- Author: Brianna Aguayo Villalon
- Editor: Marisa M Tsai
- Editor: Wendi Gosliner
US safety net programs provide aid to low-income households through cash and in-kind assistance, such as food and healthcare benefits. Using data from the Assessing California Communities' Experiences with Safety Net Supports ACCESS,study researchers examined patterns of multi-program take-up, that is participation conditioned on eligibility in California. Sociodemographic factors associated with multi-program take-up were also identified. Among the four safety net programs examined (i.e., Earned Income Tax Credit or EITC, the Supplemental Nutrition Assistance Program or SNAP, the Special Supplemental Nutrition Program for Women, Infants, and Children or WIC, and Medicaid), NPI researchers found relatively low multi-program take-up of SNAP and WIC. Meanwhile, the take-up of Medicaid was high, both as an individual program and among those participating in other programs. Sociodemographic factors, including Income, age, and primary language spoken were associated with multi-program take-up. To improve multi-program participation, study researchers recommend streamlining application processes to reduce administrative burden, data sharing among safety-net programs, and targeted recruitment of under-enrolled subgroups. Increasing multi-program take-up of safety net programs among California families can contribute to improved health equity and address key social determinants of health. This study was conducted by NPI researchers Marisa Tsai and Wendi Gosliner, Joseph Yeb with Tufts University School of Medicine, Kaitlyn Jackson and Rita Hamad with Harvard School of Public Health, and Lia Fernald with the University of California Berkeley, School of Public Health.
Wendi Gosliner from the Nutrition Policy Institute discussed efforts to enhance population health and nutrition, focusing on eliminating disparities and improving federal food programs in a recent If I Could Change One Thing health policy podcast episode. Highlighting policy amendments during the COVID-19 pandemic, Gosliner emphasized the impact on food access, particularly for SNAP, WIC, school meal programs, and expansion of the Child Tax Credit. Stressing the importance of tackling food insecurity and reducing waste, she called for comprehensive interventions in federal nutrition programs. “When we think about growing food, and all of the inputs that are needed to grow food—the energy, the water, the soil, the human labor, the money to harvest it and transport it— then it gets to us, we buy it, we store it, and then we often throw it away," said Gosliner. "The amount of resources that's wasted with each food item that is thrown away is immense. And then not only that, but food, when it's decomposing in landfills, creates methane, which is a greenhouse gas contributor all on its own. So, for so many reasons, having us throwing away a lot of food is incredibly costly.” Gosliner, NPI's director of food policy research and translation, shared insights with co-hosts James Romine and Rocio Flores in season eight, episode one of the podcast. The podcast is produced by the San Diego State University, School of Public Health. Listen online.
Eligible working families with low income that have children can receive the earned income tax credit, commonly known as the EITC, annually in the form of a lump-sum federal tax refund averaging about $2,500. Little was known about how families spend their EITC funds and the mechanisms for how this credit supports improved health outcomes. University of California researchers conducted a large survey of nearly 250 California families that received the EITC in 2020-2021. Families spent their refunds on basic needs. Half of the families surveyed reported spending their EITC refund on bills, debt or housing, over a third reported spending it on transportation and only 3% reported spending it on healthcare costs. Family recipients that were thirty years old and older were more likely to spend their EITC refund on bills and paying down debt than younger households. Researchers suggested the EITC may support improved healthy by providing families with more money to spend on nutrition and healthcare and may lower family stress by generally increasing household resources. Findings were published in the journal BMC Public Health by Rita Hamad and Kaitlyn Jackson from the University of California, San Francisco, Joseph Yeb from Tufts University, Wendi Gosliner from the Nutrition Policy Institute at the UC Agriculture and Natural Resources, and Lia Fernald from UC Berkeley. This project is part of the Assessing California Communities' Experiences with Safety Net Supports (ACCESS) study which was funded by the Robert Wood Johnson Foundation, Tipping Point Foundation, the UC Office of the President, and the Berkeley Population Center at UC Berkeley.
- Author: Mike Hsu
UC researchers identify barriers to Earned Income Tax Credit, which provides up to $7K each year per family
About 1 out of 4 Californians who are eligible for the Earned Income Tax Credit do not actually receive it – and University of California researchers are digging deeper to learn why they are not taking up this crucial benefit, which can provide nearly $7,000 annually for each family.
