Closing the Opportunity Gap for Young Children (2023) / Chapter Skim
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7 Research, Policy, and Practice: Contexts and Efforts to Address Opportunity Gaps
7 Research, Policy, and Practice: Contexts and Efforts to Address Opportunity Gaps
Pages 323-378
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, 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)
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birth outcomes from 1980 to 2011 and found that state minimum wages that were higher than the federal floor were significantly linked to reduced prevalence of infant mortality and low birthweight. In particular, each dollar above the federal minimum wage led to a 4% decrease in infant mortality and a 1–2% decrease in the prevalence of low birthweight (Komro et al., 2016)
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. A 2019 study found that higher state minimum wages significantly reduced infant mortality among infants born to Black mothers (a 20% reduction among states at or above the 75th percentile of state minimum wage levels)
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. Yet as discussed in Chapter 5, while paid family leave policies and their effects can vary, their positive effects on maternal mental health are consistent across studies.
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. Paid family leave also has been shown to increase breastfeeding, which has been linked with improvements in bonding and later child and maternal health.
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. While there is a robust literature on paid family leave, there have been few studies of medical leave.
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. To address the limitations of the FMLA, a growing number of states and cities have developed their own paid family and medical leave programs that address affordability issues and increase take-up rates.
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The implementation of unpaid leave under the FMLA and paid family and medical leave programs is not tracked systematically, so it is difficult to document FMLA enforcement and the access and outreach issues in paid family and medical leave programs. More information is needed on implementation to inform the design of practices that improve knowledge and take-up of programs.
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FIGURE 7-1 Hypothesized pathways between parents' job quality and children's health and development. SOURCE: Adapted from Joshi et al., 2020.
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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)
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. 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.
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. 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)
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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.
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. Compared with other countries, the United States has robust child labor laws but lower labor standards to protect families from economic insecurity and limited policies to address caregiving for children (e.g., child care, paid sick leave, and paid family and medical leave; WORLD Policy Analysis Center, 2022)
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Using a variety of modeling techniques that minimize selection bias, research has established that unemployed workers receiving unemployment insurance benefits have better self-rated health and mental health compared with workers who do not receive these benefits (O'Campo et al., 2015; Cylus & Avendano, 2017)
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Without access to unemployment insurance to mitigate the economic and health effects of job loss, particularly during recessions, the risk of downward family economic mobility increases, potentially widening child opportunity gaps. One study found that only one-third of children with an unemployed parent lived in families that received unemployment insurance (Issacs, 2013)
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. Given the greater barriers to access to unemployment insurance faced by Black, Hispanic, and immigrant workers, these policy improvements have the potential to help close racial/ethnic and income-based opportunity gaps.
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. State and Local Paid Family and Medical Leave and Scheduling Laws As discussed earlier, since there is no federal guarantee of paid family and medical leave or sick leave, and no federal laws address employers' unpredictable scheduling practices, some states and localities have passed laws to fill these gaps.
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. State-level laws on paid family and medical leave and scheduling address the lack of federal policies focused on improving job quality.
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. Since the committee's focus is on identifying opportunity gaps in job quality that affect children's resources and well-being, we summarize two approaches that have been evaluated using experimental or quasi-experimental designs and that showed positive impacts on employment and earnings, as well as health and well-being.1 The first approach to improving parents' job quality is based on supplementing low-wage full-time jobs and providing parents with support to help maintain their employment.
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. An employment-focused approach that does not provide child care and other benefits and supports for parents' emotional and psychological well-being may therefore be insufficient to improve parents' job quality and will not address opportunity gaps, particularly for children living in families with the lowest incomes.
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. More than 75% of participants have been Black and Hispanic workers, suggesting that these programs can help improve racial/ethnic disparities in job quality.
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. Designed to increase the stability and predictability of work schedules, the Stable Scheduling Study included two group-randomized controlled trials conducted in the retail sector (clothing stores)
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, 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)
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Research suggests that a new system, based in a core set of standards informed and driven by closing opportunity gaps, might include structurally safe and healthy learning spaces; low teacher:student ratios and small class sizes; inclusion of children with disabilities with fully funded and appropriate services and supports; culturally affirming and research-based pedagogy and instruction; bilingual learning (i.e., learning both in English and in the home language) for dual language learners; a supported, competent, and fairly compensated workforce; and attention to bias and racism in adult–child relationships and interactions.
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Indeed, the opportunity gaps discussed in this report will be closed only if states, districts, and programs identify and monitor existing gaps, adequately fund interventions to close those gaps, and implement accountability standards to track progress. The federal government has traditionally funded services, although incompletely and imperfectly, for historically marginalized groups, such as through supplemental education funding (e.g., Titles I and III)
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. 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.
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Additionally, there is evidence that increased income for parents results in a reduction in adverse health outcomes and birth experiences. Studies looking at raising minimum wages and expanding the EITC have shown that these policies produce significant reductions in infant mortality and increased birthweights.
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. Evidence shows that although state Medicaid expansions are not significantly associated with improved birth outcomes in the overall population, the expansions do help reduce racial disparities in preterm birth and infant mortality, as well as both overall rates of and racial disparities in maternal mortality (Prenatal-to-3 Policy Impact Center, 2021)
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. More recent research has shown that the loss of SNAP benefits for those who exceed the income threshold results in worse caregiver and child health, and also increases the incidence of food insecurity (Ettinger de Cuba et al., 2019)
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. Special Supplemental Nutrition Program for Women, Infants, and Children WIC provides healthy food packages, nutrition education, and breastfeeding support for low-income pregnant and postpartum women and children under age 5.
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. The President's Task Force on Environmental Health Risks and Safety Risks to Children has made recommendations in three domains: (1)
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3–4) includes the following recommendations for promoting community interventions to reduce lead exposure and disparities in exposure: • Reduce lead in drinking water in homes built before 1986 and other places children frequent.
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. With more than 13 million preschoolers in child care every day, including six million infants and toddlers, child care settings are also critical sites with the potential for lead exposure (Amoah et al., 2016)
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In summary, pollutants and environmental contaminants have potentially significant impacts on child health outcomes. These pollutants may also play a role in school achievement and attendance in the case of asthma or other chronic disease, and there are racial/ethnic and socioeconomic disparities in exposure and risk for children from vulnerable communities.
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. 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.
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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.
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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.
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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.
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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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. Comparative chart of paid family and medical leave laws in the United States.
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. The effect of paid family leave on infant and parental health in the United States.
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. Expanded unemployment insurance benefits during pandemic lowered poverty rates across all racial groups.
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. Unanticipated effects of California's paid family leave program.
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. The effect of extended unemployment insurance benefits: Evidence from the 2012-2013 phase-out.
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. Earned income tax credits and infant health: A lo cal EITC investigation.
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. Paid maternity leave and breastfeeding practice before and after California's implementation of the nation's first paid family leave program.
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. Effects of state-level earned income tax credit laws on birth outcomes by race and ethnicity.
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. The effect of California's paid family leave policy on parent health: A quasi-experimental study.
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. Paid family and medical leave: An issue whose time has come.
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. Earned income tax credit overview.
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. Prenatal-to-3 policy clearinghouse evidence review: State earned income tax credit (ER 05C.1022)
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. The effects of California's paid family leave program on mothers' leave-taking and subsequent labor market outcomes.
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. Effects of prenatal poverty on infant health: State earned income tax credits and birth weight.
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. Implementing paid family and medical leave: Lessons for state administra tors from research in New Jersey.
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