INCOME AUGMENTATION PROGRAMS AND POLICIES

Programs that directly increase individual or family incomes are potential solutions to the opportunity gap for children. Several national and state programs with this focus have been implemented over the past 50 years, starting with those under the Great Society. This section describes three income augmentation programs and policies—minimum wage, the earned income tax credit (EITC), and paid family and medical leave—and the ways in which they may reduce opportunity gaps for young children. A fourth policy, the child tax credit (CTC), is briefly discussed in a later section.

PARENTS' POOR JOB QUALITY AND OPPORTUNITY GAPS FOR CHILDREN

Parents' job characteristics are a social determinant of their children's health. The quality of parents' jobs is an important but overlooked component of the resources available to children that affect their healthy development (Heinrich, 2014). As highlighted in Figure 7-1, parents' jobs have direct and indirect pathways to children's health and development. Parents' jobs present opportunity gaps for children if they do not provide enough resources, wages, and benefits, or if they entail unpredictable work schedules, or require working at night or on weekends, making it difficult to arrange child care and producing family stress. The role of parents' jobs in creating opportunity gaps is important to consider since most families with children (89%) include at least one working parent (Department of Labor, 2022), and earnings make up more than 75% of household income (Shrider et al., 2021).

FIGURE 7-1

Hypothesized pathways between parents’ job quality and children’s health and development. SOURCE: Adapted from Joshi et al., 2020.

While parents' employment provides the main source of family resources to invest in children, there are trade-offs between the resources gained and potentially less parental time with children, as well as the quality of care arrangements to which children are exposed when parents are working (Becker, 1981; Peters, 1995). Moreover, parents' positive or negative experiences at work can spill over to affect their psychological well-being, family interactions, and children's social-emotional development (Repetti & Wang, 2014). While research shows that unemployment has a consistent negative effect on mental health, studies of employment have found both positive and negative effects depending on job quality, including wages, hours, schedules, and stability (Antonisse & Garfield, 2018).

Beyond employment status, the quality of parents' jobs affects children's healthy development. While there is no standard definition of job quality, both economic and noneconomic dimensions affect parents' health, family dynamics, and resources available to invest in children. These dimensions include compensation, such as earnings and benefits (health insurance, pensions, paid leave); working conditions (hours, predictability of schedules, job security, safety); business culture and job design (mission and autonomy); and opportunities for skill development and advancement (Howell & Kalleberg, 2019; Congdon et al., 2020).

Studies show that some characteristics of parents' jobs directly affect financial and health resources available for their children, whereas other characteristics, such as work schedules, hours, tasks, and relationships affect children indirectly through their parents (Menaghan & Parcel, 1995). Heinrich (2014) posits that exposure to lower wages and benefits and unpredictable hours and schedules can increase family stress, which negatively affects both parents' and children's mental health (Heinrich, 2014). Conversely, higher-wage jobs that provide work–family support and the opportunity to engage in creative work have been linked to improved mental health (Burgard & Lin, 2013).

A growing nonexperimental evidence base confirms that parents' job characteristics are associated with outcomes for both parents and children in the predicted directions. Indices of poor-quality job characteristics are associated with children's grade repetition and behavior issues (Kalil & Ziol-Guest, 2005; Strazdins et al., 2010) and mothers' worse postpartum mental health (Cooklin et al., 2011). Several studies establish a negative association between nonstandard schedules (Joshi & Bogen, 2007; Li et al., 2014) or unpredictable schedules (Carrillo et al., 2017; Schneider and Harknett, 2019a,b; Ananat et al., 2022) and parents' well-being and children's behavioral health and quality care arrangements. Evidence suggests that precarious work schedules may also make it more difficult for individuals and families to meet work requirements for safety net programs (Karpman, Hahn, & Gangopadhyaya, 2019). In contrast, higher-quality jobs are associated with children's improved reading and math scores and behavioral outcomes (Lombardi & Coley, 2013) and help improve new parents' mental health in dual-earner couples (Perry-Jenkins et al., 2017). In addition, more consistent work schedules and higher-quality jobs can increase options for many families to access higher-quality schools through school choice programs when their neighborhood school is underperforming, especially when those programs require families to provide transportation and child care (Sandstrom, 2015; Chingos & Blagg, 2017; McShane & Shaw, 2020; Collier, 2021). Although the preponderance of evidence suggests that lower job quality has negative implications for families, a causal relationship cannot be determined because of potential selection bias.

