Strengthening Economic Supports for Families
June 30, 2026
There is a well-established relationship between poverty and poor health. Poverty makes it harder for parents to meet a child’s most basic needs, including shelter, food, and medical care. Economic hardship also creates significant stress and can lead to changes in parents’ mental health, caregiving behaviors, or other family dynamics.
Early prevention efforts can improve the conditions in which people live, play, and grow. Strengthening economic supports for families enables them to better afford housing, childcare, healthy food, and medical care. Families’ ability to spend on these necessities simultaneously puts more back into local economies. In addition, improving work-family supports can help stabilize families by protecting their jobs/income and reducing stress while they care for themselves, children, or family members.
The approaches detailed in this action guide are key to strengthening economic supports for families — with an abundance of research demonstrating that they are at the intersection of preventing adverse childhood experiences, suicide, and overdose. Effective implementation of each takes:
- Convening and partnering with organizations that can support education efforts.
- Collecting and disseminating data on opportunities for and benefits of these prevention mechanisms.
- Raising awareness in communities and reducing barriers for low-income families.
On This Page
Bolstering Household Financial Security
Enhance Tax Credits Available to Low-Income Families
Tax credits support low-income individuals and families by reducing the taxes they owe and potentially providing refunds. These include the Earned Income Tax Credit (EITC) and the Child Tax Credit (CTC) — while both are federal tax programs, many states also run supplemental EITC and CTC programs with significant variability (i.e., some offer refundable vs. non-refundable tax credits, and they vary widely on how much cash benefits families receive).
- EITC is a refundable tax credit, meaning eligible families receive a refund for any remaining credit beyond their tax liability. They do not have to owe taxes to receive it, but they must file an income tax return, have earned income, and meet income and asset qualifications.
- CTC is a non-refundable tax credit that reduces the amount of taxes eligible families owe for each child under the age of 17. They do not have to owe taxes to receive it, but they must have earned income under $200,000 (or $400,000 if filing a joint return). Families with a CTC refund that is more than the taxes they owe can receive the Additional Child Tax Credit (which is refundable) for each qualifying child.
While many families are eligible for EITC and CTC tax credits, the IRS estimates that 1 in 5 families do not access these benefits and miss out on their value — in part because many low-income families are not required to file a return.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about tax credit benefits include state government agencies, social services, community organizations providing services to low-income families, and organizations that provide services to children and youth. In addition, schools, childcare providers, home visiting programs, and community health workers may be key communicators of families’ eligibility for these benefits.
Education
Key Data
Focus on sharing information about how EITC and CTC can reduce financial stress in households, which improves health of children and families. Collect and showcase participation rates in your jurisdiction, including how many are eligible but not participating in these tax programs.
Local Stories
Source stories directly from families positively impacted by accessing EITC and CTC tax credits, highlighting what they have done with the additional money in their bank accounts.
State Assessment
To help inform decision-makers how starting or expanding an EITC program or CTC program could enhance local economic stability and improve health, assess whether a state-run EITC or CTC program exists in your jurisdiction and how it is structured. This includes:
- Whether the tax credit is refundable vs. non-refundable.
- The amount of credit.
- Income eligibility requirements.
- Child age eligibility requirements for CTC.
Determine which tax credits and which program structures are most appropriate for potential changes at the state level.
Raising Awareness and Reducing Barriers
- Provide referrals to tax preparation services (in English and Spanish).
- Partner with community organizations to host free tax filing clinics in neighborhoods with high poverty rates. Groups can apply for the IRS Volunteer Income Tax Assistance grant program to conduct outreach to underserved communities and support operational costs of providing tax services, with the goal of those eligible for tax credits accessing free tax preparation services. In addition, organizations like Free Tax USA offer free federal tax services.
- Support informational campaigns about EITC and CTC programs, for the general public (e.g., Get Ahead Colorado/Hacia Adelante Colorado (en español)) and low-income individuals accessing health care/primary care (e.g., Increasing Access to Antipoverty Tax Credits through a Medical Financial Partnership). Ask policymakers to allocate resources to improve outreach.
