States Stepping Up to Support Families and Reduce Adverse Childhood Experiences

January 19, 2023 | Beth Giambrone, Maggie Davis

Shopping cart in grocery store, ASTHO Health Policy Update banner in upper-leftAdverse childhood experiences (ACEs), which include families struggling to pay basic living expenses, can harm a child’s social, cognitive, and emotional functioning and increase a child's risk of chronic health problems, mental illness, and substance use in adulthood. In its bid to address the COVID-19 pandemic, the American Rescue Plan Act of 2021 brought with it unprecedented assistance for children and families, which nearly halved childhood poverty in 2021. That support—and the economic boost families received as a result—expired in December 2021.

Although economic hardship is the most common ACE across all racial groups, Black and Hispanic families are more likely to experience it than white families. Additionally, American Indian and Alaska Native (AIAN) populations experience poverty at higher rates than other racial and ethnic population groups; poverty rates among AIAN children are twice those of white, non-Hispanic children. Children living in rural areas are also more likely to experience economic hardship.

Research confirms that strengthening economic supports (e.g., increasing income through tax credits, providing nutrition benefits) can improve parental mental health, children’s health, education, and social outcomes. Further research indicates that strong economic supports can help break the cycle of ACEs, particularly for Black families.

CDC has highlighted several strategies for preventing ACEs—and states have played a critical role in enacting policies to support them.

Expiration of Pandemic-Related Family Economic Supports

The American Rescue Plan Act of 2021, which provided emergency supplemental funding to address the COVID-19 pandemic, also included never-before-seen support for children and families. The law significantly expanded the federal 2021 Child Tax Credit for one year, making almost 90% of U.S. children eligible for the credit.

This temporary expansion of the Child Tax Credit reduced child poverty by 46% in 2021, lifting an estimated 2.9 million children out of poverty. The expanded tax credit was only in place for the 2021 tax year, with the credit reverting to pre-ARPA levels in January 2022, coinciding with rising living costs for families. Research shows that many family economic gains from the credit have been lost.

Supporting Families with Tax Credits

Although the federal Child Tax Credit expansion expired, states considered ways to increase economic supports to families by either expanding state tax credits or making temporary pandemic benefits permanent. States have several ways to expand economic supports to families, including child tax credits that provide families with qualifying children a credit to their state taxes as well as earned income tax credits (EITC), which incentivize work for low- and moderate-income earners by providing an additional tax credit for working. Low-income families can benefit from EITCs, with some research showing EITCs as a promising practice to prevent ACEs.

At least three states (Illinois, Hawaii, and Vermont) increased or made their earned income tax credit permanent during their 2022 legislative session.

Illinois enacted SB 157, which increases the earned income tax credit to 20% of the federal tax credit for each taxable year beginning January 1, 2023. Hawaii (HB 2510) made its earned income tax credit refundable and permanent, providing a carryforward of nonrefundable credits previously claimed.

Vermont (H 510) increased its earned income tax credit to 38% of the federal earned income tax credit and created a refundable Vermont child tax credit of $1,000 for qualifying children five years of age and under. The bill also amended the Vermont child and dependent care credit to provide a fully refundable credit that is 72% of the federal child and dependent care credit allowed to the taxpayer.

In addition to expanding the earned income tax credit, some states enacted laws focused on improving outreach and education about these financial supports. A new Oregon law (HB 4117) directs the Department of Human Services to provide education about federal earned income tax credits and other financial benefits available to people with lower incomes and navigate the tax system in ways that are culturally specific and responsive. Specifically, the program can provide grants to tribal governments and under-resourced rural community services organizations to conduct education and outreach.

Combating Food Insecurity

Food insecurity, or lack of access to adequate food for every household member, affects 10% of U.S. households. As economic hardships (such as job loss) can force a caregiver to forego buying food to pay for other needs, it can impact both the physical and mental well-being of children. The federal government has three major programs to combat food insecurity: the Supplemental Nutrition Assistance Program (SNAP), the National School Lunch Program (NSLP), and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

In 2022, 11 states considered bills to reduce food insecurity. At least three states (California, Colorado, and New Jersey) enacted laws increasing access to food assistance. California’s new law (SB 187) creates a Tribal Nutrition Assistance Program that will provide grants to eligible tribes and tribal organizations to address food insecurity and inequities between the SNAP program and the federal program providing food assistance to people living on Indian reservations.

Colorado’s new law (HB 22-1380) aims to provide greater food access and reduce food costs in low-income or underserved areas by supporting small grocery retailers. The program includes a small business consortium to offer technical assistance and subsidies to Colorado food producers and small retailers, a small food business recovery and resilience grant program that will issue one-time grants to small food retailers and family farms, and an advisory committee to assist with the grant program.

New Jersey enacted multiple bills aimed at increasing access to and receipt of SNAP benefits. The new laws focus on educating potential SNAP beneficiaries about their eligibility for benefits (A 2361), streamlining the application process (A 2359), and establishing a minimum ($50) monthly benefit for households participating in SNAP (A 2366).

Securing Safe Housing

The effects of both inflation and the COVID-19 pandemic made for a difficult situation for both renters and would-be homeowners. In 2020, nearly one in four renters in the United States spent at least half of their monthly income on housing, and rent has outpaced inflation for the last five years. In addition, the median price for a single-family home was more than $400,000 in the last quarter of 2021, a 25% increase from 2019. The combination of rising housing costs and stagnant or falling incomes can force families to live in substandard housing, constantly move due to eviction or foreclosure, or become homeless.

At least 13 states considered legislation to increase access to housing and reduce the number of people experiencing homelessness. A new California law (SB 197) directs the Department of Corrections and Rehabilitation to provide housing aligned with the core components of Housing First, provides the Department of Housing and Community Development greater flexibility in supporting the development of rental housing, and establishes the California Dream for All Program, which provides a revolving, shared appreciation loan for low- and moderate-income first-time homebuyers.

A new Washington law (HB 1905) requires the office of homeless youth prevention and protection programs to provide grants that will prevent persons under the age of 25 from exiting a publicly funded system of care into homelessness, including housing and financial support to secure stable housing.

Illinois’ new law (HB 5225) establishes an innovative program to reduce barriers experienced by people participating in apprenticeships. Under this pilot program, people enrolled in a registered apprenticeship program, pre-apprenticeship program, or work-based learning programs, will receive funding for rent and utilities, as well as childcare.

Economic supports that help prevent ACEs have benefits beyond securing safe housing and regular meals. They reduce the risk of caregiver stress, depression, and violence, and provides the opportunity for caregivers to instead focus on a child’s well-being. ASTHO will continue to monitor and report on this important issue.

Special thanks to Caitlin Langhorne Griffith, MPH, director of social and behavioral health, and Jessica Bissett, senior analyst of social and behavioral health, for contributing to this blog post.