Supporting PCEs Through Health Coverage

Asia Porter | August 2022

State of child poverty

More than 10 million children—nearly 1 in 7 (14.4 percent)—lived in poverty in 2019. The child poverty rate is 1.5 times higher than that for adults ages 18-64 (9.4 percent) and adults 65 and older (8.9 percent). In Tennessee, 22.6% of children live in poverty. When we let millions of children grow up poor without necessities such as food, housing, and health care, we deny them equal opportunities to succeed in life. Poverty decreases a child’s probability of graduating from high school, makes her more susceptible to illness, as well as more likely to fall into the cycle of incarceration.

Unfortunately, children in the U.S. experience higher poverty rates than most developed nations. In comparison, Scandinavian countries have the lowest rates of child poverty, with Denmark seeing only 2.9 percent of its children falling into poverty. Key factors that promote low rates include wage equality, investment in public welfare programs, quality public primary and secondary education, and a strong public commitment to enabling individuals to access quality health care.

Poverty and low-income status are associated with various adverse health outcomes, including shorter life expectancy, higher infant mortality rates, and higher death rates for the 14 leading causes of death. Individual- and community-level mechanisms mediate these effects.

Healthcare as a solution

Healthcare coverage is one of the most effective anti-poverty programs in the nation. However, the benefits of having access to quality, affordable healthcare go beyond reducing poverty. Healthcare coverage directly promotes positive childhood experiences by supporting families in difficult circumstances and helping children build resilience to face life challenges. Health insurance coverage reduced the poverty rate by nearly ¼ in 2014, lifting 14.4 million people out of poverty. Public health insurance alone (Medicare, Medicaid, tax credits) accounts for more than half, lifting more than 8 million out of poverty. Medicaid provides access to affordable health coverage and lowers out-of-pocket costs. Furthermore, Medicaid kept at least 2.6 million individuals out of poverty in 2010, making it the third largest anti-poverty program in the country behind the EITC and SNAP. These poverty reduction efforts had the greatest impact among adults with disabilities, the elderly, children, and racial/ethnic minorities.

Positive and Adverse Childhood Experiences

Health care plays a huge role in lifting families out of poverty and providing children with positive childhood experiences (PCEs) while also reducing adverse childhood experiences (ACEs).

Some examples of ACEs include witnessing or experiencing violence, abuse, or neglect during childhood. According to the CDC, ACEs are extremely common, with about 61% of adults surveyed across 25 states reporting having experienced at least one ACE before age 18, and almost 1 in 6 adults having experienced at least four. Research has found strong associations between ACEs and detrimental effects on adult health and wellbeing, both

mental and physical, and life opportunities like education and careers. According to the Sycamore Institute, in 2017, ACEs among Tennessee adults led to an estimated $5.2 billion in direct medical costs and lost productivity from employees missing work.

Preventing the effects of ACEs would significantly improve the lives of millions of Americans. One estimate from the CDC shows that preventing ACEs could keep up to 1.9 million cases of heart disease and 21 million cases of depression from occurring.

On the other hand, positive childhood experiences are instances of feeling genuinely loved, supported, and connected to one’s family and community. These experiences of belonging to a larger, supportive group and having trusting relationships build resilience for dealing with difficult circumstances. While the health effects of positive childhood experiences are lesser known, researchers have found that the individuals who reported the greatest number of PCEs also reported the lowest rates of mental illness. This association even applied to individuals who experienced one or more ACEs –– the more PCEs they had experienced, the better their mental health was, compared to their peers. Good mental and social health are both markers for good physical health, emphasizing the importance of a public health strategy that aims to prevent ACEs and support PCEs.

For the United States to lift families out of poverty, lawmakers should implement several policies, including expansion of healthcare coverage. Experts agree on the following policies:

· Increase the minimum wage from $7.25 to $15.00 by 2024.

· Increase the Earned Income Tax Credit (EITC) for lower-income families with children.

· Make the Child Tax Credit (CTC) fully refundable with additional benefits for families with young children.

· Increase Supplemental Nutrition Assistance Program (SNAP) benefits.

· Make housing vouchers available to all households with children below 150 percent of poverty for whom fair market rent exceeds 50 percent of their income.

To learn more about how to support families and to contribute to our advocacy efforts, please consider using this action tool to contact your Congress person.




We have lots of opportunities to get involved here at TJC! Learn more about Health Equity in Tennessee and around the nation. Visit our Action Center to see what you can do to encourage our state to solve our health needs and improve our safety net. Looking for other ways to contribute to our mission? You can also donate to TJC so that we can continue to do this work to improve our community for each and every person who’s a part of it.

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