- Ensure groups already reaching and supporting low-income families (e.g., those already providing supplemental income or housing supports) provide information about EITC and CTC federal or state programs and the need to file their taxes to access these benefits.
Enhance Supplemental Income Supports
Cash transfers are another way to help families increase household income and meet basic needs. These include Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) — while both are federal programs, states make decisions on eligibility and how funds are distributed to low-income families. However, all funds must be used to provide income support to low-income families with children and to fund services that provide work, education, childcare, and training supports that help families achieve economic stability.
- TANF is a federal block grant provided to states, which then have flexibility in how the funds are spent. Funding has remained flat since 1996, and states receive fixed funding amounts. However, TANF requires that states also contribute their own funds, called the Maintenance of Effort (MOE) funds. State policies and investments in these efforts vary widely, as each state sets its own policies for exactly who can get help, how much they can receive, and for how long.
- SNAP is a federal cash assistance program that provides cash to families, which they can only spend on food. States operate the program at the local level and determine who is eligible. As a result, those who participate in SNAP and the benefits they receive vary by state.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about TANF and SNAP benefits include state government agencies, social services, community organizations providing services to low-income families, and organizations that provide services to children and youth.
Education
Key Data
Collect and share TANF and SNAP participation rates in your jurisdiction, including how many are eligible for the programs but not participating.
Local Stories
Highlight families who have been positively impacted by accessing TANF cash assistance and SNAP benefits, including what they have done with the additional money in their bank accounts. Using their stories, show decision-makers how increasing TANF funding (through state MOE funds), expanding it to increase cash assistance distribution, or broadening SNAP eligibility could enhance local economic stability and improve health.
State Assessment
Assess how TANF cash assistance and SNAP benefits are structured in your jurisdiction. Then, determine which program structures are most appropriate for state-level changes. Structures include:
- The amount of cash assistance.
- Income and employment eligibility requirements.
- Additional rules and restrictions (e.g., time limit of funds and specific groups that may qualify for assistance).
Raising Awareness and Reducing Barriers
- Support informational campaigns about TANF cash assistance and SNAP benefits to the general public and those who might be eligible. Ask policymakers to allocate resources to improve outreach, and ensure that groups already supporting low-income families provide them with information about these programs.
- Promote co-located services and partnerships so eligible families can learn about and enroll in a variety of assistance programs during one visit.
- Create online tools designed to streamline multiple benefit applications, with easy checks for eligibility (e.g., MyFriendBen).
- Align enrollment requirements and processes (e.g., recertification periods) across assistance programs, which often have independent and sometimes lengthy enrollment and renewal requirements/procedures.
Financial Security Resources
- State Fact Sheets: How Are Families Using the Child Tax Credit?
by The Annie E. Casey Foundation: Read state-level reports on how families used their CTC credits (last updated in 2021). - Constructing a Child Tax Credit that Fits Every State by the Tax Policy Center
by the Tax Policy Center: Use this as a guide for how structure changes could impact the revenue cost and distribution of tax credit benefits. - States Stepping Up to Support Families and Reduce Adverse Childhood Experiences
by ASTHO: Learn how other states have supported families with tax credits. - State Legislative Trends on Temporary Assistance for Needy Families
by the National Conference of State Legislatures: Read an overview of state legislative trends related to TANF from 2020 to 2024. - A Closer Look at Who Benefits from SNAP: State-by-State Fact Sheets
by the Center on Budget and Policy Priorities: Learn about who participates in SNAP and what benefits they receive. - Opportunities for States to Support SNAP
by the National Conference of State Legislatures: Learn how states have enacted policies to adjust SNAP eligibility and determine how SNAP benefits can be spent. - Improving Family Economic Security Through Evidence-Based State Policy Reforms: TANF and SNAP Flexibilities
by the National Center for Children in Poverty: Peruse state profiles on how TANF and SNAP are structured/distributed (last updated in 2024), and opportunities to improve them at the state level.
