During the past several months, we’ve heard the term “Build Back Better” in reference to pandemic recovery efforts in the United States. For the many children who have been affected by the pandemic, however, we have an opportunity not to build back, but to build beyond where we once stood to create a solid foundation for future generations.

For decades, the United States has had one of the worst child poverty rates among developed nations, with more than 1 in 5 children growing up under the poverty line. New York State falls in line with this average.

As health care leaders New York, we’ve been seeing the firsthand consequences of this cracked foundation for far too long. The effects of child poverty on health are pervasive. They start from the moment a child is born and continue throughout the lifespan. Children from low-income families and neighborhoods are more likely to be born at a lower birth weight, suffer a greater rate of infant mortality, and experience setbacks in areas like language development, chronic illness, environmental exposure, nutrition, and injury. Child poverty also influences genomic function and brain development by exposure to toxic stress, which in turn produces detrimental effects on physical and behavioral health.

A growing body of research confirms a strong association between the effects of child poverty and the development of chronic cardiovascular, immune, and psychiatric disorders. Furthermore, the brunt of these effects fall on families of color. Child poverty among New York State children of color is nearly 30%, and Black children are more than twice as likely to live in poverty than their Non-Hispanic white peers.

Given this reality, our immediate efforts must include a commitment to address the health crisis of child poverty. It requires structural investments and support from both state and federal leadership. To this end, we endorse New York State’s proposed Child Poverty Reduction Act (A.1160-B / S.2755-B) – introduced by New York State Assembly member Harry Bronson and Senator Jessica Ramos – that provides a road map to sharply cutting poverty through the following measures:

· Expanding and strengthening New York’s Earned Income Tax Credit;

· Expanding and strengthening New York’s child tax credit, especially to include young children;

· Expanding work training and employment programs;

· Increasing access to subsidized housing vouchers; and

· Expanding access to quality Pre-Kindergarten and child care.

For the coming year, New York has real support from the federal government to turn the tide on child poverty, via the American Rescue Plan Act, arguably the most consequential investment in the nation’s children in a generation. Still, the American Rescue Plan will not lift all New York children out of poverty. Its child tax credit leaves out more than 70,000 ineligible immigrant children, and it is temporary.

There is no need to pretend that child poverty is too onerous or difficult to solve. Several developed nations have reduced their child poverty rates to below 10 percent. Finland and Denmark in particular have child poverty rates that are below five percent. It’s time we followed their model, and the Child Poverty Reduction Act – combined with federal measures – provides the best opportunity to do so by aiming to reduce child poverty in New York State by 50 percent over 10 years.

To avoid acting right now would be playing with fire. During the pandemic, nearly twice as many lower-income families reported delaying or missing out on multiple types of health care for their children as those above the poverty line, including check-ups, preventive screenings, specialist visits, immunizations, and more. Furthermore, many of these families were directly impacted by COVID, as people classified as living under “very high poverty” conditions have died at twice the rate of those of the lowest poverty bracket. This doesn’t even take into account the many indirect costs of the pandemic that lower income families in New York State have felt – from lack of in-person schooling, increased food insecurity, and unemployment – that threaten to leave a generation of kids permanently left behind.

Given this enormous impact, we must take this opportunity to truly build back better. It’s not enough to assume that the post-pandemic economic recovery alone will address the concerns outlined above. To all New York State legislators, as well as Governor Cuomo: we urge you to support the Child Poverty Reduction Act. Let’s build a solid foundation for all New York children to be healthy and thrive.

Steven E. Lipshultz, M.D. A. Conger Goodyear Professor and Chair of the Department of Pediatrics Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo Oishei Children’s Hospital

Patrick Brophy, M.D. William H. Eilinger Chair of Pediatrics UR Medicine Golisano Children’s Hospital

Gregory P. Conners, M.D., M.P.H., M.B.A. Stanley A. August Professor and Chair of Pediatrics Upstate Medical University Executive Director Upstate Golisano Children’s Hospital

Lucia Acosta-Castillejo, M.S.Executive Director Monroe County Medical Society American Academy of Pediatrics NY 1

Jessica GeslaniExecutive Director American Academy of Pediatrics NY 2 & 3

To read the PDF version: https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:24ff1d32-f6e9-4e98-b54c-2b59ecfb9668