Poster #26 - Developing a Child and Health Care-Inclusive Poverty Measure

• In Event: Friday Poster Reception

Abstract

In 2023 the National Academy of Sciences (NAS) released a report commissioned by the Census Bureau recommending improvements to the measurement of poverty under the Supplemental Poverty Measure (SPM) framework. Among other changes, ultimately leading to the creation of a future Principal Poverty Measure (PPM), the NAS consensus panel suggested the Census Bureau explore the treatment of health care and child care in the context of a budget-based poverty measure. Health care can be a significant household expense and garners substantial public investment via Medicare and Medicaid; thus, the panel recommended that Census adapt SPM methodology to incorporate the value of health insurance into both the measure’s threshold and resources (NAS, 2023, pg. SUM-5-7). Given that child care is one of the largest household expenditures for families with young children (Herbst, 2023), the panel recommended that a future PPM incorporate child care as a basic need for households with children and that the measure’s resources account for public investment in child care (NAS, 2023, pg. SUM-9).

This paper aims to produce estimates of a demonstration measure based on the recommendations outlined in the 2023 NAS report and the methodologies previously developed and published in Census Bureau working papers on health and child care in poverty measurement (Creamer, 2024 and DiTommaso, Landivar, and Silwal, 2025, respectively). The health inclusive poverty measure (HIPM) (Korenman and Remler, 2016) adapts current SPM methodology to incorporate a value of health insurance in poverty thresholds (based on benchmarks in the Affordable Care Act) and government support in resources. The child care inclusive poverty measure (CCIPM) methodology creates a child care basic need using county-level price data from the National Database of Childcare Prices (Women’s Bureau, 2022); need is adjusted by geography and number and age of children (under 13) in the resource unit.

This paper will first provide individual estimates of a HIPM and CCIPM using data from the 2025 Current Population Survey Annual Social and Economic Supplement. Then, the methodologies will be combined to create a child and healthcare inclusive poverty measure (CHIPM) framework, with estimates being provided for the overall population and a range of demographic groups.

Both Creamer (2024) and DiTommaso, Landivar, and Silwal (2025) show small magnitude change to the national poverty rate under HIPM and CCIPM methodologies with larger change for sub-groups more likely to be affected by medical expenses (under HIPM) and for those with children (under CCIPM). Thus, we expect similarly small increases in national poverty rates and larger increases for affected sub-groups when a CHIPM methodology is implemented. In addition to highlighting novel methodologies that estimate basic need and resource contributions, CHIPM poverty estimates move closer to achieving a budget-based poverty measure that incorporates an updated suite of basic household needs and that accounts for critical anti-poverty investment.

Author

• Adrienne DiTommaso, U.S. Census Bureau
  Presenting Author