Enhancing Work-Related Family Supports
Promote Livable Wages
Encouraging living wage policies (within state/local governments or local employers) can lead to income increases and financial stability among families. A livable wage is the hourly wage necessary to meet a person’s or family’s basic needs, given the cost of living. It goes beyond the federal minimum wage, which only accounts for food in its calculation of living expenses. While many states or localities have higher minimum wages than the federal, a livable wage may still be higher because of higher costs of basic necessities such as housing and transportation. As such, promoting livable wages is an important component of enhancing work-related family supports.
How to Implement This Approach
Partnership
Partner with organizations that can help share information on 1) employment, wages, and barriers that families face in obtaining/retaining employment, and 2) the importance of livable wages. This includes state government agencies, labor unions, chambers of commerce, trade associations, and other local employers.
Education
Key Data
Collect and share data on local employment and wages, demonstrating the difference between what individuals and families make versus what they may need to cover basic needs and be self-sufficient.
Local Stories
Highlight families who have been positively impacted by receiving livable wages from local employers, including what they have done with the additional money in their bank accounts. Share these stories directly from local families and use them as evidence for decision-makers (government officials and employers), showing how livable wages could enhance local economic stability and improve health.
State Assessment
Determine which aspects of a livable wage ordinance are most appropriate for your state. For example:
- Reflects the local cost of living. Includes a mechanism that accounts for regular cost-of-living increases.
- Clarifies which employers are required to provide workers with a living wage.
Raising Awareness and Reducing Barriers
Inform local businesses or employers on how internal policies could be set to reflect the local cost of living and account for regular cost increases. Communicate the importance of targeted and local hiring practices, so they are employing members of the local community to increase living wage employment.
If your agency provides funding to local communities or other sub-recipients, encourage applicants to request livable wages for staff working on funded projects.
Promote Paid Leave
Paid leave laws (i.e., family, sick, and vacation) allow workers to address their own health and family needs without compromising their own economic security. As a result, they can further enhance work-related family supports.
- Paid family leave provides income replacement to workers on leave for family caregiving or bonding with a new child.
- Paid sick leave provides personal time to recover from a serious health condition.
- Paid vacation allows employees to rest and re-energize while still generating income.
While there is currently no federal law requiring employers to provide paid sick leave, some states have enacted laws requiring paid sick leave. However, the coverage, eligibility, and provisions vary widely. Meanwhile, the federal Family Medical Leave Act requires employers with 50 or more employees to provide up to 12 weeks of unpaid leave to workers to care for a child, family member, or their own medical condition. Several states have developed more expansive family and medical leave programs that vary in their requirements (i.e., some require employers to provide paid leave, others offer voluntary paid leave coverage that employers can purchase for their workers, and most offer paid parental leave for state employees).
How to Implement This Approach
Partnership
Key partners that can help communicate data on employment and leave policies, as well as their importance, include state government agencies, labor unions, chambers of commerce, trade associations, and other local employers.
Education
Key Data
Collect and share local employment and leave policies, demonstrating potential lack of access to paid leave for low-income workers.
Local Stories
Highlight families who have been positively impacted by receiving paid leave, focusing on what they have done with the protected time off work while maintaining their income. Use these stories to inform decision-makers (government officials and employers) on how paid time off could enhance local economic stability and improve health.
State Assessment
Determine which aspects of paid sick leave and paid family leave policies are most appropriate for your state, and help local businesses/employers understand which policies they could establish. For example:
- Encouraging all employers to offer at least seven days of voluntary job-protected paid sick leave (if businesses are exempt, this still allows for job-protected unpaid sick time).
- Being clear about which employers are required to provide workers with paid sick leave.
- Nondiscrimination provisions to ensure employees do not face retaliation or job loss for taking paid family leave.
- Support a high wage replacement rate (amount of wages replaced while a worker is on family leave).
- Repealing preemption laws that prohibit localities from adopting paid leave laws.
- Eligibility preemption laws that prohibit localities from adopting paid leave laws.
- Eligibility requirements that broaden the definition of family members beyond what is included in Family Medical Leave Act (only a spouse, child, or parent).
- Expanded eligibility to include part-time workers in paid sick and family leave policies.
