In 2019, the National Academies of Science released a comprehensive report on how the United States (US) could reduce the burden of childhood poverty that affects the pre-pandemic poverty rate of 15.6% by cutting it in half over a decade. Policy changes to enhance the benefits of the Earned Income Tax Credit (EITC) and Supplemental Nutrition Assistance Program (SNAP) coupled with health insurance expansion and housing support are evidenced-based initiatives to reduce the amount of poverty. While this report was focused primarily on the changes that could be made to existing US based programs, researchers in Hong Kong were actively creating a different kind of intervention to reduce poverty.
In this month’s Pediatrics, (10.1542/peds.2020-007534) Chan et al report the outcomes of the Child Development Fund (CDF) Program on the psychological, health, social, and financial development of children in poverty 4 years after the implementation of the program. The CDF was a 3 year financial investment in a group of families below the poverty line in Hong Kong and included the following interventions: a Child Development Account (CDA) of $HK200/month, a mentorship program, and the creation of a personal development plan. The researchers followed 552 families enrolled in the program and compared them to 335 matched controls who did not receive the 3-pronged intervention. After 4 years and controlling for potential confounding covariates, CDF participants reported fewer behavioral problems, higher levels of study motivation, higher levels of hope, and more positive attitudes than their matched controls. And more importantly, only 7% of the families who were working still depended on government financial assistance as compared to 25% in the control group.
The CDF offers a variety of anti-poverty and pro-resilience measures, so it makes sense that it works. Could we come up with a similar program in the US? Of course we could. Will we? Most likely not. The US hasn’t made a significant effort to reduce poverty for decades, and the current effort by Senator Benet from Colorado introduced in 2019 hasn’t moved anywhere. Unfortunately, even the prospects of expanding the current programs are slim. Getting support for a new program, even though it appears to be evidence-based and cost effective, seems like a pipedream. For the sake of kids, we must advocate for policy changes to reduce poverty. I will be adding programs like the CDF to my conversations with policy makers about how to put kids first.
