American Dream vs American Reality

The increasing challenges of lower-income households with young children in the time of COVID-19

By the RAPID-EC Project Team

Infants and young children can bring untold joy and excitement into our lives. That said, life has never been easy for households with infants and young children. Figuring out child care, adjusting to altered work schedules, and managing finances with new expenses are all potential sources of stress — and these changes can be especially challenging on a limited income.

In our weekly RAPID-EC surveys, which began April 6, we have been listening to nationally representative samples of families with at least one child age five and under to find out how things are going in the context of the COVID-19 pandemic. Our data suggest that as the weeks have gone by, circumstances for lower-income households with young children are have become increasingly difficult in a number of ways.

As we describe below, child and adult mental health difficulties such as anxiety and stress, which were already higher among lower income households than others, have been steadily increasing since the pandemic began.

In contrast, these problems in middle- and upper-income households have leveled off or even started to diminish after an initial bump.

As a result, the gap in well-being between lower-income households and others is far larger than it was before the pandemic. Notably, we’ve found that these difficulties are highly correlated with lack of food and loss of school meals.

Immediate action is needed to reverse these trends.

What households with young children are telling us

Let’s begin by looking at retrospective reports by caregivers about how they and their children were doing before the pandemic arrived in the US.

In all areas of well-being we asked about — adult anxiety, stress, depression, and loneliness, as well as child anxiety and behavior problems — lower income households reported more difficulties prior to the pandemic than other households. This is consistent with prior research documenting the associations between insufficient income, household stress, and caregiving and child outcomes.

Put simply, having a limited income makes life more difficult for households with young children.

Perhaps not surprisingly, immediately after the onset of the pandemic, households of all income levels reported statistically significant increases in adult and child mental health difficulties. This included increases in adult anxiety, stress, depression, and loneliness, as well as child anxiety and behavior problems.

These changes occurred for both lower-income households and other households, and the magnitude of these changes across both income groups was similar — at least at first.

However, as time has gone on, things have become significantly more challenging for lower-income households.

Unlike middle- and upper-income households, in which levels of caregiver distress stabilized and actually began to decrease over time, lower-income households’ mental health difficulties — including caregiver anxiety, stress, depression, and loneliness — have all continued to increase

We are seeing similar trends for child mental health difficulties in lower-income households, and the divergence between lower-income and other households on these measures is consistent with our data for adults.

Specifically, in lower-income households, children’s mental health difficulties have been continuing to increase over time, whereas these issues levelled off and are starting to decrease in middle- and upper-income households.

We will have to see, in coming weeks, if these two income groups continue to move in opposite directions in terms of child well-being.

Food insecurity is a major source of anxiety

What is the explanation for the differences in well-being between lower-income households and others?

There are undoubtedly a number of factors contributing. Since the beginning of the pandemic, families with adequate financial resources have been getting used to new daily schedules, social distancing, and remote and online work and education. Although these adaptations have not been easy, many families appear to have adjusted.

The situation appears to be quite different in many lower-income households. As reported elsewhere, one of the biggest ways that the pandemic has changed life in these households is insufficient food resulting from lack of money for food purchases.

This is leading to substantial increases in reports of children not having enough to eat.

Caring for a young child can be difficult under the best of circumstances, and it is even more challenging if you are chronically hungry. Moreover, not knowing how you are going to feed your child, and being a child without sufficient food, are arguably among of the more stressful circumstances one can experience.

Within our survey data, the connection between well-being and availability of food in lower-income families is an exceedingly strong one.

In fact, it is a statistically stronger determinant of well-being among lower-income households in our data than loss of income.

Before the pandemic, a number of policies were in place to ensure a sufficient amount of nutritious food for all children. This included federal and state funded free and reduced price meals programs delivered in preschools, childcare settings, and schools. These programs provided children who qualified with up to two meals per day, which greatly increased the likelihood of adequate nutrition even when food was not available in the home.

With schools and childcare settings shut down across the country, this support has vanished. The magnitude of this problem is striking:

More than 40% of mothers with children under age 12 said they had insufficient food for their families, according to a survey reported by the Hamilton Project at the Brookings Institution,

If insufficient food is a driving force behind the increasing levels of distress in lower-income households with young children, we must put measures in place that address this problem.

Many local communities are rising to the challenge and employing innovative grassroots strategies to combat the lack of food in households with young children.

• Some are using schools as food distribution centers.
• Others are setting up emergency food banks.

However, this is clearly not enough; a recent report estimated a $1.4 billion deficit over the next six months alone in the budgets of food relief organizations around the country.

Policy Implications

Additional federal, state, and local policy efforts are clearly needed to fill the gap. Expanding benefits for publicly-funded food assistance, such as SNAP (Supplemental Nutrition Assistance Program) and Pandemic Electronic Benefits Transfer (EBT) will increase access to food.

Addressing insufficient food must be a priority because it is a health issue. It affects caregivers’ and children’s physical and mental health in serious ways.

Expanding and strengthening food assistance programs must happen now if we are to support all families with young children. Governmental and community-based initiatives have great potential to enhance well-being, and to reduce suffering, in lower-income households with young children — at least to the extent that they are associated with insufficient food.

In future weeks we will report on whether we can detect the effects of these policies in locations where they have been implemented. If such policies are having an effect, then we can expect to see a leveling off of mental health difficulties in lower income households.

Food is not the only issue

Although food is certainly a major issue, it is not the only challenge we are seeing for lower income households with young children. Lack of access to healthcare and childcare, as well as insufficient social support also require our attention.

Specifically, lower income caregivers in our survey report significantly lower rates of insurance for themselves and their children. In addition, they worry about losing their jobs if they take sick leave, and they report less support at times when they feel overwhelmed and stressed as a parent.

In addition, as many states begin the complex process of re-opening, lower income households are likely to experience specific challenges in terms of increased COVID-19 exposures and infection rates as well as related health problems and deaths.

About the project

When the COVID-19 pandemic emerged last winter, there were over 24 million children age five and under living in the United States. This period of early childhood is a critical window that sets the stage for health and well-being across the lifespan. As such, it is essential during the current health and economic crisis to listen to the voices of households with young children.

The weekly survey of households with children age five and under launched on April 6, 2020. Since then, we have been gathering weekly data about child and adult emotional well-being, financial and work circumstances, availability of healthcare, and access to child care/early childhood education.

We will continue to report on these issues as we learn more from each new weekly survey. We will also be producing policy briefs that make concrete recommendations about how to address the challenges we are seeing emerge from the family surveys.

Our goal is to use what we are hearing from families to improve the well-being of all households with young children, during the pandemic and beyond.