Our policy briefs deliver our cutting-edge research directly to
policy makers, researchers, and stakeholders in an accessible
format. These peer-reviewed resources are short and
informative analyses of our research relating to poverty and
Medicaid covers more than 72 million enrollees and represents over $500 billion in government spending annually. But does it improve the health of its beneficiaries? In a recent study, we investigated the relationship between Medicaid enrollment and mortality. To do so, we compared changes in mortality for near-elderly adults with low incomes in states that did and did not expand Medicaid eligibility through the Affordable Care Act. We found a decline of 0.132 percentage points in annual mortality associated with Medicaid expansion for this population.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) serves more than one-quarter of pregnant and postpartum women in the United States. In October 2009, the WIC food package underwent revisions to improve nutritional content. In a recent quasi-experimental study of more than two million California infants, we investigated the extent to which those revisions—which increased access to whole grains, fruits, vegetables, and low-fat milk—resulted in improvements in maternal and infant health.
Economic hardship during childhood contributes to worse mental and physical health across the lifespan. Over the past decade, researchers have begun to highlight the behavioral and biological pathways that underlie these disparities, and to identify protective factors—supportive relationships, for example—that mitigate against their occurrence. In this brief, we summarize some of this recent research and the new challenges it presents. We also make suggestions to inform both policy and practice for youth experiencing economic hardship.
Living in “deep poverty” means living on an income less than half the official poverty threshold, or, for a family of three in 2017, living with annual income of less than $9758. According to the U.S. Bureau of the Census, 18.5 million individuals in the United States—5.7 percent of the population—lived in deep poverty in 2017. At such low levels of income, it may be particularly important to understand for how long individuals continue to live in deep poverty. My recent study investigates the long-term persistence of deep poverty. While most spells of deep poverty in the U.S.
Parents struggling with food insecurity can experience heightened levels of stress, anxiety, and depression. These pressures may negatively affect their parenting, which may in turn affect the behavior of their children. In this study, we investigated the parenting aggravation levels of parents who experienced food insecurity in the aftermath of the Great Recession. We also explored the extent to which such aggravation may be responsible for the link between food insecurity and children’s behaviors.
The Food Stamp Program (FSP, known since 2008 as the Supplemental Nutrition Assistance Program, or SNAP) is one of the largest safety-net programs in the United States. It is especially important for families with children. However, the FSP eligibility of documented immigrants has shifted on multiple occasions in recent decades. When I studied the health outcomes of children in documented immigrant families affected by such shifts between 1996 and 2003, I found that just one extra year of parental eligibility before age 5 improves health outcomes at ages 6-16.
Housing and utility costs consume the majority of monthly incomes for millions of individuals and families in the United States. Missed payments can result in penalties, utility shutoffs, and evictions. Between 14 and 16 percent of the U.S.
In the United States, poverty, incarceration, and race are linked in complex ways, with much evidence that poverty may be both a cause and a consequence of incarceration. Black men are disproportionately more likely than white men to be arrested and incarcerated, a racial gap that first emerged in the early 20th century. In a new study, I explore the historical role played in that gap by education. I find that black men fully exposed to an expansion of rural primary schools between 1913 and 1932 were 1.9 percentage points less likely to be incarcerated later.
A quarter of the world’s population suffer from metabolic syndrome (MetS), a cluster of conditions that increase the risk of heart disease, stroke, and diabetes. MetS is particularly common among people of low socioeconomic status (SES). When we examined the relative roles of early-life SES and current SES in explaining MetS risk, we found that low early-life SES contributed to an 83% greater risk of MetS later on.
Among OECD countries, the United States has fallen from 1st (in 1990) to 9th (in 2016) in terms of the percentage of working age individuals with a bachelor’s degree. This makes interventions that promote college attendance in the U.S. a top policy priority. The benefits of a college education are widely known.
Young, undocumented Latino immigrants face many challenges in the United States. Undocumented Latino youth are less likely to graduate from high school and attend college than native-born youth and are more likely to live in poverty and report clinical levels of depression. Our research examines the impact of changes in legal status related to the Deferred Action for Childhood Arrivals (DACA) program on Latino immigrant young adults in California, with a focus on distress and psychological wellbeing.
When measured relative to median income, poverty in the United
States, at 16.3 percent, is much higher than in many
industrialized, democratic countries. To explain this, scholars,
politicians, and the public often focus on the risks of poverty.
Risks are characteristics more common among the poor than the
non-poor, like low education, unemployment, single motherhood, or
young age of the head of household. In a study I conducted with
David Brady and Sabine Huebgen, we found that the cause of
relatively high poverty in the U.S.
Preschool interventions are arguably one of the most important
elements of support for poor families. Head Start, a federal
program for children in low-income families administered through
the Department of Health and Human Services, is a case in point.