Over the past 40 years, wages have failed to keep up with inflation, and employers have offered fewer benefits, making it difficult for the average working family with children to cover a basic family budget that includes the costs of housing, food, child care, and health insurance (Howell & Kalleberg, 2019). At the same time, wage growth at the upper end of the labor market has significantly increased wage inequality (Howell & Kalleberg, 2019). Other dimensions of poor job quality discussed above have increased as well, including nonstandard work hours (in the evening, at night, or on weekends) and unpredictable scheduling practices, such as last-minute scheduling changes (Henly, Lambert, & Dresser, 2021). Growing wage inequality and declining job quality mean lower access to resources for lower- and middle-income families, in turn widening parental job–related opportunity gaps for children.

A recent study found that one-third of families working full-time year-round do not earn enough to cover a basic family budget, and more than three-quarters of low-income full-time working families do not have enough income to cover basic costs, including child care, transportation, housing, food, and other expenses (Joshi et al., 2022). Figure 7-2 shows the significant proportions of working families (14%) and low-income families (31%) that do not earn enough wages from full-time work to cover basic expenses or have any access to health insurance or pensions through their employers. These jobs are the most concerning in terms of providing adequate resources for families with children.

FIGURE 7-2

Share of full-time working families with jobs without adequate family-supporting wages or benefits, by race/ethnicity and foreign-born status. NOTES: Calculations based on the Current Population Survey Annual Social and Economic Supplement 2015–2019. (more...)

It is well known that racial inequities in wages and employer-provided benefits are an enduring feature of the U.S. labor market (Kristal, Cohen, & Navot, 2018; Howell & Kalleberg, 2019). Black, Hispanic, and foreign-born working parents disproportionately experience low job quality (Earle et al., 2014). Figure 7-2 shows significant racial/ethnic and nativity differences in the quality of jobs held by full-time year-round working families. Approximately 30% of Hispanic families have full-time jobs that do not provide enough wages to cover basic expenses and do not offer health insurance or pension benefits. While many families need access to income assistance to make up for these shortfalls in job resources, low-income Hispanic (43%) and immigrant (41%) families are in particular need because they disproportionately have earnings that do not cover family expenses or work for employers that do not offer benefits. In addition to lower wages and less access to employer-provided benefits, Black and Hispanic workers are more likely than workers from other racial/ethnic groups to work in jobs that require nonstandard work schedules during the evening, at night, and on weekends (Presser & Ward, 2011); to work part-time hours involuntarily (e.g., they would like to work full-time; Golden & Kim, 2020); and to have last-minute shift changes (Storer, Schneider, & Harknett, 2020). Thus, Black, Hispanic, immigrant, and low-income children have higher exposure to opportunity gaps stemming from their parents' lower-quality jobs.

These racial/ethnic and nativity differences in job quality are driven by structural factors such as occupational segregation, racial/ethnic discrimination in hiring and promotion, policy choices such as exclusion from laws that provide worker protections, and differences in access to educational opportunities and attainment (Derenoncourt & Montialoux, 2020; Shakesprere, Katz, & Loprest, 2021). To the extent that Black, Hispanic, and immigrant families have higher exposure to poor job quality, they experience greater opportunity gaps in resources to invest in children, which in turn contributes to racial/ethnic disparities in children's health (Burgard & Lin, 2013). Studies of the effects of parents' job quality on children do not disaggregate the effects of job quality on families by income, race/ethnicity, or nativity, mainly because of low sample sizes.

POLICY INTERVENTIONS AND PROGRAMS THAT ADDRESS PARENTS' JOB QUALITY

Research has established a clear need for public policies to address the child opportunity gaps created by parents' low job quality. Federal policies set minimum wages; protect family income in the event of job loss; and supplement low earnings to help offset the high costs of everyday expenses such as food, rent, and child care. Income supplements, provided by means-tested programs and tax credits, are targeted primarily to families and children with the greatest need. Limited employer-provided benefits are supplemented through public health insurance. Some social insurance programs, such as unemployment insurance, replace a portion of lost wages when workers lose their jobs. Other programs provide education and training to enable access to higher-quality jobs. Since many of these policies were established long ago, adjustments are needed to better address economic changes that affect families' economic outcomes and social-emotional health. As discussed previously, structural changes in the economy that create opportunity gaps for children include persistently low wage growth, nonstandard work schedules demanded by a 24/7 economy, and employers' unstable scheduling practices. The disparate negative effects of the economic crises associated with the COVID-19 pandemic on Black, Hispanic, and immigrant working families highlighted the need for more comprehensive policy interventions.

