Policies Supporting Young Families Can Reduce Adverse Childhood Experiences

February 12, 2024 | Juno Dolan

Elementary school classroom, ASTHO Health Policy Update banner in lower rightAdverse Childhood Experiences (ACEs) are potentially traumatic childhood events that include things like emotional, physical, and sexual abuse, as well as violence and substance abuse in the home and witnessing violence in the community. ACEs have an impact on adulthood and can increase the risk of chronic health conditions, mental illness, and substance use. Two strategies to prevent ACEs include strengthening economic supports for families (e.g., improving household financial security and establishing family-friendly work policies) and ensuring a strong start for children (e.g., home visiting, high-quality childcare, and preschool enrichment).

Policies that support housing security (e.g., creating a safe, stable, and secure housing environment) and family-friendly workplace policies like paid leave and access to quality childcare can decrease the likelihood of young children experiencing ACEs and create a strong foundation for their families. Paid leave—compensated time off from work for caregiving, personal illness, injury, or childbirth—prevents ACEs by increasing economic stability and maternal employment and reducing parental stress and depression. Quality childcare helps children build capacity for learning and has been linked to reducing child abuse and neglect.

During the 2023 legislative session, a number of states enacted policies that advance ACEs prevention measures and support families in ensuring safe places for their children to live, grow, and play.

Promoting Housing Security

Children and families who face housing insecurity are at increased risk for ACEs, experience higher rates of physical and mental health conditions, and are at increased risk for death. Unaffordable housing can lead to eviction and other forms of housing instability, such as multiple moves or even homelessness. As of 2019, 37.1 million households spent 30% or more of their income on housing. Policy options to promote housing security include additional supports for tenants (e.g., mediation programs, eviction protections) and rental agreement standards or limits (e.g., transparency requirements allowing tenants to understand the full cost of a housing option before committing to a lease).

Delaware enacted SB 1, which creates a right to legal representation for tenants with lower incomes in eviction actions. Texas (HB 1193) enacted a law prohibiting discrimination by a homeowner’s association based on a renter’s method of payment, which includes housing vouchers and other types of housing assistance. In Idaho, a new law (S 1039) requires that rental fees, including late fees, be “reasonable” and generally included in the rental agreement, while Utah (HB 315) amended the requirements for a survivor of domestic violence to terminate a rental agreement.

Finally, Colorado took additional actions to support tenants and enacted laws that prohibit security deposits that exceed two months’ rent and certain income requirements for rental eligibility (SB 23-184), eliminated restrictive rental agreement terms that require tenants to waive certain rights, including legal rights (SB 23-1095), and enacted HB 23-1120, which requires mediation prior to eviction when a tenant is receiving certain federal benefits (such as social security disability insurance or cash assistance), with some exceptions.

Paid Leave for Caregivers

Paid leave (e.g., parental, family, and medical leave) is a family-friendly work policy that decreases caregiver stress and depression and creates more economic stability for a family by reducing the threat of job loss or loss of wages from taking leave, both of which help to prevent ACEs. Paid leave policies can decrease the risk of child maltreatment, and paid leave after the birth of a child can decrease the risk of intimate partner violence in particular.

More than a dozen jurisdictions require paid leave. In 2023, Minnesota (HF 2) and Maine (HP 163) enacted comprehensive paid leave programs with implementation planned for 2026. Other jurisdictions also amended existing paid sick leave provisions this past year. For example, Georgia (SB 61) made permanent the requirement for eligible employers to allow employees to use paid sick leave to care for immediate family members. Colorado’s SB 23-017 allows eligible employees to use sick leave to care for a family member whose school or place of care has closed due to weather or other factors, handle financial and legal matters after the death of a family member, and when an employee is evacuated from their residence.

Access to Quality Childcare

Access to high-quality childcare increases the likelihood that children will experience safe and positive relationships and environments and reduces caregiver stress and depression. Quality childcare also promotes both school readiness and improved health outcomes.

At least 12 states took action to support the provision of quality childcare, with several of those states focusing on increasing the childcare workforce. For example, Texas enacted a law (HB 1615) that requires the state’s Workforce Commission to establish and administer a scholarship program for childcare workers, which can be used to pursue early childhood education credentials or training.

Minnesota (HF 2292) established a “Grow Your Own” early childhood educator program to support early childhood educator preparation programs that directly impact that workforce. And, in Oregon (HB 2504), the state’s Department of Early Learning and Care will adopt policies to reduce the barriers international early childhood professionals face when joining the early learning workforce, including requirements for professional training and academic credentials.

Two states also took action to support childcare providers more broadly. Hawaii (SB 239) will establish a childcare accreditation program to support providers pursuing accreditation, and Indiana (HB 1591) directed its early learning advisory committee to explore options in its quality program to incentivize childcare providers to increase wages for workers who complete certain education and training. Finally, Vermont (H 217) enacted legislation aimed at increasing quality childcare throughout the state, including an incentive program for certain high-quality providers and technical assistance to family childcare homes in the state.

ASTHO will continue to monitor this important area and share updates as appropriate.