Raising Awareness and Reducing Barriers
Focus efforts on informing low-income families about employees’ paid leave rights, in states or localities where paid leave policies exist. Support informational campaigns, ask policymakers to allocate resources to improve outreach, and ensure groups that already reach/support low-income families provide information about employees’ rights to paid leave.
Promote Flexible and Consistent Employee Schedules
Consistent work schedules provide parents with a predictable pattern (i.e., known beginning and ending times each workday), while flexible work schedules offer an adjustable number of hours or location. Together, consistent and flexible work schedules make it easier for parents or guardians to access quality childcare, which offers a number of benefits, such as improved well-being and work-life balance. These efforts can also increase job satisfaction and productivity.
How to Implement This Approach
Partnership
Partner with organizations that can help share information on existing work schedules and the importance of consistent, flexible work schedules to economic productivity, as well as individual well-being. This includes state government agencies, labor unions, chambers of commerce, trade associations, and other local employers.
Education
Key Data
Collect and share local employment and employee schedules, demonstrating potential lack of access to consistent and flexible schedules for low-income workers.
Local Stories
Source stories directly from families who have been positively impacted by having consistent or flexible work schedules, highlighting what they have done to balance their work with their individual and family needs. Use this as evidence in informing decision-makers (primarily employers) on how consistent and flexible employee schedules enhance family health and well-being, as well as job productivity and satisfaction.
Raising Awareness and Reducing Barriers
Inform employers in your jurisdiction on internal policies that could be established to provide employees with consistent and flexible schedules.
Work-Related Family Support Resources
- Making the Case: Engaging Businesses
by CDC: Receive training on how to best engage with local businesses. - Data Tools with Customized Tables
by the U.S. Bureau of Labor Statistics: Look at labor and employment across states and communities. - The Living Wage Calculator
by Massachusetts Institute of Technology: Calculate a local living wage based on family size. - Policy Toolkit on Living Wage
by All-In Cities: Read an overview of who should be involved and key considerations for state and local ordinances. - Equitable Development Toolkit
by All-In Cities: Help guide coalitions or organizations through implementing ordinances (last updated in 2002). - Paid Sick Leave and Paid Family Leave
by All-In Cities: Read overviews of who should be involved and key considerations for enacting these policies. - Alternative Work Schedules and Negotiating Flexible and Compressed Work Schedules
by the U.S. Office of Personnel Management: Learn from federal examples, in understanding how the government has established alternative and flexible/compressed work schedules.
Building Employment Opportunities
Provide Job Training Skills to Low-Income Individuals
In addition to providing cash transfers to help families increase household income and meet basic needs, TANF aims to move parents into jobs through work preparation and skill-building. In turn, it funds services that provide work, education, and training that help low-income families achieve self-sufficiency outside of government supports.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of TANF in building job skills for low-income families include state government agencies, social services, or community organizations providing services to low-income families.
Education
Key Data
Collect and share participation rates in TANF-funded services that build employment skills in your jurisdiction — demonstrating how these programs can enhance employment access and, in turn, increase economic security and improve family/child health.
Local Stories
Source stories from families who have increased their education or employment skills through TANF-funded programs, highlighting improved well-being. Use this local evidence to show decision-makers the benefits of increasing TANF funding (through state MOE funds) or expanding it to support employment skill-building programs.
State Assessment
Assess the distribution of TANF funding to organizations providing low-income families with employment skill-building services in your state. Then, determine whether changes at the state level are appropriate.
Raising Awareness and Reducing Barriers
Raise awareness for TANF-funded programs that can help build job skills for those who might be eligible. Support informational campaigns, ask policymakers to allocate resources to improve outreach, and work with organizations that already support low-income families to ensure they share information about these programs.
Establish Microfinance Programs to Invest in Local Businesses
Income-generating programs such as microfinance provide loans and savings opportunities to low-income households to improve the financial and social status of families, particularly women. Microfinance typically includes incentives for repayment (e.g., access to future loans) and social supports (e.g., borrower groups, in which members collectively guarantee loans for each other). Loan and savings programs are sometimes combined with participatory multisession training on relevant job skills, finances, entrepreneurship, as well as topics that promote empowerment and influence women’s social status and health.