The United States, however, lacks a comprehensive approach to addressing structural economic changes. A complex set of policies and programs addresses low earnings, and limited benefits are available through employers, but these measures do not fully address all aspects of poor job quality, do not serve all children, and can be difficult to know about or access. These limitations translate to persistent resource gaps that elevate family stress and are tied to children's social-emotional health. Higher exposure to poor job quality and uneven access to policies that alleviate it for low-income, Black, Hispanic, and immigrant families exacerbate child opportunity gaps that can lead to disparate outcomes.

This section reviews the evidence on the effectiveness of policies for promoting economic security and social-emotional health for all families with children, with attention to whether they effectively reduce gaps in family job quality experienced by low-income Black, Hispanic, and immigrant working families with children. The discussion concludes with promising practices for improving programs to better address family economic security, promote child development, and reduce racial/ethnic and nativity gaps in jobs that provide adequate compensation and schedules amenable to raising children.

ADDRESSING OPPORTUNITY GAPS AND OUTCOMES IN EDUCATION

It is clear from the literature that expanding access to high-quality early care and education (ECE), followed by well-resourced, high-quality elementary experiences, has the potential to bridge opportunity gaps associated with children's academic and learning outcomes in both the short and long terms (Pearman et al., 2019; Cascio, 2021; Bailey, Sun, & Timpe, 2022). Yet ECE programs remain insufficiently funded, and unable to serve all eligible children and families, to ensure equitable access to quality programs, and to support the competency and well-being of the ECE workforce (National Academies, 2018). The limited public investment in ECE has disproportionately impacted children of color and those from immigrant families, especially those from low-income communities. These shortfalls have been shaped in part by societal attitudes toward safety net spending and aid for people living in poverty, which in turn are entangled with racism, class bias, and a meritocratic ethos (DeParle, 2022). Contrary to such attitudes, however, the research evidence shows that strengthening safety net supports (income supplements) is associated with later average higher earnings, better health, and reduced criminal arrests (National Academies, 2019a).

ADDRESSING OPPORTUNITY GAPS AND OUTCOMES IN PHYSICAL HEALTH

Disparities in health outcomes often begin in early childhood as the result of a number of factors previously described in this report. Addressing these factors can not only improve health outcomes for parents and young children in the short term but also promote more positive health outcomes across the lifespan. Variations in access to health care and healthy environments from state to state and within communities create substantial differences in how—and the extent to which—these factors negatively impact different groups of children to create opportunity gaps. This section highlights a number of policies, programs, and approaches that can be implemented to promote positive and equitable health outcomes for children and their families.

HUMAN-CENTERED DESIGN AND POLICY DEVELOPMENT

In recent years, the application of human-centered design (HCD) principles and approaches has expanded at all levels of the social services domain. Service providers from different systems can adopt an HCD approach to establishing an effective family engagement framework as a way to improve their services. Policy makers, advocates, and agency staff with roles in designing and implementing policies can use HCD to ensure that their work centers on the needs and experiences of the user or consumer from the beginning so the policies will have the intended impact for children, families, and communities.

First applied to the development of consumer goods and online applications and websites, HCD is based on the premise that working with the stakeholders most directly affected by a particular issue is critical to develop the most effective solutions. The approach entails three phases: inspiration, ideation, and implementation (IDEO.org, 2015). In general, HCD turns on its head the notion that only trained “experts” should lead the design process, whether its intended outcome is a commercial product, a website, or the development or implementation of a policy.

