Effects of a monthly unconditional cash transfer starting at birth on family investments among US families with low income.

How does unconditional income for families in poverty affect parental investments for their young children? Mothers in four US metropolitan areas were randomized to receive a monthly unconditional cash transfer of either $333 per month (high) or $20 per month (low) for the first several years after childbirth. During the first 3 years, high-cash gift households spent more money on child-specific goods and more time on child-specific early learning activities than the low-cash gift group. Few changes were evident in other core household expenditures. Compared with low-cash gift families, high-cash gift families reported lower rates of public benefit receipt and fewer were residing in poverty, although mean income and wealth remain low for the majority of families by year 3. No statistically significant differences were evident in mothers' participation in paid work, children's time in childcare or mothers' subjective wellbeing.

Contraception use and satisfaction among mothers with low income: Evidence from the Baby's First Years study.

OBJECTIVES: Low income can lead to limited choice of and access to contraception. We examine whether an unconditional cash transfer (UCT) impacts contraceptive use, including increased satisfaction with and reduced barriers to preferred methods, for individuals with low income. STUDY DESIGN: Baby's First Years is a randomized control study of a monthly UCT to families with low incomes. The study enrolled 1000 mothers at the time of childbirth across four US sites in 2018-2019; 400 were randomized to receive a UCT of $333/mo and 600 were randomized to receive $20/mo for the first years of their child's life. We use intent-to-treat analyses to estimate the impact of the cash transfer on contraception use, satisfaction with contraception method, and barriers to using methods of choice. RESULTS: Over 65% of mothers reported using some type of contraception, and three-quarters reported using the method of their choice. We find no impact of the UCT on mothers' choice of, satisfaction with, or barriers to contraception. However, the cash transfer was associated with trends toward using multiple methods and greater use of short-term hormonal methods. CONCLUSIONS: We find high levels of satisfaction with current contraceptive use among mothers of young children with low income. Receipt of monthly UCTs did not impact contraception methods, perceived barriers to use, or satisfaction. Yet, 25% were not using the method of their choice, despite the provision of cash, indicating that this cash amount alone may not be sufficient to impact contraceptive use or increase satisfaction. IMPLICATIONS: Satisfaction with contraception use among low-income populations may be higher than previously documented. Nevertheless, provision of modest financial resources alone may not sufficiently address access, availability, and satisfaction for individuals with low-incomes of childbearing age. This suggests the importance of exploring how other nonfinancial factors influence reproductive autonomy, including contraceptive use.

Associations between maternal stress and infant resting brain activity among families residing in poverty in the U.S.

Growing evidence suggests that maternal experiences of stress shape children's functional brain activity in the first years of life. Individuals living in poverty are more likely to experience stress from a variety of sources. However, it is unclear how stress is related to resting brain activity among children born into poverty. The present study examines whether infants born into households experiencing poverty show differences in brain activity associated with maternal reports of experiencing stress. The analytic sample comprised 247 mother-infant dyads who completed maternal questionnaires characterizing stress, and for whom recordings of infant resting brain activity were obtained at 1 year of age (M=12.93 months, SD=1.66; 50% female). Mothers (40% Black, non-Hispanic, 40% Hispanic, 12% White, non-Hispanic) who reported higher stress had infants who showed more resting brain activity in the lower end of the frequency spectrum (relative theta power) and less resting brain activity in the middle range of the frequency spectrum (relative alpha power). While statistically detectable at the whole-brain level, follow-up exploratory analyses revealed that these effects were most apparent in electrodes over frontal and parietal regions of the brain. These findings held after adjusting for a variety of potentially confounding variables. Altogether, the present study suggests that, among families experiencing low economic resources, maternal reports of stress are associated with differences in patterns of infant resting brain activity during the first year of life.

Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial.

