Childhood hunger in 2021

Dr. Diana Cutts
D'var Torah Bamidbar
May 15, 2021

Shabbat Shalom.  Thank you for your invitation to speak. I’m very honored to share this very special virtual space with you this morning.

I sometimes feel a bit like Dorothy – slightly bewildered about how I landed here, in front of you all.  The short answer, of course, is that your Rabbis, for whom I have much respect, asked me. Plus, years ago my youngest children, Joey and Greta, began their lives as students with 2 wonderful years at the Gan. They officially graduate from college later today, so there’s a debt of gratitude to be repaid, too.   The longer answer involves my personal development as a pediatrician, researcher, and advocate.

I’m told I showed an early interest in caring for children, and was fortunate to have parents who nurtured and supported that interest. After I finished my pediatric training, my husband, whose family roots are in North Minneapolis, and I moved to the Twin Cities and I began my practice.

I found myself drawn to a specialty area – taking care of infants and young children who were not growing well. With a clinical team of pediatric dietitian, developmental and other specialists, we cared for babies like this one, working to achieve the kind of successful treatment you can see in this before and after photo, and helping kids and parents get on track for a healthy future.  The painful recognition that factors beyond my exam room were too often more powerful than anything I could do in my exam room came quickly.

I was incredibly fortunate to connect with a national group of child health experts across the country, now called Children’s HealthWatch and together we began to study how material hardships impact very young children’s health and how policies can alleviate harm. Our earlier work was focused on Food Insecurity, but over time we expanded our interests to include Housing Instability and other hardships. We’ve collected data from the parents of infants and toddlers at the frontline of care, in the EDs or clinics of 5 national sites in Boston, Baltimore, Little Rock, Philadelphia, and Minneapolis. Covid interrupted continuous data collection that spanned over 20 years.  We’re now conducting a covid impact survey by phone of previously interviewed parents, and just re-starting interviews with our core survey again. So, I met Rabbi Kravitz because of our shared interest in Food Insecurity work, but – as he’s already educated you well on that topic -  today I will talk a bit more broadly about Child Poverty in the United States.

So what can I tell you about Child Poverty in 2021? Of the 34 Million people living in poverty in the US in 2019 (the most recent national data available) nearly one third, 10.5 million, are children. Children are the poorest age group in our country, and the younger the child, the higher the risk of poverty. While overall the child poverty rate was 14.4% for all children, that for children less than 6 is higher as the bar graph shows… Just as there are variations by age, there are wide variations by race, with poverty rates of 8.3% for white children, compared to rates of 26.5% for Black, and 21% for American Indian/Alaskan Native and Hispanic children.   - This overall rate of 14.4 % is pre-covid, however, and researchers now estimate that child poverty has risen to over 20% for all children as a result of the pandemic, affecting an additional 4 Million children.  So, US children today have a 1/5 likelihood of poverty.

One cannot talk about Child Poverty in the US without talking about racism. Economists, historians, and others educate us that systemic racism has prevented the success of families of color by limiting education and employment, and prohibiting purchase of property and access to loans.  And these income inequities are only magnified by the covid pandemic, as families of color have been hardest hit by illness and death from covid-19, job loss, and material hardship.  It’s estimated that at least 43,000 US children have lost a parent to covid, and that Black children are most disproportionately affected.

Our Children’s HealthWatch pre vs post-covid study shows sharply rising Household Food Insecurity, from 21 to 35%, Housing Instability increases from 27 to 43%, and Child Food Insecurity – a much less common and more severe food insecurity that directly limits food for children - increases from 2 to 7%.  We saw that evictions actually decreased, the impact of moratoriums which protected families from evictions. This all feels a little grim, but there is Good News in the form of Federal Relief.

4 packages have been passed by Congress over the past year. The key measures in the first 3 packages, collectively, include economic impact payments – or the three waves of what we’ve called stimulus checks, creation and extension/expansion of Pandemic EBT which provides dollars for food for children out of school and childcare who would otherwise receive free or reduced school meals, SNAP (formerly known as food stamps) benefits at maximum levels with a 15% increase, rental and utility assistance, eviction moratoriums, expanded health insurance coverage, expanded unemployment insurance and paid leave.

These were a good start, but the 4th Act, The American Rescue Plan Act, a $1.9 Trillion economic stimulus bill, takes things to a new level. You can see the broad array of assistance in includes in this overview slide, but I’m going to focus on the real winner for Children, the Expanded Child Tax Credit, which is the primary driver behind reducing child poverty.

This part of the bill, makes temporary expansions to the existing tax credit for a year. It increases the benefit from 2K to 3K for children 6-17 extending the benefit to 17 year olds where it previously went to age 16, and it rises to $3,600 for children under 6. Families are provided the full refund, rather than a portion, including families with little or no income who were previously excluded or got reduced refunds. Half the credit is to be sent this July, so that relief will not need to wait until the 2022 tax filing season. This change expands the credit to an additional 27 M children typically left out. Because families of color are overrepresented among families in poverty, this component of the expansion has a large racial equity impact. In all, 90% of US children/families benefit (including PR and US territories for the first time). It’s predicted to lift 6.1 Million children out of poverty, a reduction of 49%, and to drop the child poverty rate to < 10%, from its current of ~ 20%.

There will be some challenges – the estimated reduction in child poverty will only be realized if those with the lowest incomes access the benefit, so outreach will be critical – to increase awareness, to ensure that all families file taxes – even those who are not obligated. Anxiety that the benefit will count as income such that a family might be made ineligible for other assistance must be allayed. There’s free IRS software available for families earning < 72K, and the national volunteer tax assistance programs, called VITA nationally, and called Prepare and Prosper in the twin cities will be critical resources. I urge you to consider volunteering with these programs, if you have any interest in helping!

The Biden-Harris administration has 2 new proposals now under debate. The first, called the American Jobs Plan is mainly about infrastructure in housing and the care economy. The second, shown here, is called the American Families Plan. It includes historic investments in childcare and universal pre-K, expands food assistance, expands the EITC, and extends the Child Tax Credit through 2025, and restores eligibility to immigrant families.

So, I’ll end as I began –  thanking you for the opportunity to share this time with you, and urging you to learn more about these policies, ask questions, get involved, consider your role in Tikkum Olam – Repairing the World. This is not a we/they issue, this is an us issue. These children are our children and grandchildren’s classmates and friends, and their future co-workers and neighbors. This is a really monumental opportunity to help every child get, as Children’s Defense Fund says, a Healthy Start, A Fair Start, A Safe Start, and a Moral Start. Shabbat Shalom.

Diana Cutts, MD, is Chair of Pediatrics at Hennepin Healthcare and has practiced pediatrics in the Twin Cities for over 30 years. She is an Associate Professor of Pediatrics at the University of Minnesota School of Medicine and Principal Investigator with Children’s HealthWatch, a national network of pediatric researchers focusing on the intersections of Food Insecurity and other hardships, health, and public policy. Dr. Cutts graduated from the University of Illinois Medical School and completed pediatric residencies at Boston City and Children’s Hospitals. She credits her 4 children with additional in-the-trenches training, a heavy responsibility now assumed by 2 recently arrived grandchildren.

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