Exploring how an HCD approach can be operationalized in a school, community, or policy context can inform the planning and implementation of authentic family engagement within processes, systems, and day-to-day practices. In the context of policy development and implementation, an HCD approach will incorporate the following principles:

• The approach goes beyond getting feedback from end users, instead collaborating with them as codesigners with equal decision-making power (Pahlka, 2018; Weeby, 2018). “In short, community voice without community leadership is significantly less effective” (Weeby, 2018, p. 10).
• The design process intentionally dismantles barriers to access to publicly funded services and benefits so policies can lead to equitable outcomes across race and ethnicity, linguistic group, socioeconomic status, gender, geography, and other social factors associated with unequal opportunities and outcomes (Pahlka, 2018).
• The design process involves multidisciplinary teams that include not only policy makers but also stakeholders such as design professionals, subject matter experts, policy implementers, and procurement and compliance professionals (Pahlka, 2019).
• Iterative processes and feedback loops are incorporated to improve policy design and implementation, driven by real-time, actionable data from user experience, allowing for “experimentation that can inform policy development with the knowledge of what's actually working towards the original intent” (Pahlka, 2019, p. 6).

Applying an HCD approach to policy requires that policy leaders take additional steps to ensure that equity is at the center of the process. Otherwise, the work will exclude critical voices and result in policies and implementation processes that continue to create barriers for certain communities to access publicly funded services to which they are entitled. First, the definition of “end users” in HCD includes those whose voices are often not at the table and who face the greatest barriers to accessing services and benefits. Participation in HCD processes takes time, and involving users who happen to be able to engage will likely perpetuate the inequities in current systems (Weeby, 2018). Also, HCD processes need to “take into consideration the historical and social contexts within which many social ‘problems' exist” (Weeby, 2018, p. 11). As discussed earlier, barriers to accessing publicly funded programs that can reduce opportunity gaps are as much a result of historical disinvestment and disenfranchisement of low-income communities and communities of color as of poorly designed or implemented policies. Neglecting this history will only lead to incomplete solutions, even when the “end users” are at the center of the process (Weeby, 2018).

To date, HCD approaches have been used to good effect in a number of public policy areas. Examples include designing the Centers for Medicare & Medicaid Services' strategy for transferring health care delivery from a procedure-based to a value-based system (Sinai, Leftwich, & McGuire, 2020); creating prototypes of tools that school districts can test and adapt to implement public school funding reform in California (Knudson, 2019); identifying key lessons and developing outreach materials to improve the implementation of paid family leave in New Jersey (Schulte, 2021; Zucker, 2021) and increasing participation in EITC programs in New York (Rodriguez et al., 2021).

Taken together, the experience thus far in applying HCD to the policy arena shows that the approach holds great promise for creating more equitable policies and implementation processes that address many of the causes of the opportunity gaps discussed in this report. A fundamental overhaul of the systems that have contributed to these opportunity gaps for children and their families is needed, and providers and policy makers alike need to bring families to the table as authentic partners in informing policies and systems. Only then will the shared responsibility for the learning and development of children translate to deep and sustainable impact.

PUBLIC–PRIVATE PARTNERSHIPS

Public–private partnerships are an increasingly effective approach for fostering multisectoral collaboration and leveraging the strengths of stakeholders from a wide variety of disciplines and sectors. Opportunity gaps exist across a number of domains. Many of the factors that drive opportunity gaps in education, physical health, and social-emotional development and well-being cut across these domains; a multisectoral approach will be required to reduce, mitigate, and eliminate them. Through public–private partnerships, the public sector, philanthropic organizations, private-sector businesses, and other stakeholders can combine and sustain efforts to address opportunity gaps more efficiently.

A number of states already use public–private partnerships to support programs, interventions, and services aimed at addressing disparities in outcomes in a variety of health, education, and developmental domains. For example, some of these partnerships have focused on increasing school readiness; funding the development of community-level early care, health, and education systems; increasing access to health services; providing parent education and family support to promote health and social-emotional health; and facilitating the alignment of foundation funding in such areas as school attendance, home visiting, and policy advocacy to promote improvements in outcomes for children (U.S. Department of Health and Human Services, 2014; NCSL, 2012).

Part of the committee's task was to identify the potential roles, actions, and supports that would enable the philanthropic community to assist in addressing the opportunity gap. Public–private partnerships are one way in which philanthropic organizations can engage with other stakeholders to this end. Philanthropic organizations are well positioned to engage communities at the national, state, and local levels to help deliver community-driven solutions for promoting equity across a variety of sectors. The 2017 National Academies report Communities in Action: Pathways to Health Equity highlighted a number of ways in which the philanthropic community could promote health equity—for example, supporting community organizing, building capacity, supporting enforcement of civil rights laws to target injustice, and prioritizing equity in the social determinants of health by investing in minoritized and low-income communities (National Academies, 2017). While the focus of that report was on health equity, many of these concepts and actions can be applied more broadly to promoting equity in education and social-emotional health and well-being as well.