While research shows a range of benefits lasting beyond preschool
for participants, evidence of the “fade-out” of cognitive gains
of the preschool years and the differential impact of the program
on children with different skill levels in the preschool
population has prompted debate over its efficacy.
Poor children in the United States are less healthy than other
children, which may be a central factor in why poverty persists
across generations. Research approaches that use variation in
public programs let researchers disentangle the effects of a
program itself from other factors. These approaches confirm the
broad benefits of safety net programs that target children’s
health and nutrition. They also suggest that access to these
programs in early life improves children’s economic well-being as
adults, which likely transmits to the next generation.
The Great Recession led to unemployment rates unseen since the
deep recessions of the early 1980s. At the same time, significant
changes in the safety net both before and during the downturn
have changed the way we support children in vulnerable
households. In a new
study, we examine how and to what extent the current
safety net provides protection to at-risk children during
economic downturns. We find that increases in unemployment affect
children in the poorest households most. We also find that while
the safety net is strongest at stabilizing household incomes for
these children, children in immigrant households get no
Each year, over 1.5 million Americans rely on homeless programs
for overnight shelter. These programs provide beds and
services, and they act as a last resort for many of the most
impoverished individuals and families in the U.S. In a new study,
I found that a higher level of federal funding successfully
shelters those who would otherwise be unsheltered, with little
evidence that it increases the total of individuals in the
homeless population. However, homeless families move to
communities with more generous programs, so non-residents also
benefit from local funding. This fact may affect local government
incentives to fund programs and services.
Hospitals and clinics frequently rely on bicultural healthcare
workers as cultural brokers to offer translation and other
assistance to help low-income immigrant patients overcome
cultural barriers to healthcare. In a new study, we find that
Spanish-bilingual nurses navigate complex relationships with
their Latino patients in medical institutions with assorted
regulations and often limited resources. They do so by developing
diverse care strategies.
California’s Continuum of Care Reform Act (CCR) shifts
foster care in the state toward placing children with families
and more support for foster parents. We conducted a survey-based
study to learn about who is most likely to be willing to serve as
a resource family, the level of knowledge about foster care and
potential motivations for fostering. We found that the strongest
motivations among potential parents are to support foster youth
and their biological parents rather than any emotional or
financial benefits for themselves. Strong deterrents were
financial strain and worries about being able to adequately care
During a job interview, workers cannot tell whether an employer
is prejudiced. However, they can observe the race of a potential
supervisor. In a new study of racial inequality in the labor
market, we tested a model of Black and White workers’ wages and
job stability using a unique dataset that includes the race of
the worker’s supervisor and state-level measures of prejudice.
Our findings suggest that higher levels of prejudice in the state
may cause Black job applicants to accept lower wages in exchange
for the security of working for a Black supervisor. This could
lead to lower average wages for Black workers.
In recent years, for-profit colleges have seen sharp increases in
enrollment despite public community colleges being much cheaper.
In a recent study, we sent almost 9,000 fictitious resumes of
young job applicants who recently completed their schooling to
online job postings in seven major U.S. cities across six
occupational categories to track employer callback rates. We find
no evidence that employers prefer applicants with resumes listing
a for-profit college relative to those whose resumes list either
a public community college or no college at all.
Jobs that offer hours that vary from week to week present
significant challenges for low-wage workers. In a new study we
find that the number of workers with inconsistent work hours
increased significantly throughout the Great Recession and
recovery. These workers had lower incomes and higher poverty
rates than those with steady hours. However, the increase in
inconsistent hours was smaller among union members and in states
with higher-than-average unionization. This suggests unionization
could improve the chances a worker will have the steady income
needed to plan for even short-term basic needs.
Direct health care support and personal care jobs have the
largest projected growth in the next decade. Immigrants make up
growing percentages of workers in these fields, and having a
better understanding of their range of experiences in these
occupations will help attract and retain them. My new research
finds that African immigrant direct health care workers often
experience prejudice based on both their race and African
backgrounds. They also see their jobs as lacking opportunities
for advancement, and often struggle to meet basic needs with
In the U.S., low-income immigrants are disproportionately
excluded from social services. Even those who have gained formal
access must often overcome informal institutional barriers. In a
new study, I interviewed low-income Mexican immigrant mothers
with limited English skills to understand these informal barriers
in education and healthcare settings as they advocated on behalf
of their children. The study suggests that mothers are most
effective in a less bureaucratized setting and when staff
recognize how deeply they care for and understand their children.
Discussions of the safety net available to families in poverty
overwhelmingly focus on government assistance programs. An
additional component of how many families make ends meet is with
support from their private networks, especially from parents,
grandparents, or extended family. For some, this “private safety
net” can support material needs not sufficiently met though
earnings and public assistance. However, some individuals may
lack connections to family members who can provide such support.