How to Implement This Approach
Partnership
Work with organizations that can help share information about 1) self-employment and local financing opportunities, and 2) the importance of microfinance opportunities to promote entrepreneurship, empowerment, and economic security in low-income households. This includes state government agencies, financial institutions (banks or credit unions), state/local offices of finance or financial empowerment, investors, and other lenders.
Education
Key Data
Data should showcase local self-employment and microfinance opportunities, demonstrating potential lack of access among low-income families (especially women).
Local Stories
Share how families in the community have been positively impacted by having microfinance opportunities, including what they have done to build a business and how this has helped them support their families. Showcase their stories to demonstrate to decision-makers (primarily financial institutions, investors, or other lenders) how microfinance opportunities could enhance local economic development while propelling individuals and families towards self-sufficiency.
State Assessment
Help determine what investments might look like for local financial institutions or other investors/lenders — from communal borrowing to low- or no-interest startup loans, or innovative savings plans. Educate them on microfinance programs that focus on providing funding, job training, business skills, and social support/empowerment to low-income families.
Grameen America serves as a model program example, which focuses on providing access to fair and affordable financial services to support the upward economic mobility of low-income women.
Raising Awareness and Reducing Barriers
Raise awareness for the benefits of microfinance opportunities, including improving job and entrepreneurial skills, empowering individuals to support their families and achieve self-sufficiency, and boosting the health of the local economy.
Employment Resources
- State Legislative Trends on Temporary Assistance for Needy Families
by the National Conference of State Legislatures: Read an overview of state legislative trends related to TANF from 2020 to 2024. - TANF and MOE Spending on Basic Assistance, Work, Education, & Training Activities, and Child Care, FY 2022
by the U.S. Office of Family Assistance: Read a summary of federal TANF and state MOE expenditures by spending category, including direct assistance. - Microloans
by the U.S. Small Business Administration: Learn about smaller-size loans that can help small businesses start up/expand and fund intermediary lenders of community organizations that have experience lending and providing technical assistance to borrowers.
Supporting Stable and Affordable Housing
Enhance Supply and Access
Enhancing the availability of housing supply as well as affordable options ensures that all families have access to housing. Housing is considered affordable when a family spends less than 30% of their income on their rent or mortgage. Tapping into relevant state grants and programs can be effective here, including:
- The Community Development Block Grant supports community development activities and can help fund affordable housing. The U.S. Department of Housing and Urban Development allocates funding to states, counties, and cities, which then determine how to provide these funds to the community. While it is not strictly a housing production program (as funds support overall neighborhood revitalization efforts), at least 51% of CBDG-funded units must benefit low- to moderate-income families.
- The Low-Income Housing Tax Credit (LIHTC) program provides tax incentives to purchase, build, or rehabilitate affordable housing.
- The Housing Choice Voucher program provides rent or a portion of it to designated affordable housing units, covering the cost for families who receive vouchers. It is federally funded but administered by state or local public housing agencies. As a result, there are significant differences by state (e.g., in payment standards for rent, whether landlords must require vouchers, which families are prioritized, how long a waiting list might be, how often housing is inspected, etc.).
- Public housing, which is owned and managed by state or local Public Housing Agencies (PHAs).
- Housing Trust Fund programs, which provide a dedicated pool of public or private funds to support affordable housing efforts.
- Emergency Rental Assistance programs, which provide short-term and direct financial aid (for past or future rent/utility costs) to renters facing housing instability.
How to Implement This Approach
Partnership
Partner with organizations that can help inform the public and decision-makers about the benefits of affordable housing for low-income families. This includes state government agencies, housing agencies or coalitions, economic development agencies, social services, community organizations providing services to low-income families, or private sector developers/realtors deeply embedded in the housing market.
The U.S. Department of Housing and Urban Development provides funding to Continuum of Care programs throughout the nation. Connecting with the appropriate organization in your jurisdiction may enhance the efforts of these groups who are working on promoting access to and utilization of affordable housing programs.