Philanthropic organizations can take on a number of roles in efforts to reduce the opportunity gap. They can serve as conveners to bring together members of government, community organizations, and individuals to identify community needs; work within to communities to develop and fund grants to address local needs; create opportunities to develop leaders who can help sustain efforts and build capacity; develop, fund, implement, test, and scale promising interventions to promote equity; and fund research that focuses on the needs of groups experiencing the greatest disparities and builds the knowledge base needed to address the numerous opportunity gaps that exist across sectors. It is important to note, however, that philanthropic organizations cannot meet the demand for programs, services, and infrastructure alone. It is through partnership with other stakeholders—community members, employers, government, and other community institutions—that they can play a key role in addressing and responding to the needs of the communities and populations they serve and fostering and sustaining innovative approaches to promoting equity.

CONCLUSIONS

There is strong evidence that the social safety net reduces child poverty. Safety net programs are crucial for providing the resources needed to address the opportunity gaps discussed in this report, improving economic security, and countering structural racism. These programs include the EITC, WIC, SNAP, Medicaid, minimum wages, and paid family leave. Increased investment for support of these programs is associated with improved outcomes across a variety of domains. However, differences in state policies can create geographic disparities in the supports available through these programs, and administrative burden can limit access and exacerbate inequities. The complexity of programs and uncertainties related to eligibility, continued participation, and benefit levels create stress and insecurity within households. In addition, eligibility restrictions significantly limit the ability of safety net programs to reduce opportunity gaps for children in Hispanic and immigrant families that could be mitigated by more inclusive eligibility rules and reduced administrative burden.

Because of the lack of comprehensive surveys, limitations of program administrative data, and the lack of program implementation studies, a number of equity-focused research questions about paid family and medical leave remain unanswered. A growing nonexperimental evidence base shows that parents' poor job quality is associated with greater social-emotional issues for young children by raising parents' stress levels. Black, Hispanic, immigrant, and low-income children have higher exposure to opportunity gaps associated with parents' low-quality jobs. More comprehensive data sets that include measures of parents' jobs and children's outcomes are needed to understand how differential exposure to opportunity gaps in parents' job quality affects differences in children's health and education outcomes by income, race/ethnicity, and immigrant status.

Parental job characteristics are an often overlooked social determinant of health for young children. Recent rigorous studies demonstrate that the implementation of scheduling laws in the lower-wage retail sector leads to improved scheduling practices. Studies have found that scheduling laws have positive impacts on job satisfaction, overall happiness, and sleep quality, but null impacts on social-emotional health for adults or children. However, evidence suggests that inconsistent or unreliable work schedules can make it difficult for some families to meet the work requirements necessary for them to access safety net programs. Earnings subsidies, sectoral job training, and wraparound service approaches help improve parents' job quality and can open doors for Black and Hispanic workers to enter higher-wage sectors; however, none of these approaches addresses structural issues such as racial discrimination in hiring, wages, or advancement. Thus, programs can potentially help reduce racial/ethnic opportunity gaps in parents' job quality and psychological stress that influence children's development, but more research is needed to test rigorously whether these strategies reduce gaps in children's social-emotional outcomes.

Taken together, results from these interventions show that proactively changing employer practices with the goal of reducing stress from work–family conflicts can be effective in improving the social-emotional and physical health of working parents, which in turn positively affects children's health. These studies also show that, to improve social-emotional outcomes, interventions need to be improved and tailored for parents who work in lower-wage occupations and in the service sector. These are challenging to redesign because of narrow profit margins and lean staffing (Kelly & Moen, 2020). Since Black, Hispanic, low-income, and immigrant working parents work disproportionately in the service sector and are underrepresented in professional occupations (Earle et al., 2014), opportunity gaps in job quality by income and race/ethnicity will remain unless employer scheduling practices are improved.

Despite the number of programs and policies in the United States with the potential to close the opportunity gap, the complex system of these programs and policies is not equally accessible to all children and families—especially those who are in greatest need of services. Both state-to-state and intrastate variations in the implementation and funding of various programs and policies (e.g., Medicaid expansion, minimum wages, the EITC) lead to persistent inequities in outcomes for children.

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