conditions, and promote better overall health, especially in low-resource communities. . Investing in school nutrition is particularly timely with pandemic-related measures, such as universal free lunches, which are due to expire in June, and ongoing supply chain and labor shortages.

The Affordable Care Act, which passed 12 years ago in March, was a critical first step in promoting the health and financial well-being of low-income families by making health insurance more accessible and affordable, and providing “plus” financial benefits for low-income people. -income families: better credit ratings, less food insecurity, fewer evictions. But more than a decade later, children still have worse health outcomes in the United States than in other developed countries.

Extending the child tax credit and expanding child care, preschool education, and school meals would dramatically improve the health and learning of America’s future workforce while leveling rules of the game for vulnerable families like those of Beatrice and Mariana. Medical Colleges: Urge elected officials to quickly adopt these common-sense, evidence-based solutions. Our children deserve better.

Michael Hole, MD, MBA, is a physician and professor of politics at the University of Texas at Austin, where he is executive director of the Impact Factory, a hub for social entrepreneurship. He also co-founded StreetCred, a non-profit organization that helps low-income families file their taxes and build wealth in medical clinics. Matthew Alexander is a medical student at Virginia Commonwealth University.