Importance: Children experiencing poverty are more likely to experience worse health outcomes, including injury, chronic illness, worse nutrition, and poorer sleep. The extent to which poverty reduction improves these outcomes is unknown. Objective: To evaluate the effect of a 3-year, monthly unconditional cash transfer on health, nutrition, sleep, and health care utilization among children experiencing poverty who were healthy at birth. Design, Setting, and Participants: This longitudinal randomized clinical trial recruited 1000 mother-infant dyads between May 2018 and June 2019. Dyads were recruited from postpartum wards in 12 hospitals in 4 US cities: New York, New York; Omaha, Nebraska; New Orleans, Louisiana; and Minneapolis/St Paul, Minnesota. Eligibility criteria included an annual income less than the federal poverty line, legal age for consent, English or Spanish speaking, residing in the state of recruitment, and an infant admitted to the well-baby nursery who will be discharged to the mother's custody. Data analysis was conducted from July 2022 to August 2023. Intervention: Mothers were randomly assigned to receive either a high-cash gift ($333/mo, or $3996/y) or a low-cash gift ($20/mo, or $240/y) for the first several years of their child's life. Main Outcomes and Measures: Primary preregistered outcomes reported here include an index of child health and medical care and child sleep disturbances. Secondary preregistered outcomes reported include children's consumption of healthy and unhealthy foods. Results: A total of 1000 mother-infant dyads were enrolled, with 400 randomized to the high-cash gift group and 600 to the low-cash gift group. Participants were majority Black (42%) and Hispanic (41%); 857 mothers participated in all 3 waves of data collection. We found no statistically detectable differences between the high-cash and low-cash gift groups in maternal assessments of children's health (effect size [ES] range, 0.01-0.08; SE range, 0.02-0.07), sleep (ES range, 0.01-0.10; SE, 0.07), or health care utilization (ES range, 0.01-0.11; SE range, 0.03-0.07). However, mothers in the high-cash gift group reported higher child consumption of fresh produce at child age 2 years, the only time point it was measured (ES, 0.17; SE, 0.07; P = .03). Conclusions and Relevance: In this study, unconditional cash transfers to mothers experiencing poverty did not improve reports of their child's health, sleep, or health care utilization. However, stable income support of this magnitude improved toddlers' consumption of fresh produce. Healthy newborns tend to grow into healthy toddlers, and the impacts of poverty reduction on children's health and sleep may not be fully borne out until later in life. Trial Registration: ClinicalTrials.gov Identifier: NCT03593356.

EVALUATING CONTRADICTORY EXPERIMENTAL AND NON-EXPERIMENTAL ESTIMATES OF NEIGHBORHOOD EFFECTS ON ECONOMIC OUTCOMES FOR ADULTS.

Although non-experimental studies find robust neighborhood effects on adults, such findings have been challenged by results from the Moving to Opportunity (MTO) residential mobility experiment. Using a within-study comparison design, this paper compares experimental and non-experimental estimates from MTO and a parallel analysis of the Panel Study of Income Dynamics (PSID). Striking similarities were found between non-experimental estimates based on MTO and PSID. No clear evidence was found that different estimates are related to duration of adult exposure to disadvantaged neighborhoods, non-linear effects of neighborhood conditions, magnitude of the change in neighborhood context, frequency of moves, treatment effect heterogeneity, or measurement, although uncertainty bands around our estimates were sometimes large. One other possibility is that MTO-induced moves might have been unusually disruptive, but results are inconsistent for that hypothesis. Taken together, the findings suggest that selection bias might account for evidence of neighborhood effects on adult economic outcomes in non-experimental studies.

The Effect of a U.S. Poverty Reduction Intervention on Maternal Assessments of Young Children's Health, Nutrition, and Sleep: A Randomized Control Trial.