Understanding how access to a private safety net varies by group
is key to assessing kin support’s role in alleviating material
At the core of debates about Head Start is evidence of its
effectiveness, which has been questioned due to the reduction in
test score gains, known as test score “fade-out”, in the years
following participation. However, short-term test score gains may
not accurately reflect the impacts of the program. A number of
studies suggest that the program yields long-term improvements
that include social, cognitive and physical well-being. These
findings show that, overall, Head Start produces a positive
return on investment.
Urban poverty has become more geographically concentrated in
recent years. Areas of concentrated poverty are also
frequently located relatively far from many job opportunities. If
low-wage employers discriminate against applicants from poor or
more distant neighborhoods, those applicants and their
neighborhoods may face even deeper poverty. In a
new study, I find that employers are less likely to respond
positively to applicants who list addresses in distant, poor
neighborhoods. However, the applicant’s commute distance rather
than neighborhood affluence itself is the largest factor.
Household economic security contributes to child and family
wellbeing, and is especially important during the rapid
developmental periods of infancy and early childhood. My new
study shows that, on average, the economic wellbeing of U.S.
households falls in the months before and after a birth,
especially among parents with low levels of education and single
mothers who live without other adults. Timely and more generous
income supports and policies facilitating mothers’ employment
could boost economic wellbeing during this critical period.
Despite a near-continuous decline over the past 20 years, the
teen birth rate in the United States continues to be higher than
in other developed countries. Many have advocated for long-acting
reversible contraceptives (LARCs), which are more effective at
preventing pregnancy than more commonly used contraceptives. In a
new study, we
analyze Colorado’s Family Planning Initiative, the first
large-scale policy intervention to improve access to LARCs in the
U.S. We find that the program reduced the teen birth rate by
about five percent, and these effects were concentrated among
Colorado counties with higher rates of poverty.
National efforts to increase college attainment and to address
the nation’s skills gap have focused heavily on community
colleges. Understanding returns to community college programs is
particularly important for low-income students, since nearly half
of low-income students begin their college careers at community
colleges, compared to just 15 percent of high-income students.
Using administrative data from California, we find that
students who earn vocational certificates and degrees see large
earnings gains that vary substantially by course of study.
Children are removed from their families for different reasons,
but poverty and disconnection from financial support such as
employment or public benefits are associated with referrals to
child welfare and children being placed outside the home. Our new
research suggests that efforts to minimize the negative
financial impact of child placement for parents have the
potential to improve both the financial lives of vulnerable
families and their chances for reunification.
Official measures of poverty may not capture the difficulties
afflicting low-wage workers, since households can still
experience material hardship while not considered poor by
official measures. From a survey of front-line service workers,
we find that material hardship is associated with higher levels
of self-reported depression and overall poorer mental health.
This suggests that the mental health of low-wage workers may
benefit from laws that not only increase earnings but also
facilitate income stability. Low-wage workers may also benefit
from programs that directly address material hardship.
In the United States, food assistance programs have been
established to improve the well-being of poor and low-income
children. The School Breakfast Program is a federal program that
offers breakfast to any student who attends a participating
school. In a new study, I evaluate the impact this program has on
student achievement in elementary schools nationally using
variation across states that require schools to participate in
the program. The results suggest that state mandates for the
School Breakfast Program are effective at increasing academic
achievement among low-income students by improving nutrition.
The goal of federal food and nutrition programs in the United
States is to improve the nutritional well-being and health of low
income families. The Special Supplemental Nutrition Program for
Women, Infants and Children (WIC) provides federal grants to
states to support nutrition for pregnant and post-partum mothers
and children up to age five. Our study, one of the first to
convincingly describe the program’s causal effect, found that
WIC’s implementation led to an increase in average birthweight,
especially among mothers with low levels of education. This
suggests that the value of WIC benefits for needy participants is
substantial compared to the program’s relatively low costs.
Where children grow up has a striking effect on where they live
as young adults. Our new study examined an experimental federal
housing voucher program from the 1990s to learn what factors may
contribute to children living in higher-income neighborhoods as
young adults. We find that housing assistance helps the next
generation to exit concentrated poverty. We also found that a
family’s finances, ties to neighborhoods and the housing market
all play roles, but a family’s desire to live in higher-income,
more integrated neighborhoods is also important.
Paid Family Leave (PFL) provides income for workers to take time
off to care for a newborn or sick loved one. The U.S. is the only
industrialized country without national PFL. Moreover,
job-protected leave is not universal. A large body of research on
policies outside the U.S. suggests that paid and protected leave
help workers remain in the labor force. Increasing researchers’
access to governmental administrative data would further show how
to improve these policies for U.S. workers. Limited existing data
from California PFL show that the majority of new mothers do not
take advantage of this policy, and that take-up is even lower
among low-wage women.
