The White House and Congress are set to make a once-in-a-generation investment in our nation’s infrastructure. While improvements to roads, bridges and broadband are crucial and necessary, we also urgently need to make bold investments in the “1,000-day infrastructure” for the health and well-being of American families.
The 1,000 days between a woman’s pregnancy and a child’s second birthday is a time of tremendous potential and enormous vulnerability — and that vulnerability is even more apparent in the throes of the COVID-19 pandemic.
To thrive mothers and children need, in the first 1,000 days, food and good nutrition, access to quality health care, paid family and medical leave, child care and the tax credits that allow families to keep extra cash to pay for household necessities.
Today, mothers and children are on the front lines of the worst hunger crisis in modern American history. For those who depend on the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the monthly benefits do not always meet their monthly needs and they must reapply for coverage throughout the first 1,000 days, adding a bureaucratic burden to new mothers. Congress must bolster these two vital federal nutrition programs or risk setting far too many children on a path to a life of poor health.
Access to high quality health care — another pillar of the 1,000-day infrastructure — leads to better maternal and infant outcomes. Many will be surprised to learn that U.S. mortality rates for both mothers and their babies are higher than those of any other high-income country. Maternal mortality rates for Black and Indigenous women are two to three times higher than those for white women. We must do more to address racial and ethnic disparities in maternal and infant health care.
All states are required to provide Medicaid coverage to income-eligible pregnant women and for 60 days after a child is born, but too many families lose access following that 60-day period. In order to ensure that all moms and babies can have a healthy first 1,000 days, Medicaid coverage should be extended for the entirety of this period. In addition, Children's Health Insurance Program (CHIP) coverage should be guaranteed to all low-income children.
The United States is the only high-income country that does not guarantee workers paid leave to welcome a new child, care for an ill loved one, or attend to a serious health issue. Some employers voluntarily offer paid leave, but the recipients tend to be higher-income, not families receiving WIC or Medicaid. The recently introduced Building an Economy for Families Act secures the third pillar of the 1,000-day infrastructure by providing families comprehensive and equitable paid family and medical leave.
Investment in child care for infants and young children is also badly needed to adequately support families in the first 1,000 days. The Child Care for Working Families Act establishes a ceiling that no family pays more than seven percent of their income for high-quality child care, and low-income families would not pay anything at all.
Last, the American Rescue Plan included a one-year expansion of the Child Tax Credit (CTC), making the credit available to all low-income and middle-class families with children. CTC expansion is expected to cut child poverty nearly in half and 70 percent of those lifted out of poverty would be Black or Latino children. Because poverty occurs at higher rates in families with younger children, a permanent CTC expansion could be a monumental improvement to the 1,000-day infrastructure.
Bread for the World and 1,000 Days, an initiative of FHI Solutions, have advocated for greater investments in the nutrition and well-being of mothers, infants and toddlers around the world. With the largest U.S. infrastructure package in more than 50 years, let’s make these same investments here at home. We will see the return for generations to come.
Blythe Thomas is the director of 1,000 Days, an initiative of FHI Solutions. Rev. Eugene Cho is president and CEO of Bread for the World.