Policies that improve the socioeconomic conditions of families tend to have the largest impacts on health.1 Strong empirical evidence consistently links low income to children’s development, academic achievement, and health,2,3 including exposure to child abuse and neglect.4 Policies that strengthen household financial security can reduce child abuse and neglect by improving parents’ ability to satisfy children’s basic needs (e.g., food, shelter, medical care), provide developmentally appropriate child care, and improve parental mental health. Policies can change the context for families by improving the balance between work and family (“family-friendly work”), thereby allowing parents to provide the necessary care for children and increasing the likelihood that children experience safe, stable, nurturing relationships and environments. Studies show several “family-friendly” work policies reduce risk factors for child abuse and neglect, such as stress and depression.

Approaches

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Economic supports for families can be strengthened by targeting household financial security and family-friendly work. Strengthening household financial security can reduce child abuse and neglect by improving parents’ ability to satisfy children’s basic needs (e.g., food, shelter, medical care), provide developmentally appropriate child care, and reduce parental stress and depression, both risk factors for child abuse and neglect.4 Strengthening household financial security may also reduce children’s exposure to crowding and contribute to residential stability and stability in child care arrangements. Household financial security can be strengthened in various ways:

• Child support payments: States can modify how Temporary Assistance for Needy Families (TANF) benefits are affected by child support payments. In many states, the child support payments are used by the state to reimburse itself, but states may also elect to allow some or all of the child support payment to be passed on to the custodial parent and child without any reduction in the TANF benefits. Allowing child support payments to be passed on to the custodial parent in part or in full without reducing TANF benefits increases household income.

• Tax credits for families with children (e.g., state and federal Earned Income Tax Credit, EITC) help low income families increase their income while incentivizing work or offsetting the costs of child-rearing. The federal EITC is a refundable credit originally designed to encourage work by offsetting the impact of federal taxes on lowincome families. The amount of the credit varies depending on income earned through work, marital status, and the number of qualifying children. State EITC’s are usually based on a percentage of the federal EITC and vary in their eligibility and funding amounts; approximately half of the states in the U.S. have enacted EITCs.5

• State options for managing federal nutrition assistance programs: The Supplemental Nutrition Assistance Program (SNAP) is a federally funded program managed by the U.S. Department of Agriculture (USDA) that provides cash benefits, which can only be used to purchase food, to low income households. States have several options that can facilitate access to SNAP (e.g., online application; frequency or simplicity with which households report household income or work hours; whether child support is considered in income calculations; disqualifications imposed).6 SNAP benefits help low income parents meet children’s basic needs for food. Because SNAP benefits allow a parent’s income from other sources to be used on things besides food, SNAP decreases family poverty and poverty among children.7 SNAP also reduces the severity of food insecurity.8

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Family-friendly work policies change the context for families by improving the balance between work and family while ensuring economic security. This makes it easier for parents to provide necessary care for children.

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• Livable wages allow working parents enough income to cover the costs of living and provide for their children’s basic needs (e.g., food, shelter, appropriate child and medical care), reducing the likelihood of child neglect. Its impacts on parental mental health may also improve parenting behaviors.

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• Paid leave provides income replacement to workers on leave for family caregiving, bonding with a new child (paid parental leave), or personal leave taken to recover from a serious health condition (paid sick leave) or get rested and re-energized (paid vacation). Paid leave can reduce risk factors for child abuse and neglect (e.g., parental stress).

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• Flexible and consistent schedules provide workers with a predictable pattern of work and/or allow for adaptability within the work environment. Flexible schedules include flexibility in work scheduling (e.g., compressed work weeks, flexible beginning/ending times to work day, flexibility in scheduling shifts and breaks to allow for child care coverage), flexibility in the number of hours worked (e.g., part-time work), and flexibility in the workplace location (e.g., home office, satellite location, alternate location). Inconsistent schedules or shift-work can make it challenging to balance work and family responsibilities, which includes obtaining stable child care and access to child care assistance.

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