In 2010, an estimated 2.7 million children and one in nine
African-American children had an incarcerated parent.
Incarceration creates challenges for inmates’ families. Resources
that inmates had contributed are removed, while incarceration
introduces new expenses. Children with incarcerated fathers have
worse educational outcomes and poorer mental health than
otherwise comparable children. Employment assistance and less
restrictive visitation rules may mitigate the economic and
emotional effects incarceration has on families.
During the most recent economic recession in the U.S., many
parents lost their jobs. When a parent loses a job, it can impact
their child’s well-being in complex ways. In a new study, we
sought to understand how a parent losing a job affects their
children’s health. We found that after a job loss, an increase in
public coverage offset much of the decrease in private coverage.
In addition, we found almost no effects on children’s use of
routine health care services and no evidence that job loss
negatively affects children’s physical health in the short run.
However, we do find that parental job loss results in a
deterioration of mental health for some children, which may have
negative implications for child health in the long run.
Truancy in California is a pervasive problem that
disproportionately impacts children in high-poverty schools. Our
study examined how school safety and connectedness relate to
truancy in California’s high-poverty middle and high schools.
We found that children who perceive their schools to be unsafe
and feared being in fights were more likely to skip school.
Students who reported that they were more closely connected to
their schools, particularly students who reported having a
teacher or adult who cared about them, were more likely to
attend. School-wide initiatives enhancing both school safety and
connectedness may lead to improved school attendance at
California’s most disadvantaged schools.
A major component of the Affordable Care Act (ACA) was a mandated
expansion of Medicaid. The law also prescribed cuts to Medicaid
Disproportionate Share Hospital (DSH) payments, which subsidize
hospitals with high levels of uncompensated care. For states that
have opted out of Medicaid expansion, Medicaid reimbursements
will not make up for lost DSH payments. However, DSH cuts may
also create additional financial challenges for these hospitals
in opt-in states if Medicaid expansion does not reduce overall
California health advocates are increasingly aware of the hazards
of Valley Fever (Coccidioidomycosis), a disease caused by a
fungus spore living in semi-arid regions of the west and
southwest U.S. California has the most associated deaths despite
only representing about 31 percent of all U.S. cases. Policy
makers can reduce its impact on low-income communities and save
millions of dollars in treatment each year by addressing the
circumstances of infection, as well as the difficulties
low-income populations face in accessing care.
After decades of reductions in official measures of family
violence, annual incidence rates have plateaued over the past ten
years. Poverty and the increased stress it causes can increase
the risk for family violence, which suggests that economic
downturns like the Great Recession may contribute to this
stagnation. Income support in new and existing interventions
may help reduce family violence, especially among high-risk, poor
Intensified violence and poverty in the Northern Triangle
countries of Central America have spurred migration among
youth who seek to either reunite with family or to support
families who remain abroad. Policies to protect these youth would
promote their holistic integration into U.S. society, enforce
safety and well-being along the U.S. southern border and help
strengthen the youths’ countries of origin socially, economically
Despite significant efforts to deter unauthorized immigration,
repeat migration to the United States following deportation is
common. In a new study, my co-authors and I examined how having
family in the U.S. affects the intent to return among migrants
deported to El Salvador. We found that being separated from their
families in the U.S. is the most important factor in the intent
to return, even despite the severe penalties if caught.
Domestic violence is a significant problem in the U.S. It leads
to serious medical and emotional costs for victims and their
children, but also has important negative spillovers. Our new
work finds that exposure to a higher proportion of peers
experiencing domestic violence during primary school leads to
lower academic achievement in the long-run, even after moving to
schools with a mixed peer composition.
With obesity affecting over a third of the U.S. population,
public health advocates—including first lady Michelle
Obama—have called to “drink up” on water instead of sugary
beverages. In new work, supported by the Center for Poverty
Research, we find that low-quality drinking water is a potential
barrier to reducing the consumption of sugar-sweetened beverages
in high-poverty rural immigrant communities.
In recent years, inner-city school districts have worked to
balance budgets despite funding cuts and unpredictable enrollment
due to demographic changes. While redistricting—the process of
changing school boundaries, closing and/or consolidating
schools—can effectively address budget and enrollment problems,
it can disproportionally affect disadvantaged students and
With unauthorized youth at the forefront of immigration reform
discourse and policy proposals, understanding the diversity of
their profiles and experiences is necessary to create holistic
Some safety net programs, such as unemployment insurance (UI) and
food stamps (SNAP), have shown to automatically stabilize income
during financial downturns. The Earned Income Tax Credit (EITC)
raises millions of American workers out of poverty, but its
impact in times of crisis has not been explored.
Public insurance can provide needed medical coverage for those
who cannot afford it. Considering that private insurance is often
bound to employment, a public option could have an impact on the
labor market if it reduces incentives to work.