Prioritizing Economic Support Policies to Prevent ACEs and Promote Public Health

Families that experience economic security also have improved health outcomes and contribute to healthier communities, due to reduced familial stress and increased access to care. For example, while poverty is a risk factor for a wide variety of health outcomes (e.g., child abuse and neglect), increasing family resources through the Earned Income Tax Credit (EITC) or financial supports like Temporary Assistance for Needy Families (TANF) and child care subsidies may reduce child maltreatment and other poor health outcomes. Policies that provide additional financial stability which in turn can prevent heart disease, stroke, cancer, lung disease, diabetes, Alzheimer’s, and suicide. However, not everyone who is eligible can access the available benefits, which can further contribute to the gaps that families with lower incomes experience.

Jurisdictions pursuing policy change to address public health challenges should first explore the options available to meet their specific public health goals. Currently, several policy resources visualize the landscape of public health laws across the United States. These comprehensive datasets can help health agency leaders explore approaches in jurisdictions with similar resources, challenges, and opportunities. That said, law is not the only type of policy intervention available to policymakers interested in increasing financial stability for families. Jurisdictions also create policy through rulemaking, amendments to program planning documents, and administrative and operational changes.

Health agency staff can increase economic stability for individuals and families by exploring economic support policy options outlined in the following policy resources in order of greatest (expected) health official authority or influence to smallest.

Supplemental Nutrition Assistance Program

The Supplemental Nutrition Assistance Program (SNAP), administered by USDA, is a financial benefit that allows eligible households to purchase nutritious foods. The monthly benefit, or allotment, is calculated at the household level and considers a number of factors. The federal government funds the entirety of the monthly benefit, but states share in the cost of administering the program.

Resources

• State Options Report by USDA Food and Nutrition Service: This report outlines how every state approaches more than a dozen available flexibilities. States can explore changes to SNAP by using these tools to educate themselves about SNAP, its operations, and policy alternatives pursued by other jurisdictions.
• Supplemental Nutrition Assistance Program (SNAP) Benefits Per Person by KFF: This table, map, and trend graph display the average SNAP benefits per person.

Temporary Assistance for Needy Families

TANF is a federal block grant program that allows states to provide financial assistance and other support to low-income families with children. The nature of the program means that states have flexibility in how funds are spent, though funding has remained flat for many years. While the federal government provides a fixed funding amount, states must also contribute what is known as Maintenance of Effort (or MOE) funds.

Resources

• The Welfare Rules Database by Urban Institute: These reports and tables identify each jurisdiction’s approach to TANF program operations, including how they establish asset limits, treat various types of family income, and what they require of families to maintain benefits.
• Temporary Assistance for Needy Families by ACF: These tables show caseload data for TANF from fiscal year 2023, including the total number of families and recipients.

Child Care Subsidies

The federal Child Care and Development Block Grant Act of 1990 authorizes financial support to subsidize access to child care programs by low-income families. These funds, along with additional child care funding to states, are known as the Child Care and Development Fund (CCDF). While there are several federal requirements, the lead agencies that administer the program in the states and territories have the flexibility to determine how best to serve their population with available funding (e.g., jurisdictions pursue varied approaches to prioritization for child care services, provider payment policies, and some facets of eligibility criteria).

Resources

• Child Care and Development Fund (CCDF) Policies Database by Administration for Children & Families: This database identifies each jurisdiction’s approach to CCDF policy, allowing users to sort by policy category, which includes waitlist and priority policies as well as copayment approaches and relevant variables within that category in each state or territory.

Unemployment Insurance

States and the federal government participate in the Unemployment Insurance (UI) program, which provides limited financial benefits to certain workers who have lost their jobs. Each state, Washington, D.C., Puerto Rico, and the Virgin Islands run their own UI programs within federal guidelines. UI is primarily funded through employer taxes at the state and federal levels and operated at the state level through various agencies/departments responsible for workforce, economic development, or labor issues.

Resources

• State Law Information by United States Department of Labor: This page provides a variety of data on unemployment insurance laws, including a Comparison of State Unemployment Laws as well as state-by-state information on workers covered, benefit eligibility, financing methods, and more.
• Significant Provisions of State Unemployment Insurance Laws Effective July 2024 by United States Department of Labor: This table demonstrates select UI program approaches, including weekly benefits and their calculation, benefit duration, and tax approaches.

State Tax Credits

Two federal tax credits that support working families are EITC and the Child Tax Credit. States can choose to offer similar credits for low-income workers and families. Changes to state tax policy generally require legislative action.

Resources

• Earned Income Tax Credit Laws by LawAtlas: This map showcases state-earned income tax credit laws, including answers to many technical and operational questions about the jurisdiction’s tax laws (Note: Last updated in August 2020).
• State and local governments with Earned Income Tax Credit by IRS: This table features links to state-specific guidance.
• Child Tax Credit Enactments by NCSL: This table compiles legislation from the 15 states that have enacted state child tax credit laws (2013-present).
• Earned Income Tax Credit Enactments by NCSL: This table compiles enacted EITC legislation for 31 states, Washington, D.C., Guam, and Puerto Rico.
• Summary of the Rigorous Research on State Earned Income Tax Credits by Prenatal-to-3 Policy Impact Center: This two-page summary provides an evidence review snapshot of state EITC.