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New Report Shows Nation’s Babies Faced Adversity Long Before COVID-19

Long-lasting disparities worsened impact of pandemic for families of young children

As the COVID-19 pandemic upended the lives of virtually every American, a new report from national early childhood nonprofit ZERO TO THREE shows that arguably no group was hit harder than families of young children, with deeply entrenched disparities creating a world where the littlest among us were particularly vulnerable to a major crisis. The State of Babies Yearbook: 2021 lays out not only how babies and toddlers lack the supports they need to thrive, but how throughout the country, racial and economic inequities start even before birth.

For the third year, ZERO TO THREE, the nation’s leading early childhood nonprofit dedicated to the health and well-being of babies and toddlers, looked at every state in the United States and the District of Columbia to examine how where a baby is born impacts the course of their life. The report, supplemented by data from the Rapid Assessment of Pandemic Impact on Development Early Childhood (RAPID-EC) Household Survey, reveals a nation that stood on the sidelines for decades while families – particularly families of color – juggled economic and child caring needs amidst threadbare systems of support.

ZERO TO THREE Chief Policy Officer Myra Jones-Taylor stated:

“The pandemic has been painful for all of us, but it didn’t need to be so devastating for babies, toddlers, and their families. Because our nation has ignored the needs of young children for decades, COVID-19 was free to wreak havoc on the conditions that contribute to our babies’ development and our families’ stability. In particular, Black and Brown babies and babies in families with low incomes continue to face greater barriers due to significant and systemic disparities.

“It’s long past time that we end this painful cycle. The status quo before COVID-19 was unacceptable, and as we build back, we need to be better than before. We need our leaders at every level – local, state, and federal – to put in place bold, permanent policies that will address these barriers and ensure all children have a strong start in life.”

The State of Babies Yearbook, an initiative of ZERO TO THREE’s Think Babies, bridges the gap between science and policy with national and state-by-state data on the well-being of America’s babies. Now in its third year, the Yearbook compiles more than 60 indicators, specifically for children ages zero to three, to measure progress in the domains of Good HealthStrong Families, and Positive Early Learning Experiences. Data for selected indicators is disaggregated by race/ethnicity, income, and rural/urban areas, enabling a closer look at the disparities that can exist even within states whose babies, on average, are doing well.

The 2021 Yearbook is supplemented by data from the RAPID-EC Household Survey collected during the pandemic to show how the crisis has and continues to affect families with young children. The biweekly, nationally representative survey shows families are struggling to access basic needs, are in jeopardy of losing their income or homes, and are struggling to maintain their mental and physical health under these highly stressful conditions. Findings also show disparities due to race, income, and geography, widening the existing gaps between American families.

Noteworthy findings from the Yearbook include:

  • As many as 40 percent of infants and toddlers lived in families with low income (less than $54,000 for a family of four) before COVID-19, and nearly 19 percent of the nation’s 11.5 million babies were living in outright poverty. And the percentages of babies in poverty were highest among American Indian/Alaskan Native and Black infants and toddlers, at nearly double the national average.
  • More than half of families who reported having had low income pre-COVID-19 lost income during the pandemic. Among families with young children, since the pandemic began, 42.2 percent have experienced a decrease in income, 33.9 percent experienced a decrease in employment, and 26.6 percent are unemployed, temporarily out of work, or furloughed.
  • Maternal mortality continues to occur at a rate of 17 deaths per 100,000 live births nationally, and the underlying issue of inequity in health care access has become more apparent in the racial disparities of COVID-19 infections and deaths. For example, the maternal mortality rate among Black women is significantly higher than the national average at 37.3 deaths per 100,000 live births.
  • As many as 1 in 10 babies (10 percent) are born preterm, but the preterm birth rate for Black infants is significantly higher at 14.1 percent. And while 1 in 12 babies (8.3 percent) were born at low birthweight, Hispanic (7.5 percent) and white (6.9 percent) infants were below that national average, while Black infants approached nearly twice that rate at 1 in 7 (8.3 percent).
  • As a result of COVID-19, 26 percent of families have reported high food insecurity. 53 percent of families with low income reported food insecurity, and Black and Latinx families were more likely to encounter food security than the average family, at 35 and 34 percent respectively. Before the pandemic, Census data showed that more than 1 in 7 households with infants and toddlers had low or very low food insecurity.
  • The fallout of COVID-19 and its resulting economic shutdown have made child care’s importance for child and family success clear. Pre-COVID, families and providers struggled with the precarious economics of child care, and the pandemic has intensified that struggle and left the system in disarray. Infant care remains too expensive for many families to afford, exceeding the cost of college tuition in more than half of states.

The State of Babies Yearbook: 2021 uses a transparent ranking process to group states into one of four tiers to provide a quick snapshot of how states fare on selected indicators and in domains. These tiers represent four groupings of states that are approximately equal in size. The following scale designates a given state’s placement in one of four tiers, listed from highest to lowest performing:

  • “GROW” for Working Effectively
  • “GRO” for Improving Outcomes
  • “GR” for Reaching Forward
  • “G” for Getting Started

All states have room to grow to do better for babies. The differences between and within them reflect differing levels of investment in services and systems for babies that can help buffer the effects of poverty and other adverse experiences.

As the State of Babies Yearbook shows, the status quo for babies and families before the pandemic was already unacceptable, leaving them particularly vulnerable to crises large and small. To simply return to the way things were is unacceptable. To do better for our babies and for our nation’s future, we need Congress and state leaders to seize the opportunity to create forward-looking, family-centered policies that our nation has lacked. Policymakers need to put policies that help babies and families first, including:

  • Making the expanded Child Tax Credit permanent and establishing a minimum wage of $15 per hour;
  • Enacting comprehensive paid family leave policies that promote bonding between parents and babies and enable workers to care for their own and family members’ extended health needs;
  • Extending Medicaid coverage for mothers and babies by mandating Medicaid coverage for women through 12 months postpartum and all children until age three, and ensuring coverage of infant and early childhood mental health services for babies and caregivers; and
  • Building the world-class child care system families and early educators deserve, enacting a comprehensive program that places quality care within reach of all working families – particularly those with low and moderate income – and compensating early educators for the highly skilled work they do.

To read the full State of Babies Yearbook: 2021, including state-specific results, visit stateofbabies.org.

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