Importance: Children experiencing poverty are more likely to experience worse health outcomes during the first few years of life, including injury, chronic illness, worse nutrition, and poorer sleep. The extent to which a poverty reduction intervention improves children's health, nutrition, sleep, and healthcare utilization is unknown. Objective: To determine the effect of a 3-year, monthly unconditional cash transfer on health, nutrition, sleep, and healthcare utilization of children experiencing poverty who are healthy at birth. Design: Longitudinal randomized control trial. Setting: Mother-infant dyads were recruited from postpartum wards in 12 hospitals in four cities across the U.S. Participants: 1,000 mothers were enrolled in the study. Eligibility criteria included: an annual income below the federal poverty line, being of legal age for consent, speaking English or Spanish, residing in the state of recruitment, and having an infant admitted to the well-baby nursery with plans to be discharged to the custody of the mother. Intervention: Mothers were randomly assigned to receive either a high-cash gift ($333 per month, or $3,996 per year; n=400) or a low-cash gift ($20 per month, or $240 per year; n=600) for the first several years of their child's life. Main Outcomes and Measures: Pre-registered maternal assessments of the focal child's health, nutrition, sleep, and healthcare utilization were collected at children's ages 1, 2, and 3. Results: Enrolled participants were majority Black (42%) and Hispanic (41%). 857 mothers participated in all three waves of data collection. We found no statistically detectable differences between the high-cash and low-cash gift groups in maternal assessments of children's overall health, sleep, or healthcare utilization. However, mothers in the high-cash gift group reported higher child consumption of fresh produce compared with mothers in the low-cash gift group at age 2, the only time point it was measured (ß=0.17, SE=0.07, p=0.03). Conclusions and Relevance: In this RCT, unconditional cash transfers to mothers experiencing poverty did not improve their reports of their child's health, sleep, or healthcare utilization. However, stable income support of this magnitude improved toddler's consumption of fresh produce. Healthy newborns tend to grow into healthy toddlers, and the impacts of poverty reduction on children's health and sleep may not be fully borne out until later in life. Trial Registration: Baby's First Years (BFY; ID NCT03593356) https://clinicaltrials.gov/ct2/show/NCT03593356?term=NCT03593356&draw=2&rank=1.

Unconditional Cash and Family Investments in Infants: Evidence from a Large-Scale Cash Transfer Experiment in the U.S.

Economists have limited causal evidence on how families receiving unconditional income would spend those funds. We examine financial and time investments in infants among families living in poverty from a large-scale, multi-site randomized controlled study of monthly unconditional cash. We find increased spending on child-specific goods and mothers' early-learning activities with their infants. The marginal propensity to consume child-focused items from the cash transfer exceeded that from other income, consistent with the behavioral cues in the design. We find no statistically detectable offsets in household earnings or impacts on pre-registered outcomes related to expenditures, labor supply, childcare or subjective well-being.

Earned Income Tax Credit Receipt By Hispanic Families With Children: State Outreach And Demographic Factors.

The Earned Income Tax Credit (EITC), the largest refundable tax credit for low-to-middle-income US families with children, has been shown to improve maternal and child health and reduce public spending on health. However, many eligible families do not receive it. This study used 2014 Survey of Income and Program Participation data to explore predictors of EITC receipt among Hispanic families, an understudied segment of the eligible population. We found lower likelihoods of receipt among Hispanic income-eligible families, even those who were eligible US citizens by naturalization, compared with their peers. Parent self-employment and lower English language proficiency were also associated with lower EITC receipt. With new data collected on state policies, we found that states' granting of drivers' licenses to undocumented people, availability of government information in Spanish, and employer mandates to inform employees were associated with greater EITC receipt among all income-eligible families, including Hispanic families. These findings showcase ways in which information and outreach at the state level can support the equitable receipt of tax refunds and similar types of benefits distributed through the tax system.

The impact of a poverty reduction intervention on infant brain activity.

Early childhood poverty is a risk factor for lower school achievement, reduced earnings, and poorer health, and has been associated with differences in brain structure and function. Whether poverty causes differences in neurodevelopment, or is merely associated with factors that cause such differences, remains unclear. Here, we report estimates of the causal impact of a poverty reduction intervention on brain activity in the first year of life. We draw data from a subsample of the Baby's First Years study, which recruited 1,000 diverse low-income mother-infant dyads. Shortly after giving birth, mothers were randomized to receive either a large or nominal monthly unconditional cash gift. Infant brain activity was assessed at approximately 1 y of age in the child's home, using resting electroencephalography (EEG; n = 435). We hypothesized that infants in the high-cash gift group would have greater EEG power in the mid- to high-frequency bands and reduced power in a low-frequency band compared with infants in the low-cash gift group. Indeed, infants in the high-cash gift group showed more power in high-frequency bands. Effect sizes were similar in magnitude to many scalable education interventions, although the significance of estimates varied with the analytic specification. In sum, using a rigorous randomized design, we provide evidence that giving monthly unconditional cash transfers to mothers experiencing poverty in the first year of their children's lives may change infant brain activity. Such changes reflect neuroplasticity and environmental adaptation and display a pattern that has been associated with the development of subsequent cognitive skills.

