Poster #119 - Trends, Transitions, and Socioeconomic Disparities in Child Wellbeing, 2016–2024

• In Event: Friday Poster Reception

Abstract

This study examines trends and transitions in child wellbeing including food insufficiency, health insurance coverage, and language disorders from 2016 through 2024 for children aged 0 to 17, with attention to disparities by income and race try to answer a question: did children end up better or worse off, and did the answer depend on who they were?We address this question in two steps.

First, we draw on the National Survey of Children's Health (NSCH) to map state-level net changes between 2016 and 2024, revealing that national trends mask profound geographic inequality. Uninsured rates worsened most severely in Indiana and across much of the South and Mountain West; language disorder rates rose sharply in Texas and Washington; food insufficiency worsened in Mississippi and parts of the Northeast while improving in several Western states.This variation is not random, actually, it maps onto differences in states' Medicaid policies, early intervention funding, and nutrition program implementation.States that invested in their social safety nets fared better; those that did not left their most vulnerable children behind.

Second, to capture who is getting better and who is getting worse, we exploit nine waves of NSCH data using synthetic panel methods following Deaton (1985) and Dang and Lanjouw (2023) to recover household-level transition probabilities between adjacent survey years. We construct cohorts based on child birth year and estimate pair-specific serial correlation parameters (ρ) for each adjacent year-pair from 2016–17 through 2023–24, then apply a bivariate normal framework to recover four joint transition probabilities including exit from hardship (p₁₀), entry into hardship (p₀₁). All estimates use NSCH complex survey weights.

For food insufficiency, entry rates were elevated across all groups in the pre-pandemic period near 20% for low-income children, declined sharply through 2021–22 reflecting pandemic-era support expansions, then rose again toward 10% by 2023–24 as those supports were withdrawn. Critically, exit rates trended downward throughout the entire period across all groups, which fell from around 17% in 2016–17 to single digits by 2022–23. For health insurance, loss of coverage among low-income white children peaked at 9.3% in 2021–22 consistent with Medicaid unwinding, while enrollment surged for low-income BIPOC children to 10.8% in 2023–24, pointing to delayed re-enrollment following coverage disruptions that policy could have prevented. Language disorder onset spiked to 6.1% among low-income BIPOC children in 2020–21 (triple the rate of higher-income white children) , likely capturing pandemic-related disruptions to early screening and intervention services whose effects may prove lasting without targeted remediation.

These patterns point to an urgent policy implication. The asymmetry between rising hardship entry rates and falling exit rates signals a hardening of disadvantage that market forces and state governments alone cannot reverse. Federal action is warranted: strengthening Medicaid continuity requirements, expanding nutrition assistance, and investing in early childhood developmental services  with particular attention to states where low-income and BIPOC children face the most severe conditions, would directly address the mechanisms this study identifies as driving growing inequality in child wellbeing.

Author

• Tiantian Vicky Tang, University of Minnesota
  Presenting Author