What are the Forces and Influence at Work?

• Young children are living in poverty: Children living in poverty at birth are significantly more likely to be persistently poor throughout childhood.[1]Children who are persistently poor during childhood also have a greater likelihood of living in poverty in adulthood. Poverty is associated with a wide range of major risks to children’s developmental health including toxic stress in young children, which is linked to poor physical and mental health outcomes across the lifespan.[2]
• Low-income families often live in unsafe neighborhoods with high crime rates, poor physical infrastructure and services, and environmental hazards: Poverty makes it much more difficult for families to find quality housing within their means. In many areas, the most affordable housing is in poor condition and located in areas of concentrated poverty with poor public services, higher crime rates and environmental hazards such as poor air quality and an increased risk of lead poisoning.
• Children of color do not have equal access to opportunities and supports: Children of color are much more likely to grow up in persistent poverty[3] and to live in neighborhoods of concentrated poverty.  They are also less likely to have health insurance coverage than white children. Parents of color still experience discrimination in many aspects of daily life, including housing[4] and employment[5] that create additional challenges in promoting their children’s well-being. These gaps in the opportunities and resources available to minority children systematically disadvantage children of color and can negatively impact their developmental health.
• Children from immigrant families are often marginalized: Linguistic and cultural differences are often significant barriers for parents in accessing the information, services and opportunities available to other families with young children. Children in immigrant families are more likely to be living in poverty,[6] less likely to have access to health care[7] and less likely to be enrolled in a prekindergarten program.[8] Many children in immigrant families live in constant fear that they or a loved one will be deported and suffer emotional trauma when separated from a parent or sibling due to immigration status.[9] These barriers to well-being pose significant risks to the developmental health of young children from immigrant families which may have lifelong health consequences.
• Children and families lack consistent access to health care: Lack of employer-provided health benefits is especially common among the lowest-wage workers who are least able to afford health care. This makes it much more difficult for low to moderate income families to afford medical and dental care for their children and for themselves. Parental health also has a major impact on children’s well-being; parents who are in good health have fewer barriers to full employment, less need to spend large sums on health care and fewer obstacles to spending time with their children.  Parental eligibility for Medicaid varies significantly from state to state-- many parents are not eligible for Medicaid even if their children are, so their health needs often go unmet.[10] In medically underserved areas, even families with adequate health coverage may encounter a lack of primary and specialist health care providers who accept their insurance within range of their transportation options.
• Lack of equitable access to educational opportunities: Beginning with infant and toddler care and learning programs and continuing up to college access and continuing education, the opportunity gap between children who can access quality education and those who cannot has a huge impact on outcomes for children’s life and health. Research shows that quality child care and preschool education can have a significant positive impact on children’s educational attainment in later school years. Families who can afford high-quality early learning opportunities for their children can access these benefits, while families with lower incomes need to rely on the options they can afford-- which are often of significantly lower quality. This opportunity gap makes it more difficult for parents to help their children get ready for kindergarten and sets children up for lower likelihood of academic and career success.
• Low and middle-income families cannot access needed supports: Families with young children need access to supports such as paid family and medical leave, quality child care, access to reliable transportation and other resources that help build economically stable families. For low and moderate-income families, the high cost of many of these supports puts them out of reach.
• The number of uninsured children has decreased by 2 million since 1997 but nearly 9 million children remain uninsured and coverage rates of immigrant children have declined.  [10] Uninsured rates have dropped by roughly 25 percent for African-American, Hispanic, and white children, but African-American and Hispanic children are still more likely to be uninsured than white children. Hispanic children are disproportionately uninsured (40 percent of all children), compared to 36 percent White and 18 percent African-American. [11]  About 3 in 10 children (32 percent) without health coverage are under 6. [12]

[1] Ratcliffe, C., & McKernan, S.-M. (2010). Childhood poverty persistence: Facts and consequences. Washington, DC: Urban Institute Press. Available online.

[2] Shonkoff J.P., & Garner, A.S. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129 (1), e232-46.

[3] Ratcliffe, C., & McKernan, S.-M. (2010). Childhood poverty persistence: Facts and consequences. Washington, DC: Urban Institute Press. Available online

[4] US Department of Housing and Urban Development (2013). Housing discrimination against racial and ethnic minorities 2012. Washington, DC: Department of Housing and Urban Development Office of Policy Development and Research. Available online.

[5] Pager, D., Western, B. & Bonikowski, B. (2009). Discrimination in a low-wage labor market: A field experiment. American Sociological Review 74, 777-99.

[6] Wight, V. R., Thampi, K. & Chau, M. (2011). Poor children by parents’ nativity: What do we know? New York City: National Center for Children in Poverty. April 2011. Available online.

[7] Ku, L., & Jewers, M. (2013). Health care for immigrant families: Current policies and issues. Washington, DC: Migration Policy Institute, National Center on Immigration Policy. Available online.

[8] Hernandez, D.J., & Napierala, J.S. (2013). Diverse children: Race, ethnicity and immigration in America's new non-majority generation. New York City: Foundation for Child Development. Available online.

[9] Yoshikawa, H., & Kholoptseva, J. (2013). Unauthorized immigrant parents and their children's development: A summary of the evidence. New York City: Foundation for Child Development. Available online.

[10] Golden, O., & Fortuny, K. (2011). Improving the lives of young children: Meeting parents’ health and mental health needs through Medicaid and CHIP so children can thrive. Washington, DC: Urban Institute. Available online.