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New Report Reveals Economic and Care Disparities, Continued Mental and Emotional Distress Among Nation’s Babies and Families

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ZERO TO THREE report shows 41% of low-income families saw earnings decline in 2021, and that access to childcare remains a challenge

The mental and physical health of our nation’s infants and toddlers continues to be jeopardized by the devastating impacts of the COVID-19 pandemic. The fourth annual State of Babies Yearbook: 2022, released today by leading early childhood nonprofit ZERO TO THREE, affirms that many parents and primary caregivers today still do not have what they need to ensure a strong foundation for their children. Longstanding disparities before the pandemic in health and early learning, economic stability, and access to child care have left many families to fend for themselves.

Data included in the report show that the 40 percent of babies in families with low income before the pandemic were more likely to experience more economic insecurity during the pandemic. More than four in 10 low-income families with young children saw their income decrease in 2021, compared to roughly two in 10 of higher-income families. The numbers were reversed for families seeing their incomes rise in 2021: 38 percent of higher-income families reported an income increase, compared to just 25 percent of lower-income families. The data reveal that even in a growing economy, structural disparities continue to hurt babies and young children.

These inequities are also apparent in access to child care. The use of non-parental child care increased substantially over the course of the year, from 53.3 percent of surveyed families in January 2021 to 66 percent in December. However, the return to non-parental care was lower among families with low income, reflecting continued job losses among these families and decreased availability of care providers. In addition, public programs meant to support access to early development and care opportunities are not reaching all families who could benefit. Only 11 percent of eligible infants and toddlers have access to Early Head Start, and under 5 percent of federally eligible families receive help paying for child care. The constraints on public programs and limits to private access leave many young children and families scrambling for proper care.

Also of critical concern, children and caregivers’ overall mental health has shown some improvement since the first year of the pandemic, but families are still reporting lower levels of emotional support and higher levels of loneliness and emotional distress than before the pandemic began, when one in five mothers were already reporting less than optimal mental health.

“The pandemic has exposed and exacerbated our nation’s longstanding failure to invest in the health and well-being of every baby, particularly those from families of color and those with low-incomes,” said Miriam Calderón, chief policy officer at ZERO TO THREE. “The mental and physical well-being of our babies and toddlers are powerful indicators of our nation’s overall health. But the State of Babies Yearbook: 2022 shows that all is not alright for the littlest among us. Families with young children are not receiving the resources they need to provide their infants and toddlers with the basic necessities required to thrive, which can have lifelong repercussions.”

The State of Babies Yearbook, an initiative of ZERO TO THREE’s Think Babies, provides a snapshot of how babies are faring nationally, in all 50 states, the District of Columbia, and Puerto Rico across more than 60 indicators and policy areas essential for a good start in life. The report synthesizes a wide range of data, from census data, the National Survey of Children’s Health, the Rapid Assessment of Pandemic Impact on Development Early Childhood Household Survey, and other sources. In doing so, the Yearbook provides policymakers and local leaders with an extremely comprehensive source of data on the well-being of children and families.

The report is structured around three areas necessary for babies to thrive: Good Health, Strong Families, and Positive Early Learning Experiences. States are tiered based on how well they support children and families in each of those areas. The tiers, from least supportive to most supportive, are: Getting Started, Reaching Forward, Improving Outcomes, and Working Effectively (GROW).

This year, 12 states or localities, primarily in the Northeast and Northwest, achieved the highest tier (W):

  • Colorado, Connecticut, District of Columbia, Maine, Maryland, Massachusetts, Minnesota, New Jersey, Oregon, Rhode Island, Vermont, Washington.

13 states, primarily in the South and Plains or Mountain West, achieved the lowest tier (G):

  • Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Kentucky, Louisiana, Mississippi, Nevada, South Carolina, Texas, Wyoming.

“For race, income, and geography to no longer determine whether a child has the opportunity to reach their full potential, we need every state to do more for their babies and their families,” said Calderón. “And we cannot expect states to do it alone. We need a strong national agenda that addresses disparities and creates equitable opportunities for every young child in every zip code across America.”

In the report, ZERO TO THREE makes the following policy recommendations:

  • Reinstate and make permanent the expanded Child Tax Credit.
  • Mandate Medicaid coverage for 12 months postpartum.
  • Enact a national paid family and medical leave policy that promotes bonding between parents and babies and enables workers to care for their own and family members’ health needs.
  • Sustain child care and build the world-class system families deserve by enacting a comprehensive child care program that places quality child care within reach of all working families, particularly those with low and moderate income.
  • Transform pediatric care by adding child development specialists to pediatric teams.
  • Fully fund Early Head Start so that all eligible infants and toddlers can enroll in the program.
  • Expand early intervention services to meet the developmental needs of infants and toddlers, including developmental screening and follow-up and incorporating more infant and early childhood mental health expertise and services.

Following the release of the State of Babies Yearbook, ZERO TO THREE will virtually connect babies and families from all 50 states and the District of Columbia to their Members of Congress for their annual Strolling Thunder™ event on May 17 as part of the organization’s Think Babies initiative. This event gives Congressional leaders the chance to hear the stories behind the numbers as families and caregivers share their experiences raising children and what they need to support their baby’s healthy development.


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