“At the end of the day we are going to be judged on what we have been to the poor, to the hungry, the naked, the homeless.” They, like all suffering humanity, like all ‘Christs in distressing disguises’ deserve love and compassion.” — St. Teresa of Calcutta
More than 32.4 million U.S. children live in low-income families with 16 million (22 percent) living below the federal poverty level ($22,000 with a family of four). According to the National Center for Children in Poverty, 20 percent of children under age 6 live in poverty, a rate two to three times higher than that of other major industrial nations. Poverty is a major determinant of health and a significant factor in perpetuating health disparities. Poverty has many faces; from hunger to homelessness to hopelessness.
We know that poverty in childhood may have a long and lasting impact on the child well into adulthood by creating toxic stress on the developing child. Toxic stress contributes to increased rates of asthma, obesity, dental issues, injuries, mental health problems and tobacco exposure in children who live in poverty. The factors contributing to these increased rates reside not only with the individual or family but in the community, environment, society and policy arenas.
Poverty is strongly linked with child neglect. It can be construed as a form of societal neglect, particularly in a country with enormous resources. However, most low-income families are not neglectful of their children. Conversely, neglect is hardly limited to poor families.
There is ample evidence that shows a promising future belongs to those nations that invest wisely in their children while failure to do so undermines social and economic progress. Dr. James Heckman, a Nobel Prize-winning economist has research showing that nurturing, learning experiences and physical health from birth to 5 greatly impact success or failure in society. The most economically efficient time to develop skills and social abilities is in the very early years when developmental education is most effective. According to Dr. Heckman, disadvantaged families are least likely to have the economic and social resources to provide early developmental stimulation every child needs as a basic opportunity for future success in school, college, career and life. Therefore, it is important to invest in educational and developmental resources for disadvantaged families to provide equal access to successful early human development.
From birth to age 3 there is a tremendous amount of brain growth but very little public spending during a crucial period of a child’s life. For ages 0-3 that would be on average about a $50 billion investment. Perhaps the $245 billion now spent annually on mental health problems for our children and adolescents would decrease substantially.
There is a need to invest in our children. They should be our priority. Programs addressing early childhood education and parenting support which have been shown to improve a child’s long-term health, well-being and productivity yield a return on investment as high as 14 percent per year. There is a need to build on investments in programs that help lift families out of poverty, like the Earned Income Tax Credit and Child Tax Credit. These programs work! Without these critical supports, it is estimated that nearly one in three children would live in poverty instead of one in five. There is a need to support increases in the minimum wage that better approximates a ‘living wage’ for families. Finally, there is a need to protect and expand federal anti-poverty and safety net programs, including those that provide health care, early education, school and summer meals, quality child care, affordable housing and home visiting as well as critical nutritional assistance like the Special Supplemental Nutrition Program for Women, Infants, and Children and the Supplemental Nutrition Assistance Program.
The rising child poverty rate is an indictment of America. To have 20 percent of children under 6 living in poverty is unacceptable. We are marching in the wrong direction and we cannot remain a strong nation by continuing to cut essential services for children and families.
Pat Bruno, MD, FAAP, is a pediatrician for Geisinger Health System.