Child care plays a critical role during the formative years and is key to familial stability. A new poll illustrates the challenges that parents face in accessing quality, affordable child care, and the opportunities for improvement.
I remember how it felt when I returned to work after the birth of my first son. Trying to figure out child care was confusing, overwhelming, and downright stressful. Of course I wanted the very best care for my baby, but I didn’t know what “high quality” really looked like. Our first arrangement was with a nearby woman who cared for a few other children in her home. Pretty quickly, I decided it wasn’t the right fit. I cobbled together a mix of family and part-time care while searching for a new solution. I am so grateful I had friends, family, and a supportive work environment to pull this off. I then tried in-home care, hiring a string of visiting nannies, none of which worked out. One of them quit with no notice, leaving me in a very difficult position at work.
Then I found what seemed like a great center-based program, and was prepared to sign up. But as I left the building after my initial visit, I bumped into a friend who had a bad experience there and advised looking elsewhere. What if she was right? I couldn’t take the chance, so I kept searching, relying on the generosity of family in the meantime.
Eventually I found a center that worked out. I felt my baby was nurtured and well-cared for, but the costs were enormous, and frankly, to this day I am still not sure if it was truly “high quality.”
A poll released by NPR, The Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health finds that parents and caregivers, like me, recognize the value of high quality child care and early education experiences.
Strong majorities say child care positively affects their children’s overall well-being, social development, and physical health. The benefits extend to parents and caregivers, too. They report better job prospects and improved relationships with spouses and partners as a result of child care. Perhaps most important, more than three-quarters of respondents say child care strengthens the relationship between parents and children.
Academic research agrees. Study after study has found that quality child care and early education increases academic achievement and graduation rates, reduces achievement gaps, and decreases risk for unemployment, drug use, and incarceration. Benefits extend throughout the community, with stronger families, improved economic development and more livable neighborhoods.
Of course, the news isn’t all good.
Parents and caregivers say they frequently have trouble finding child care—and cost is the biggest challenge. More than two-thirds say they have “just a few” or “only one” realistic care option, and three-quarters say the expense of care causes financial problems in their households. Low-income families and families of color are especially likely to report difficulty finding care. To successfully build a Culture of Health, we cannot exclude anyone. If families of color cannot access the many positive benefits of quality child care, it only reinforces existing health disparities and inequities.
Finding back-up care is also a major challenge for parents. When a child gets sick, parents worry about missing work or getting in trouble with their supervisor. Mothers are especially concerned that taking unplanned days off may limit long-term career prospects.
The survey also reveals that parents frequently overestimate the quality of care they receive. Studies from the National Institutes of Health rate most child care in the United States as “fair,” with only 10% ranking “excellent.” Parents surveyed perceive the exact opposite. They rate most care as excellent, with only 12% reporting “fair” or “poor” quality. Parents may need more information to better evaluate quality and make the best choice for their children. No one should settle for substandard care.
The results from this poll resonate deeply with me. Searching for affordable, quality child care was incredibly stressful for me, my husband, my extended family, and probably for my baby. And I’m one of the lucky ones! Even in the most difficult moments, I knew I wouldn't lose my job or have trouble putting dinner on the table because of child care problems. But as this new poll demonstrates, many thousands of parents face those risks every day. I can only imagine how wrenching it must feel for those families, and the terrible choices it forces them to make.
Science tells us that a strong early start is essential to the healthy development of children. Research shows time and again that the kind of care a young child receives affects their entire life. Based on the findings of the NPR/RWJF/Harvard poll, parents and caregivers understand this. They want to ensure the best for their children, but it is also clear that they face real obstacles to obtaining reliable, affordable, high-quality care.
At RWJF, our vision for a Culture of Health entails providing all children with the tools to enable a healthy start in life. That’s why we’re working to promote access to high quality child care for all families, no matter where they live or how much money they earn. The long-term health and well-being of our nation depends on it.
Kristin Schubert, MPH, is a director at the Robert Wood Johnson Foundation. Her role at the Foundation has focused on applying a public health perspective to the health issues faced by vulnerable populations, particularly vulnerable adolescents.