Childhood Safety Net Investments and Health Disparities From Birth Through Young Adulthood

/Abstract Safety net supports for families with children are a key component of the resources available to U.S. families with low and moderate incomes. Effective provision of social supports through the state may positively affect child health and development by augmenting access to resources both within and outside of the home, with benefits accruing from the prenatal period through early adulthood and beyond. Most research seeks to isolate the effects of a single program or public investment, providing critical evidence but not accounting for the fact that most households with children—particularly low-income households—access multiple public supports (Edelstein, Pergamit, and Ratcliffe 2014; Jackson and Fanelli 2023; Macartney and Ghertner 2023). Because federal, state, and local governments must determine spending levels and how to spend funds for the children and families who rely on it, it is critical to understand how different forms of public investment work independently and in combination to affect children. Drawing on an interdisciplinary team, we will use quasiexperimental methods to estimate the effects of early-life exposure to safety net generosity–spending and benefits levels–on a multidimensional set of outcomes. Specifically, we will: (1) Examine the causal effects of early-life exposure to safety net investments on health and development from birth through middle childhood; (2) Examine how early-life safety net environments differentially affect children by socioeconomic status (SES) and race/ethnicity. We will analyze two large-scale sources of data on short- and medium-term outcomes for children: birth outcomes from the universe of U.S. births, using data from the CDC National Vital Statistics System (NVSS); and age 8/9 health and skill development, using data from the National Survey of Children’s Health (NSCH). Our analyses of existing high-quality, publicly available data will enable additional research examining the effects of federal, state, and local investments on the health and development of U.S. children and families. Project Number: 1R56HD114872-01A1 | Fiscal Year: 2025 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: Margot Jackson | Institution: BROWN UNIVERSITY, PROVIDENCE, RI | Award Amount: $500,000 | Activity Code: R56 | Study Section: Social Sciences and Population Studies A Study Section[SSPA] View on NIH RePORTER: https://reporter.nih.gov/project-details/1R56HD11487201A1