Social
The 2021 Child Tax Credit expansion and perinatal health: a quasi-experimental study Rita Hamad* Rita Hamad Deborah Karasek Daniel F. Collin Justin S. White Guangyi Wang
Objective: Poverty alleviation policies play an important role in mitigating socioeconomic and racial/ethnic disparities in perinatal health. The 2021 temporary expansion of the Child Tax Credit (CTC) provided monthly payments of up to $300 per child during July-December 2021 and allowed the most economically disadvantaged families to qualify. It has been linked to decreased material hardship and food insecurity, but few studies have examined effects on perinatal health. The goal of this study was to estimate impacts of the 2021 CTC expansion on perinatal health, including differences among minoritized populations.
Methods: Data were drawn from national birth certificate files (January 2021-February 2022; N=3,487,943) and the Pregnancy Risk Assessment Monitoring System (PRAMS; January-December 2021; N=28,874). Using quasi-experimental difference-in-differences analyses in each data set, we compared changes in perinatal outcomes before versus after the 2021 CTC expansion for CTC-eligible versus ineligible individuals. Outcomes included gestational hypertension, gestational diabetes, birthweight, preterm birth (<37 weeks’ gestation), low birthweight (<2,500 grams), small-for-gestational-age (SGA), and large-for-gestational-age (LGA).
Results: In birth certificates, the CTC expansion was associated with reduced birthweight (-5.54 grams, 95%CI: -7.83, -3.25) and reduced LGA births (-0.26 percentage points, 95%CI: -0.38, -0.14). In PRAMS, the CTC expansion was associated with reduced SGA (-2.77 percentage points, 95%CI: -4.99, -0.55). There was no association for other outcomes. Among subgroups, individuals without Medicaid had decreased birthweight; individuals with lower education, Medicaid, and those who were unmarried had reduced SGA births.
Conclusions: The 2021 CTC expansion was associated with improvements in birthweight distribution, perhaps due to decreased financial insecurity, with more positive impacts on SGA among those of lower socioeconomic status.