The Public Health Case for a Universalist Child Tax Credit

Berkowitz, Seth A.; Orr, Colin J.; Palakshappa, Deepak

doi:10.1001/jamapediatrics.2022.2503

Cited by 7 publications

(10 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, the 2021 reform of the Child Tax Credit in the United States, which has since expired, was associated with reductions in food hardship among families with children of similar magnitudes to those predicted by the results of this study. 68,69 The details of the 2021 Child Tax Credit reform (in particular, monthly payments and removal of income requirements) parallel child benefits commonly issued in corporatist or social democratic states, 70 a fact that provides support for the estimates of this study.…”

Section: Discussionsupporting

confidence: 54%

Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries

Berkowitz,

Drake,

Byhoff

2023

International Journal of Social Determinants of Health and Heal

Self Cite

View full text Add to dashboard Cite

We sought to determine whether a country's social policy configuration—its welfare state regime—is associated with food insecurity risk. We conducted a cross-sectional study of 2017 U.N. Food and Agriculture Organization individual-level food insecurity survey data from 19 countries (the most recent data available prior to COVID-19). Countries were categorized into three welfare state regimes: liberal (e.g., the United States), corporatist (e.g., Germany), or social democratic (e.g., Norway). Food insecurity probability, calibrated to an international reference standard, was calculated using a Rasch model. We used linear regression to compare food insecurity probability across regime types, adjusting for per-capita gross domestic product, age, gender, education, and household composition. There were 19,008 participants. The mean food insecurity probability was 0.067 (SD: 0.217). In adjusted analyses and compared with liberal regimes, food insecurity probability was lower in corporatist (risk difference: −0.039, 95% CI −0.066 to −0.011, p = .006) and social democratic regimes (risk difference: −0.037, 95% CI −0.062 to −0.012, p = .004). Social policy configuration is strongly associated with food insecurity risk. Social policy changes may help lower food insecurity risk in countries with high risk.

show abstract

Section: Discussionsupporting

confidence: 54%

Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries

Berkowitz,

Drake,

Byhoff

2023

International Journal of Social Determinants of Health and Heal

Self Cite

View full text Add to dashboard Cite

show abstract

“…This cross-sectional study brings awareness that one may be associated with the other and that public benefit program policies, a cornerstone of prevention for child maltreatment, may require equity-centered reevaluation. If equitable reductions in both poverty and related adverse outcomes are to be realized, we may need to explore rescinding means-tested eligibility criteria and give greater consideration for universal eligibility and other means of promoting equitable access to resources and services …”

Section: Discussionmentioning

confidence: 99%

“…If equitable reductions in both poverty and related adverse outcomes are to be realized, we may need to explore rescinding meanstested eligibility criteria and give greater consideration for universal eligibility and other means of promoting equitable access to resources and services. 43…”

Section: Discussionmentioning

confidence: 99%

Public Benefit Programs and Differential Associations With Child Maltreatment by Race and Ethnicity

Puls,

Hall,

Boyd

et al. 2024

JAMA Pediatr

View full text Add to dashboard Cite

ImportancePublic benefit programs, including state spending on local, state, and federal-state partnership programs, have consistently been associated with overall reductions in child protective services (CPS) involvement. Inequities in eligibility and access to benefit programs may contribute to varying associations by race and ethnicity.ObjectiveTo determine whether associations between state spending on benefit programs and rates of CPS investigations differ by race and ethnicity.Design, Setting, and ParticipantsThis cross-sectional ecological study used repeated state-level measures of child maltreatment from the National Child Abuse and Neglect Data System and population estimates from the US Census Bureau for all Black, Hispanic, and White children. All 50 US states from October 1, 2009, through September 30, 2019 (fiscal years 2010-2019), were included. Data were collected and analyzed from May 13, 2022, to March 2, 2023.ExposuresAnnual state spending on benefit programs per person living below the federal poverty limit, total and by the following subcategories: (1) cash, housing, and in-kind; (2) housing infrastructure; (3) child care assistance; (4) refundable earned income tax credit; and (5) medical assistance programs.Main Outcomes and MeasuresRace- and ethnicity-specific rates of CPS investigations. Generalized estimating equations, with repeated measures of states, an interaction between race and spending, and estimated incidence rate ratios (IRRs) and 95% CIs for incremental changes in spending of US $1000 per person living below the federal poverty limit were calculated after adjustment for federal spending, race- and ethnicity-specific child poverty rate, and year.ResultsA total of 493 state-year observations were included in the analysis. The association between total spending and CPS investigations differed significantly by race and ethnicity: there was an inverse association between total state spending and CPS investigations for White children (IRR, 0.94 [95% CI, 0.91-0.98]) but not for Black children (IRR, 0.98 [95% CI, 0.94-1.02]) or Hispanic children (IRR, 0.99 [95% CI, 0.95-1.03]) (P = .02 for interaction). Likewise, inverse associations were present for only White children with respect to all subcategories of state spending and differed significantly from Black and Hispanic children for all subcategories except the refundable earned income tax credit (eg, IRR for medical assistance programs for White children, 0.89 [95% CI, 0.82-0.96]; P = .005 for race and spending interaction term).Conclusions and RelevanceThese results raise concerns that benefit programs may add relative advantages for White children compared with Black and Hispanic children and contribute to racial and ethnic disparities in CPS investigations. States’ eligibility criteria and distribution practices should be examined to promote equitable effects on adverse child outcomes.

