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This systematic review examines how childcare deserts, areas with insufficient licensed child care, reflect and reproduce racial, geographic, and economic inequities. Guided by Critical Policy Analysis, this review interrogates how disjointed funding, workforce instability, and policy design limit access to childcare for Black, Latinx, and low-income families. Using systematic review methodology, studies were synthesized to identify structural patterns in child care access. Preliminary findings reveal that high costs, staffing shortages, and disjointed policies disproportionately impact infants, toddlers, and children with disabilities. This review challenges calls for equity-driven reforms that reimagine early childhood education and care.