The expanded Child Tax Credit led to improved health and nutrition among adults, UCLA-led research suggests

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Monthly cash payments to eligible families under the temporary pandemic-era expansion of the federal Child Tax Credit led to better adult health and food security, new UCLA-led research suggests.

The policy, which expired at the end of 2021, has not been renewed due to concerns among legislators over the credit being overly generous, particularly to lower-income families with limited tax liability, and the lack of an associated work requirement. The findings, published June 24 in JAMA Health Forum, could inform the debate over the policy’s future, said Dr. Jordan Rook, a fellow in the National Clinician Scholars Program at UCLA and the study’s lead author.

“Cash transfer programs like the 2021 Child Tax Credit expansion may be powerful tools in improving the health, wellbeing, and nutrition of families,” said Rook, who is also a general surgery resident at the David Geffen School of Medicine at UCLA.  “Evidence like this can help guide the public, the media, and politicians as they advocate for and debate the policy's future.

Currently about one in six U.S. families with children lives in poverty, leading to poorer health and shorter life expectancy, according to the research team.

Prior to the pandemic, the Child Tax Credit provided up to $2,000 per child ages 16 or younger for families with eligible incomes. Under the pandemic-era American Rescue Plan signed into law on March 11, 2021, the credit increased to $3,600 per child ages five or younger, and $3,000 per child ages 6 to 17. Families were eligible to receive half of this amount in the form of monthly checks, which each month were worth between $250 to $300 per child. The credit was fully refundable, meaning that all low-income families with children were eligible to receive the entire credit, regardless of their work status or income.

These monthly payments reduced poverty by 40% in households with children, according to the researchers. But the policy, a temporary measure to assist families during the pandemic, expired on December 31, 2021.

The researchers used data taken from about 39,500 respondents to the National Health Interview Survey from January 2019 to December 2021. They found that prior to initiation of the monthly payments, 60% of credit-eligible adults reported excellent or very good health and 88% reported having food security-- that is, access to sufficient food to meet normal dietary needs. Among ineligible adults, 55% said they had excellent or very good health and 89% reported food security.

They then used a study design known as a “difference-in-differences” technique to compare changes in health and food security between credit-eligible families and credit-ineligible families to estimate the impact of the Child Tax Credit monthly payments. Based on this technique, they estimate that following the start of the payments, eligible adults were 3 percentage points more likely to report excellent or very good health and 1.9 percentage points more likely to report food security than ineligible adults.

“Assuming the conservative estimate of one adult per household, this represents improved health for 1.08 million adults, and newfound food security for 684,000 households,” Rook said. “These changes potentially represent important gains in health and nutrition for hundreds of thousands of US families because of this pandemic-era policy.”

The study has some limitations, among them the possibility that job losses and expansions to other social programs such as unemployment and SNAP during the pandemic might have affected the findings.

Additional study authors are Dr. Cecile Yama, Dr. Adam Schickedanz, Dr. Steven Lee, and Lauren Wisk of UCLA; and Dr. Alec Feuerbach of SUNY Downstate /Kings County.

The study was funded by the VA Office of Academic Affiliations and the Los Angeles County Department of Health Services, both through the National Clinician Scholars Program Fellowship; the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK116932 and R03 DK132439); the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD099308); and the Health Resources and Services Administration of the U.S. Department of Health and Human Services (UA6MC32492, the Life Course Intervention Research Network). The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

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