Association Between Material Hardship in Families With Young Children and Federal Relief Program Participation by Race and Ethnicity and Maternal Nativity

CONCLUSIONS AND RELEVANCE The results of this cohort study suggest that the COVID-19 crisis exacerbated preexisting inequities in food insecurity and difficulty paying rent according to race and ethnicity and maternal nativity and that equity-focused policy changes are needed to ensure that all children and their families in the US can afford basic needs for optimal health. [...] These inequities reflect persistent structural racism and xenophobia.14,15 To mitigate the effects of the COVID-19 crisis, the US Congress passed a series of relief packages between March 11, 2020, and March 25, 2021, allocating trillions of dollars in aid to bolster the US economy and alleviate economic hardships for families and individuals. [...] The sample is similar in family demographic characteristics and child health outcomes to low-income families in the National Survey of Children’s Health.50 All hardships, program participation, and other data were self-reported and thus subject to recall bias, although the food security measure is validated30 and the measure of being behind on rent has strong criterion validity and has been used i. [...] Author Contributions: Dr Lê-Scherban and Ms Coleman had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. [...] Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.