Net Worth Poverty and Child Development.

The authors investigate whether net worth poverty (NWP) reduces children's well-being. NWP-having wealth (assets minus debts) less than one fourth of the federal poverty line-is both theoretically and empirically distinct from income poverty (IP) and is the modal form of poverty among children. Data come from the Panel Study of Income Dynamics and its Child Development Supplement on children ages 3 to 17 years observed between 2002 and 2019. The authors use linear mixed-effects models to investigate the associations among NWP, IP, and four cognitive and behavioral outcomes. NWP reduces children's cognitive scores and was associated with increases in both problem behavior scores. Negative associations for NWP are similar in magnitude to those found for IP. Much of the NWP effect operates through asset deprivation rather than high debt. The results illustrate the potential risks many children, previously overlooked in studies of IP, face because of wealth deprivation.

Net Worth Poverty in Child Households by Race and Ethnicity, 1989-2019.

OBJECTIVE: This study is the first to examine net worth poverty, and its intersection with income poverty, by race and ethnicity among child households in the United States. BACKGROUND: Scholarship on economic scarcity for children has largely concentrated on income deficits and thus leaves open important questions about wealth deficits. METHOD: Data come from the 1989-2019 waves of the Survey of Consumer Finances, on households with at least one resident child under the age of 18. Net worth poverty is measured as household net worth, defined as total assets minus total debts, that is less than one-fourth of the federal poverty line. RESULTS: In 2019, 57% of Black and 50% of Latino child households were net worth poor. The majority of these households were not income poor. Racial and ethnic differences in net worth poverty (unlike those for income poverty) persist even when sociodemographic variation predicting income poverty is controlled for. CONCLUSION: Net worth poverty is so prevalent in the lives of non-White children that, after sociodemographic characteristics are controlled for, Black and Latino child households have about the same probability of not being poor as they do of being net worth poor. IMPLICATIONS: A focus on income deprivation alone will overlook the precarious economic conditions related to family net worth and ignore growing disparities by race and ethnicity.

Baby's First Years: Design of a Randomized Controlled Trial of Poverty Reduction in the United States.

Childhood economic disadvantage is associated with lower cognitive and social-emotional skills, reduced educational attainment, and lower earnings in adulthood. Despite these robust correlations, it is unclear whether family income is the cause of differences observed between children growing up in poverty and their more fortunate peers or whether these differences are merely due to the many other aspects of family life that co-occur with poverty. Baby's First Years is the first randomized controlled trial in the United States designed to identify the causal impact of poverty reduction on children's early development. A total of 1000 low-income mothers of newborns were enrolled in the study and began receiving a monthly unconditional cash gift for the first several years of their children's lives. Mothers were randomly assigned to receive either a large monthly cash gift or a nominal monthly cash gift. All monthly gifts are administered via debit card and can be freely spent with no restrictions. Baby's First Years aims to answer whether poverty reduction in early childhood (1) improves children's developmental outcomes and promotes healthier brain functioning, and (2) improves family functioning and better enables parents to support child development. Here we present the rationale and design of the study as well as potential implications for science and policy.

Behavioral Economics and Parent Participation in an Evidence-Based Parenting Program at Scale.

Evidence-based and culturally relevant parenting programs strengthen adults' capacity to support children's health and development. Optimizing parent participation in programs implemented at scale is a prevailing challenge. Our collaborative team of program developers, implementers, and researchers applied insights from the field of behavioral economics (BE) to support parent participation in ParentCorps-a family-centered program delivered as an enhancement to pre-kindergarten-as it scaled in a large urban school district. We designed a bundle of BE-infused parent outreach materials and successfully showed their feasibility in site-level randomized pilot implementation. The site-level study did not show a statistically significant impact on family attendance. A sub-study with a family-level randomization design showed that varying the delivery time of BE-infused digital outreach significantly increased the likelihood of families attending the parenting program. Lessons on the potential value of a BE-infused approach to support outreach and engagement in parenting programs are discussed in the context of scaling up efforts.

Experiences of Hispanic Families with Social Services in the Racially Segregated Southeast: Views from Administrators and Workers in North Carolina.

