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N.Y. can ease child poverty: Two former health commissioners lay out a plan



As children started school this month, many could look back on carefree summer days. Some New York children enjoyed sleepaway camp, or a beach vacation, or playing in the pool this summer. Yet others wondered where their next meal was coming from, slept in dangerously hot apartments, and relied on inhalers as they struggled to breathe.

 All are New York’s children — and right now too many of them, nearly one in five, are experiencing the hardships of poverty. Children experiencing poverty are at higher risk of illness, hunger, homelessness, and violence. The brunt of these effects falls on families of color, who are more likely to have low income, less wealth, and live in neighborhoods with fewer resources.

Children don’t choose these conditions; they reflect generations of disinvestment and discrimination. No child should have to shoulder these burdens. 

Poverty is bad for health. As former health commissioners of New York City and New York State, we are committed to redressing child poverty because it is one of the surest ways to improve health over a lifetime. Children living in poverty are 17% more likely to have asthma, twice as likely to be hospitalized, and 2.5 times more likely to have toxic levels of lead in their blood. 

Consider a child with lead poisoning. We learned as medical students to be watchful for the subtle symptoms associated with lead, like language and learning delays. Lead can cause direct damage to neurons, with cognitive effects that persist into adulthood. In the same way, other effects of poverty “get under the skin” to affect a child’s health even when they are grown. 

New York is among the higher income states. It may surprise you to know that children in New York State are more likely to live in poverty than children in 40 other states. Nearly 35% of Bronx children are experiencing poverty, as are 46% of Syracuse children.

In Buffalo, Gov. Hochul’s home city, more than one in three children live in poverty.

Yet continuing with the status quo is a choice that our elected leaders make — every day, every budget year, every legislative session. Just last month, the U.S. Senate declined to lift nearly half a million kids out of poverty by voting against expanding the federal child tax credit.

We saw an alternate reality amidst the tragedy and suffering of COVID-19. The pandemic-era expansion of the federal child tax credit cut child poverty nationwide (and in New York) by half. The solution is elegantly simple: put money into the pockets of parents and caregivers.

Rigorous research shows these funds are used for basic needs, like food and rent — and parents spend it locally. But by 2022, we regressed such that the state’s rate of children living in poverty was even higher than it was before COVID-19

While we support future federal action on expanding the child tax credit, as Vice President Kamala Harris recently proposed, Hochul and the New York State Legislature need not wait. We can act now. 

In fact, the governor and Legislature passed a law in 2021 committing to cut child poverty in half by 2032. Yet here we are, nearly three years later, with too little to show for this commitment. The law chartered an advisory council of experts, parents, advocates, and state representatives.

Recent modeling from the advisory council shows that increasing the state’s existing child tax credit to $3,000 per child per year — and making the credit available to children in New York’s lowest-income families — would reduce child poverty in New York by 44%. That change alone would bring the state within reach of its child poverty reduction goal.

We can look to other states for inspiration, too. Harris’ running mate, Minnesota Gov. Tim Walz, has articulated a goal of making his state “the best place to raise a child.” There, the child tax credit of up to $1,750 per qualifying child per year is more than five times New York’s current child tax credit, and will reduce child poverty in Minnesota by 33%

In Michigan, the Rx Kids program is the first-ever citywide “cash prescription” for pregnant moms and their babies. Rx Kids provides all pregnant moms in the city of Flint with no-strings-attached cash of $1,500 during pregnancy and $500 each month throughout a baby’s first year. Michigan lawmakers recently approved $20 million to expand the program across the state.

While a program known as the Bridge Project also provides unconditional cash for babies in New York City, Rochester, and Buffalo, efforts to procure state funding (to supplement philanthropic donations) have been unsuccessful.

Of course, these kinds of cash transfer policies require significant investment. Expanding the New York State child tax credit would require investing an estimated $3.5 billion annually, to be phased in over time. Yet these are indeed investments, rather than costs, since they yield a return in averted health care costs and social service expenditures — as well as the economic dividend associated with stronger and better educated New Yorkers.

The dividend benefits parents as well as kids. Last month, the United States surgeon general issued an advisory on the wellbeing of American parents, specifically citing the increased mental health concerns for parents and caregivers who are experiencing poverty.

According to the advisory, one in four U.S. parents reported not having enough money to cover the basic needs of their family during the past year. This stress and the anxiety of financial insecurity negatively impact the whole family’s mental health.

Addressing family economic security is crucial to the future wellbeing of our children and our state. To quote Surgeon General Vivek Murthy, “The work of parenting is essential not only for the health of children but also for the health of society.”

The costs of inaction are stark: as it stands, ours may be the first generation of Americans for whom less than half of our kids will earn more income than their parents.

A report from the National Academies of Science, Engineering, and Medicine estimated that child poverty costs the nation between $800 billion and $1.1 trillion annually in terms of increased health expenditures, lost adult productivity, and increased costs of crime. This equates to a cost of about $60 billion to New York State each year. 

Just as in medicine, when it comes to investing in child poverty reduction, an ounce of prevention is worth a pound of cure.

A New York free of child poverty would mean more families are able to provide the things every parent wants for their children: nourishing meals, safe and stable housing, consistent health care, and opportunities to play sports and participate in the arts.

We could break cycles of generational hardship, creating pathways to lasting success and stability. If we eliminated child poverty, New York’s children would be healthier, safer, and more likely to thrive as they enter adulthood.

Where will New York be in 2032, the finish line set by our leaders for cutting the state’s child poverty rate in half? We find ourselves reflecting on this question not just as doctors but as a father and a grandmother, respectively.

Regardless of our occupation or our political persuasion, we should all agree that failure to protect our children dims the future for everyone. New York ought to lead the way toward a brighter tomorrow, starting with halving child poverty and ultimately eliminating it altogether.

Chokshi is a professor at the City College of New York and a primary care physician at Bellevue Hospital. He previously served as the health commissioner of New York City. Bassett is a professor and director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University. She previously served as the health commissioner of both New York State and New York City.

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