A series of reports from five cities across the US found that young children and their parents are healthier when they are able to afford basic needs. New research published by Children's HealthWatch, headquartered at Boston Medical Center, highlights the need for policymakers to improve access to and effectiveness of programs that enable all families with low incomes to afford basic needs such as food, shelter, utilities, medical care, prescription medicines and childcare.
Researchers surveyed more than 18,000 families of children under age 4 in the emergency departments and primary care clinics at urban hospitals in Baltimore, Boston, Minneapolis, Philadelphia, and Little Rock. The study team created a composite measure of hardships that included a family's ability to afford food, utilities, and health care, and maintain stable housing. All hardships described in the study have previously been associated with poor child and caregiver health. This study, however, examined the differences between children living in hardship-free families versus those in families with any or multiple hardships.
In all cities, living in a hardship-free family was associated with good overall health for children and caregivers, positive developmental outcomes for young children, and positive mental health among mothers. Nearly half of families interviewed at Hennepin County Medical Center in Minneapolis reported that they were hardship-free. At Boston Medical Center, only about one quarter of the families surveyed reported zero hardships, which may be due to higher housing costs.
"This report provides a snapshot on our progress to ensure every family can easily afford their bills and allow children to reach their potential, and gives us a goal to ensure all children live in hardship free families in the future," says Dr. Megan Sandel, Co-Lead Principal Investigator at Children's HealthWatch and Pediatrician at Boston Medical Center.
The reports also examine the link between childcare constraints, when parents are unable to work or attend school because of an inability to afford childcare, and hardships. In each city, parents who reported being able to access affordable childcare were more likely to be hardship free.
"High quality, affordable child care, available from infancy, is essential to families' well-being," says Dr. Diana Cutts, Co-Lead Principal Investigator at Children's HealthWatch and Chief of Pediatrics at Hennepin County Medical Center.
Each report recommends state and local policy solutions to improve the health of children. The research teams advocate for implementing policies to increase wages, along with ensuring access to programs that support low-income families being able to meet basic needs, such as food and housing security and medical care. Further, the authors suggested screening for hardships in health care settings and connecting patients and their families to resources that promote health.