show abstract

“…Unlike prior iterations of the Child Tax Credit, these payments were fully refundable, meaning that all low-income households were eligible to receive the full value of the credit as a direct deposit or check . Since expiring at the end of 2021, the Child Tax Credit reverted to its prior design . As one of the largest economic policy interventions in recent history (the US Congressional Budget Office estimated that the 1-year expansion of the Child Tax Credit cost $185 billion), it is vital to understand how the Expanded Child Tax Credit (ECTC) was associated with changes in health to inform the design of future cash transfer programs.…”

Section: Introductionmentioning

confidence: 99%

“…14 Since expiring at the end of 2021, the Child Tax Credit reverted to its prior design. 15 , 16 As one of the largest economic policy interventions in recent history (the US Congressional Budget Office estimated that the 1-year expansion of the Child Tax Credit cost $185 billion 17 ), it is vital to understand how the Expanded Child Tax Credit (ECTC) was associated with changes in health to inform the design of future cash transfer programs.…”

Section: Introductionmentioning

confidence: 99%

Changes in Self-Reported Adult Health and Household Food Security With the 2021 Expanded Child Tax Credit Monthly Payments

et al. 2023

View full text Add to dashboard Cite

ImportanceThe 2021 Expanded Child Tax Credit (ECTC) provided families with children monthly payments from July 2021 to December 2021. The association of this policy with adult health is understudied.ObjectiveTo examine changes in adult self-reported health and household food security before and during ECTC monthly payments.Design, Setting, and ParticipantsThis repeated cross-sectional study used multivariable regression with a difference-in-differences estimator to assess adult health and food security for 39 479 respondents to the National Health Interview Survey (January 2019 to December 2021) before vs during monthly payments. Analyses were stratified by income to focus on low-income vs middle-income and upper-income households.ExposureEligibility for ECTC monthly payments from July 2021 to December 2021.Main Outcomes and MeasuresOverall self-reported adult health and household food security as binary outcomes (excellent or very good health vs good, fair, or poor health; food secure vs food insecure).ResultsIn this nationally representative cross-sectional study of 39 479 US adults (mean [SD] age, 41.0 [13.0] years; 7234 [21.7%] Hispanic, 321 [0.9%] non-Hispanic American Indian/Alaska Native, 2205 [5.7%] non-Hispanic Asian, 5113 [13.7%] non-Hispanic Black, and 23 704 [55.8%] White individuals), respondents were predominantly female (21 511 [52.4%]), employed (33 035 [86.7%]), and married (19 838 [55.7%]). Before disbursement of ECTC monthly payments, 7633 ECTC-eligible adults (60.1%) reported excellent or very good health, and 10 950 (87.8%) reported having food security. Among ECTC-ineligible adults, 10 778 (54.9%) reported excellent or very good health and 17 839 (89.1%) reported food security. Following disbursement of monthly payments, ECTC-eligible adults experienced a 3.0 percentage point (pp) greater adjusted increase (95% CI, 0.2-5.7) in the probability of reporting excellent or very good health compared with ECTC-ineligible adults. Additionally, ECTC-eligible adults experienced a 1.9 pp greater adjusted increase (95% CI, 0.1-3.7) in the probability of food security than ECTC-ineligible adults. In income-stratified analyses, the association between ECTC eligibility and overall health was concentrated among middle-income and upper-income households (3.7-pp increase in excellent or very good health; 95% CI, 0.5-6.9). Conversely, the association between ECTC eligibility and food security was concentrated among low-income adults (3.9-pp increase in food security; 95% CI, 0-7.9).Conclusions and RelevanceThe results of this cross-sectional study suggest that monthly ECTC payments were associated with improved adult overall health and food security. Cash transfer programs may be effective tools in improving adult health and household nutrition.

show abstract

The Public Health Case for a Universalist Child Tax Credit

Cited by 7 publications

References 5 publications

Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries

Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries

Public Benefit Programs and Differential Associations With Child Maltreatment by Race and Ethnicity

Changes in Self-Reported Adult Health and Household Food Security With the 2021 Expanded Child Tax Credit Monthly Payments

Contact Info

Product

Resources

About