Education
Key Data
Collect and disseminate data about the availability of affordable housing compared to those facing housing insecurity or who are unhoused in your jurisdiction, demonstrating the need for quality and affordable housing versus what is available (e.g., Ohio Housing Needs Assessment).
Local Stories
Share stories directly from families who have been positively impacted by affordable housing, highlighting how this has impacted their well-being. Demonstrate how starting or expanding state-led efforts to increase supply or enhance and sustain access to affordable housing could enhance local economic stability and improve health.
State Assessment
- Consider conducting a Health Impact Assessment, which allows for a robust assessment of local data and community input to guide the development of housing policies and programs that best support stabilizing housing for low-income families.
- Formulate approaches that align with the Housing First model, which prioritizes finding families a stable place to live before attending to anything less critical. As a result, it does not make requirements for getting supportive services (e.g., getting a job, building budgeting skills, or getting substance abuse or mental health treatment) as a condition for housing.
- Determine whether Community Development Block Grant funding can be allocated in a way that increases the supply of housing to low-income families specifically.
- Assess what Housing Choice Voucher structures exist in your state and local agencies, and determine which are most appropriate for potential changes.
- Determine whether any policies 1) may support increasing the supply of affordable housing in your jurisdiction, or 2) are needed to provide tenants at risk of eviction with legal assistance and/or legal counsel.
Raising Awareness and Reducing Barriers
- Inform decision-makers how starting or expanding state-led efforts to increase supply and access to affordable housing could enhance local economic stability and improve health.
- Contribute to an informational campaign for low-income families about affordable housing availability, plus how to access this housing through existing state- or local-led programs (e.g., Colorado Housing Connects). Ask policymakers to allocate resources to improve outreach, and ensure groups that already reach/support low-income families provide information about housing assistance, too.
- Support outreach to property owners, developers, and community members about how they can help to build and sustain affordable housing in their communities.
- Help community members/decision-makers understand the importance of inclusionary zoning policies, which require developers to secure a proportion of housing units for affordable housing, and developers/property owners on LIHTC.
- Address any concerns related to the NIMBY (Not In My Backyard) mentality, which is what occurs when local residents oppose the development of affordable housing.
- Support local opportunity zones in your state to enhance private investment into economically distressed communities. Investors in these areas may be eligible for preferential tax incentives, and the investments can enhance community development/affordable housing options.
- Promote co-located services and partnerships so eligible families can learn about and enroll in a variety of assistance programs during one visit. Create online tools designed to streamline multiple benefit applications, with easy checks for eligibility.
- Align enrollment requirements and processes (e.g., recertification periods) across assistance programs, which often have independent and sometimes lengthy enrollment and renewal requirements/procedures.
Housing Resources
- Health Impact Assessment and Housing
by Pew: Use this as a guide for conducting an HIA in your jurisdiction. - HIAs and Other Resources to Advance Health-Informed Decisions
by Pew: Find completed HIAs for reference, filtering the map for housing. - VA’s Implementation of Housing First
by VA.gov: Learn from VA’s implementation of the Housing First model. - Unlocking Housing Choice: Limitation and Opportunities in the Housing Choice Voucher Program
by Enterprise Community: Learn about opportunities for improvement in the HCV program. - Inclusionary Zoning, Housing Trust Funds, and Just Cause
by All-In Cities: Learn who should be involved and key considerations for related policies. - Right to Counsel for Tenants
by PolicyLink: For information on how to implement right to counsel legislation. - Opportunity Zones Toolkit Volume 1 and Volume 2
by the U.S. Department of Housing and Urban Development: Follow along a roadmap to planning for economic development in the first toolkit edition, and learn about best practices and case studies in the second.
This resource reflects the collective efforts of many contributors, including ASTHO staff Alison Maffey, MSW, Vice President, Social and Behavioral Health; Caitlin Langhorne-Griffith, Director, Injury, Suicide, & Violence Prevention; Rachel Scheckman, Senior Analyst, Intersection of ACEs, Suicide & Overdose Prevention; and Erin Wright-Kelly, DrPH, MA, of Community Impact Partners, LLC.
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