North Carolina-as a state in the racially segregated Southeast-offers a unique context to understand access to social services for Hispanic families and children. Theories of administrative burden posit that Hispanic families likely face high learning, compliance, and psychological costs. Hispanic families face challenges that compound these costs: limited English language and literacy proficiency, complex household composition, and citizenship status of family members and other household members. With new survey results and qualitative data on social service administrators and front-line workers, we examine how these costs may affect access to programs for Hispanic families who reside in a state with a history of racial divisions that have shaped local policy implementation. Some workers noted transportation barriers and complex application processes as limiting access. While we expected to find that Hispanic families may be disadvantaged by decentralized service delivery in a manner that is similar to the experiences of African American families, workers instead note significant resources that help facilitate Hispanic families' access to programs. Workers view national anti-immigrant policies and rhetoric, rather than state and local policy rules or resource constraints, as limiting their capacity to serve Hispanic families.

Pride-Based Self-Affirmations and Parenting Programs.

We newly apply the concept of self-affirmation typically used in the domain of health and education to the domain of parenting. Recruiting parents of children age 13 or younger (n = 1,044), we test how eliciting positive self-concept affects interest in receiving parenting materials and participating in a parenting program. We find that an adapted, pride-based written self-affirmation exercise increased parents' positive self-concept and their interest in parenting programs and resources, particularly among parents with a high baseline fear of judgment associated with seeking help. Implications for applying insights from psychology as a strategy to mitigate fear of judgment to optimize participation in an evidence-based parenting program at scale are discussed.

Advancing Transparency and Openness in Child Development Research: Opportunities.

Transparency and openness are basic scientific values. They lie at the heart of practices that accelerate discovery and broaden access to scientific knowledge. In this article, we argue that these values are essential to ensure the enduring influence of research on child development. They are also critical for the Society for Research in Child Development (SRCD) to accomplish its mission to benefit diverse global stakeholders and constituents. A companion article in this issue (Gilmore, Cole, Verma, van Aken, Worthman) discusses the challenges in realizing SRCD's vision for a science of child development that is open, transparent, robust, impactful, and conducted with the highest integrity. Here, we discuss opportunities for the society to set standards that ensure the full integration of transparency and openness into developmental science.

The Impact of Default Options for Parent Participation in an Early Language Intervention.

In this study we tested, via a randomized control study design, different enrollment options for a scaled city-wide text-based early learning program among 405 mothers who were receiving newborn home visiting services. We found that when automatically enrolled with a voluntary option to opt out, 88.7 percent of mothers in the experimental group stayed in the program and continued to receive the text-based content over the course of 26 weeks. In contrast, only 1 percent of mothers in the control group who heard about the text-based program through conventional recruitment flyers voluntarily enrolled in the program. Opt-out and opt-in patterns did not differ by characteristics typically considered as interfering with program participation: low income status, first-time motherhood status, total number of children, maternal language, flagging for depressive symptoms, and household residential instability. Findings suggest that automatic enrollment might be an effective engagement strategy for text- and similar digitally-based early childhood programs.

A housing mobility program's impacts on teen and young adult parenting.

OBJECTIVE: To assess the impact of Moving to Opportunity for Fair Housing Demonstration Program (MTO) implemented in 1994 in five U.S. cities (Baltimore, Boston, Chicago, Los Angeles, and New York City) on teen births. METHODS: We analyzed baseline and long-term evaluation data for youth (ages 13-20) and young adults (ages 21-30) (N = 7861) who were children or teens at baseline. We used regression analyses to estimate the impact of housing vouchers on having a teen birth. RESULTS: Overall, MTO had no significant effect on teen births. However, among young adults whose parent had a child before age 20, the proportion with a teen birth themselves was 21% lower among those offered housing vouchers to low-poverty neighborhoods with no restrictions compared to those not offered housing vouchers (p < 0.05). CONCLUSION: MTO appeared to decrease intergenerational teen births among young adults. Further exploration of housing relocation may help untangle risks and protective factors for reducing intergenerational teen births. PUBLIC HEALTH IMPLICATIONS: Reducing intergenerational teen births is important, especially among those facing economic, environmental, and health risks. Comprehensive programs addressing multiple social determinants of health are vital to reducing teen births.