What do Washington’s kids need to be healthy? You might be tempted to give the most basic of answers — nutritious food, clean diapers, a safe home to live in. You would be right. Meeting a child’s basic needs is proven to build a foundation for health and protect children from the most damaging health impacts of economic hardship.
Yet Washington state lawmakers have made it harder for some parents to lay that groundwork for their kids with a decade of deep cuts and harsh restrictions on WorkFirst /Temporary Assistance for Needy Families (TANF). The program is supposed to help parents meet these most basic needs for kids when their family is facing hard times like job loss, a mental health crisis or losing housing.
During my career as a pediatrician working with low-income local families, I met with many parents struggling to support their families and to provide health care, high-quality child care and safe housing for their children. Luckily, two decades ago there were some government-supported programs that helped resilient parents keep a home together.
I recall the mom of one of my infant patients. Susan was just getting back up on her feet after having been homeless. She was sober and doing well in a treatment program. At her well-child clinic visits, her infant daughter was thriving. Susan had a job, which she loved, working in a home day care where she could also take her daughter.
But at her daughter’s six-month checkup, Susan was distraught. The great job was going away. The day care was closing. She didn’t know how she could pay the rent. Our clinic social worker got her onto Work First/TANF to obtain emergency financial assistance to pay rent and stay housed while providing support services and time to find another suitable job.
At that time in 2008, Work First/TANF was reaching 50 families for every 100 in poverty. Today, Washington only reaches 29 families for every 100 in poverty. Harsh cuts to the program have cut off thousands of families from basic assistance as they are struggling to make ends meet.
As a pediatrician, I could provide children with the basic health care they needed. But WorkFirst/TANF provides families with the direct financial assistance, job training and support services to help them build that stable foundation for their children’s health.
When parents and guardians need and receive direct financial assistance, studies show they use it to provide resources that support their children’s healthy development. Susan herself had a childhood impacted by poverty and parental mental illness. Susan was determined this would not happen to her daughter, but her precarious financial and work situation was challenging.
Severe poverty-related stress has been linked to lasting consequences for children’s brain development, social-emotional learning and overall health. Recent science has shown that adverse childhood experiences like homelessness, housing instability, inadequate food and nutrition, and living with a parent experiencing a mental health crisis, can have ripple effects throughout a child’s lifetime and into adulthood. The consequences can be prevented through providing more financial and social support to families.
Sadly, fewer parents can rely on Work-First/TANF. In King County alone, over a thousand families were cut off due to budget cuts, time limits and not being able to meet paperwork and other requirements in 2018. Statewide, more than one-third of families who were cut off were homeless at the time.
When families in our region are struggling to meet their basic needs — when they don’t have safe housing, enough food or money for diapers — they are also struggling to meet basic health needs for their kids. The Washington Legislature needs to restore funding to WorkFirst/TANF in 2020 and ensure that when families fall on hard times, they can at least have the basics.
Elinor Graham is a retired pediatrician who served families in south Seattle and south King County for 28 years while working with the Seattle-King County Department of Health and then on the University of Washington faculty in the Dept. of Pediatrics at Harborview. She works with the Washington Chapter of the American Academy of Pediatrics to advocate for families with limited resources.
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