America’s children are poor. Kids are our country’s most impoverished group and it’s getting worse. Earlier this month, the Census Bureau reported the Supplemental Child Poverty Rate — which accounts for aid provided by government social programs — more than doubled in one year, from 5.2% to 12.4%, meaning more than 9 million children are now poor.
Pediatricians did not need the Census Bureau to tell us more children and families are struggling. Working on the front lines of child health, we notice when our patients ask more about local food banks than immunizations. We notice when babies lose weight because families are diluting formula with excess water to make it last longer — a potential health disaster. Last week, I told the mother of a newborn I was concerned about her baby’s heart murmur. But she’s worried about affording diapers.
Poverty is our nation’s most common child disease. Child poverty is backbreaking, impacting lifelong physical and mental health and derailing kids from opportunities that would enable them to achieve their full potential.
It hits children hardest. Poor children have decreased access to care, are more likely to overuse the emergency room and exhibit higher rates of asthma. Babies born to impoverished mothers weigh less, are at higher risk of infant mortality and are more likely to have language delays. Chronic poverty is associated with impulsivity, poor school performance and teenage pregnancy. Poverty haunts children into adulthood, imparting a higher risk of cardiovascular and psychiatric disease.
How did so many children become poor so fast? The American Rescue Act, passed during the pandemic, expanded the Earned Income Tax Credit, increasing the benefit and making 17 million more people eligible. Congress also expanded the Child Tax Credit, resulting in more dollars directly in the pockets of the working-class families I care for. In some cases, families saw benefits more than triple — supporting them through a period of 10% inflation and economic instability.
Pediatricians saw the impact of this extra help in our hospitals and office every day. Parents could now afford the special, but costly infant formulas preterm infants need, could refill asthma prescriptions and purchase nutritious food that wasn’t high in calories or fat. A study by the Casey Foundation found 65% of families used money from tax credits on food, utilities, rent and clothing, elevating families above the poverty line.
But the child tax credit expired in 2021, almost immediately pushing 3.7 million children into poverty and contributing to the dramatic rise in poor children reflected in the Census report. Now policy decisions could make life worse for kids.
Congress made requirements more stringent to qualify for the Supplemental Nutrition Assistance Program — which offsets the cost of food for needy families and children — potentially cutting 350,000 women from the program. And now Congress is poised to further weaken the social supports children need. A proposal would cut support for the Women, Infants and Children program by $185 million. This program provides nutritional assistance to 6.6 million women, children and babies in early childhood. Cuts would also eliminate extra dollars for purchasing fruits and vegetables, essential for the health of developing children.
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My patients are too young to follow the latest budget deals coming out of Washington, but they will suffer if the needs of kids are not front and center. Food bank inventory is low, and parents are again asking if their children “really need” their asthma inhalers. The pamphlets with directions to the diaper banks need to be refilled daily, and mothers and fathers are again reporting cutting back on their own medicines to ensure they can afford prescriptions for their children.
The 2023 Census Report is a window into our national priorities. When we allow child poverty to double in a year by removing tax credits and threaten more cuts to social programs, we are really saying that children do not matter. When we make it harder for hungry children to get food, we are saying despite the profound, long-lasting effects of child poverty, our kids are still last in line.
Pediatricians often say children are 100% of our future. But they are also our present. Instead of petty cuts to food programs, the report should motivate us to strengthen the safety net for kids. Children have no vote and no voice, so they are easy to ignore. The doubling of child poverty in one year demonstrates what happens when adults don’t speak for them.
Shetal Shah is chair of the national Pediatric Policy Council and a member of the American Academy of Pediatrics Section on Neonatal-Perinatal Executive Committee.