Food Insufficiency Following Discontinuation of Monthly Child Tax Credit Payments Among Lower-Income US Households

Abstract

ImportanceThe 2021 expanded Child Tax Credit provided advance monthly payments to many US families with children from July through December 2021 and was associated with a reduction in food insufficiency. Less is known about the effect of the discontinuation of monthly payments.ObjectiveTo assess whether the discontinuation of monthly Child Tax Credit payments was associated with subsequent changes in food insufficiency among lower-income US households with children.Design, Setting, and ParticipantsThis population-based cross-sectional study used data from the Household Pulse Survey, a recurring online survey of US households conducted by the US Census Bureau, from January 2021 to March 2022. This study estimated difference-in-differences regression models for households making less than $50 000, less than $35 000, and less than $25 000 annually, adjusting for demographic characteristics and state of residence. The estimation sample of households making less than $50 000/y included 114 705 responses, representing a weighted population size of 27 342 296 households.ExposuresReceipt of monthly Child Tax Credit payments, as measured by living in a household with children during the period of monthly payments from July through December 2021.Main Outcomes and MeasuresHousehold food insufficiency, as measured by a respondent indicating that there was sometimes or often not enough food to eat in the household in the previous 7 days.ResultsAmong 114 705 households making less than $50 000/y, respondents were predominantly female (57%); White (71%); not of Hispanic, Latino, or Spanish origin (79%); had high school or equivalent education (38%); and were unmarried (70%). Following the discontinuation of monthly Child Tax Credit payments, food insufficiency in US households with children increased by 3.5 percentage points (95% CI, 1.4-5.7 percentage points) among households making less than $50 000/y, 4.9 percentage points (95% CI, 2.6-7.3 percentage points) among households making less than $35 000/y, and 6.2 percentage points (95% CI, 3.3-9.3 percentage points) among households making less than $25 000/y. These estimates represent a relative increase in food insufficiency of approximately 16.7% among households making less than $50 000/y, 20.8% among households making less than $35 000/y, and 23.2% among households making less than $25 000/y.Conclusions and RelevanceIn this population-based cross-sectional study, discontinuation of monthly Child Tax Credit payments in December 2021 was associated with a statistically significant increase in household food insufficiency among lower-income households, with the greatest increase occurring in the lowest-income households.

Changes in Self-Reported Adult Health and Household Food Security With the 2021 Expanded Child Tax Credit Monthly Payments

“…While prior studies using nationally representative data reported on changes in food insufficiency (a single-question measure), this study measured food security, a more descriptive 4-level construct validated by the USDA . The study findings were consistent with prior research on this topic and potentially provide additional evidence of the positive association between income and food security …”

“…30 The study findings were consistent with prior research on this topic and potentially provide additional evidence of the positive association between income and food security. [20][21][22][23]45,46 The association of ECTC eligibility with health was most pronounced in middle-income and upper-income households and not low-income households. We hypothesize several reasons for this surprising finding.…”

“…We included receipt of SNAP as a covariate given changes in the benefit associated with the COVID-19 pandemic and to remain consistent with similar prior studies. [20][21][22]32…”

“…Four studies have investigated the association between the ECTC and household nutrition. However, 3 of these studies only assessed food insufficiency, which is a narrow, single-question measure of household nutrition . The only study to address food security, which is often measured with the US Department of Agriculture’s (USDA) 10-question survey, recruited participants from a single medical center and may have limited generalizability .…”

Associations of neighborhood social vulnerability with emergency department visits and readmissions among infants with bronchopulmonary dysplasia

“…[21][22][23] Black individuals in the US are exposed to higher levels of air pollution, have less access to healthcare, worse health outcomes, and higher levels of food insecurity. 21,[24][25][26] A large, California population-based study demonstrated signi cant racial and ethnic disparities in readmission for Black early, moderate, and late preterm infants after NICU discharge when compared to White infants. 6 However, a smaller retrospective cohort study found that among extremely low birth weight infants, race was not signi cantly associated with risk of rehospitalization, whereas medical comorbidities and low family income were.…”