The Relationship between Childcare and Material Hardship: An Exploratory Study

Background: Childcare hardship (CH) occurs when parents cannot procure the childcare services needed to maintain normal household functioning, often due to cost and availability. CH may result in frequently changing childcare arrangements or piecing together multiple arrangements, which increase parenting stress and have negative associations with child development. Parental job disruptions associated with CH in-turn impact the acquisition of basic goods and services. Like CH, material hardship (MH) occurs when a household’s consumption of goods and services (e.g., food, housing, healthcare) falls below an acceptable standard. Society increasingly recognizes that CH and MH are related, evidenced by the Biden Administration’s American Families Plan, which is expected to include $225 billion to offset childcare costs, $200 billion towards health insurance premiums, and $45 billion towards food assistance for low-income families. However, there remains little empirical evidence about the association between CH and MH. The purpose of this study was to examine the relationship between CH and four forms of MH: bill-pay, food, healthcare, and housing.

Method: In this exploratory study, we examined associations between CH and MH using data from a statewide evaluation of healthcare innovations in Iowa, the State Innovation Model (SIM) Statewide Consumer Survey (SCS). Our weighted sample (N= 804,213) included Iowans who participated in a telephone survey in early 2018 and indicated having children in the home.

We hypothesized that households with MH would have increased odds for CH and that respondents who identified as female, Black, Indigenous, or People of Color (BIPOC), and single parents would be more likely to experience CH. Using binary logistic regression, we investigated odds of cost, availability, and any CH by MH and several relevant demographic covariates.

Results: Both CH and MH were common in our sample as 21% reported CH in the previous year and 39% reported MH including bill-pay (16%), food (26%), healthcare access (12%) and housing (10%). As hypothesized, respondents with healthcare access hardship were twice as likely to report any CH and nearly twice as likely to report availability hardship. Those with food hardship were nearly three times more likely to report availability hardship, and those with housing hardship were twice as likely to report cost hardship.

Also as hypothesized, CH was more likely for single parents and women. CH also had a strong positive association with income. Those earning between $100k-150k were over five times more likely to report CH compared to those earning over $150k. Contrary to our hypothesis, respondents who identified as BIPOC had lower odds of CH, which may be related to higher poverty rates and lower median income among BIPOC households in the state (e.g., those households would qualify for childcare assistance through the Child Care and Development Block Grant).

Conclusion: Results suggest that CH is not an issue isolated to those in vulnerable groups. One-fifth of our sample experienced CH, including families of all demographic groups. The strong associations between CH and MH suggest that the procurement of childcare services is essential for families to meet their basic needs and avoid hardship.