“The EITC is the largest poverty alleviation program in the country for families with kids, lifting millions of people out of poverty every year,” said Rita Hamad, associate professor at the University of California, San Francisco in the Institute for Health Policy Studies. “We know from previous work – including our own studies – that the EITC is effective at improving health, including birth weight, child development, household food security, and parents' mental health.”
Hamad is the co-lead author of an article on EITC take-up, recently published in Health Affairs, which begins to answer why only 74% of Californians receive the EITC benefit for which they are eligible.
“Billions of dollars are going unclaimed by families who could really use the money to improve their families' health and well-being,” said Hamad, who is also director of UCSF's Social Policies for Health Equity Research Program.
More broadly, about 80% of eligible families across the country take advantage of the EITC, according to previous research. But those studies only looked at tax records, and do not shed light on the specific circumstances of households that missed the credit.
“What our study did was reach out to those families and start to collect some richer information on what's happening – why aren't people getting the benefit, and what can we learn to help more people get something that can make a big difference for families,” said co-lead author Wendi Gosliner, project scientist at the Nutrition Policy Institute, a program of UC Agriculture and Natural Resources.
On EITC, ‘the more we know, the better'
Surveying 411 EITC-eligible Californians with children, researchers found that roughly 25% of respondents did not receive the benefit (including the 9% that did not file taxes). And although the sample is non-representative, the study did produce some significant findings.
For example, take-up of the EITC and CalEITC (its California state counterpart) was less likely among eligible individuals who do not speak English, had no prior knowledge of the programs, and are younger.
The age factor – correlated with inexperience in tax filing – underscores the need to clarify eligibility verbiage and materials. Gosliner noted that several respondents thought all people under the age of 25 were ineligible, when in fact those under 25 who have dependents would qualify for the federal credit (for the CalEITC, all individuals over 18 are eligible).
Such findings help fine-tune the education and outreach activities of advocacy groups such as Golden State Opportunity, a nonprofit that works to create financial stability for low-income workers across California.
“Knowing that a barrier for younger people is lack of knowledge, we can increase our outreach to community colleges and other youth-serving organizations with messaging that reaches them where they are,” said Amy Everitt, president of Golden State Opportunity. “Thanks to this research we can better understand the diverse audiences we need to reach – when it comes to the EITC, the more we know, the better.”
Need for clearer tax information, better processes
The researchers are currently analyzing the qualitative data they gathered from the interviews to produce a follow-up paper. But Gosliner shared that some of the respondents' concerns were worries about owing the government, the belief that filers must pay back the EITC money, and lack of understanding about the tax system in general and the EITC specifically.
“It's very user-unfriendly,” Gosliner said. “Even the name of the program doesn't make sense to people – they don't understand it, they don't know what it means...it's like we intentionally create these hurdles to receive the benefit.”
Both Gosliner and Hamad recommended that the government simplify the tax process, while providing free, high-quality filing services in multiple languages to ensure families are receiving the benefits that can help reduce health inequities.
“Our study speaks to the fragmentation of the social safety net, with families needing to fill out multiple redundant applications to participate in each different program,” Hamad said. “A better solution would be to have government agencies coordinate with one another, so that families who are cash-strapped with limited time can fill out just one streamlined application.”
Information on federal EITC: https://www.irs.gov/credits-deductions/individuals/earned-income-tax-credit-eitc
Information on CalEITC: https://www.caleitc4me.org/
The full article can be found at: https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.00713
The other authors of the study are: Erika M. Brown, UCSF; Mekhala Hoskote, UC Berkeley and UCSF; Kaitlyn Jackson, UCSF; Elsa M. Esparza, UC Berkeley; and Lia C. H. Fernald, UC Berkeley.
/h3>/h3>/h3>Working families with low- to moderate-income can receive up to $6,000 in Federal benefits and an additional $3,000 in California state benefits through the Earned Income Tax Credit, one of the largest poverty alleviation programs in the nation. The Centers for Disease Control and Prevention considers EITC a critical evidence-based cost-effective intervention to improve health within five years, however only 53-80% of eligible families received these benefits in 2017 and 2018. Nutrition Policy Institute's Wendi Gosliner will collaborate with Rita Hamad from the University of California, San Francisco and Lia Fernald from UC Berkeley on a project to test an outreach program designed to improve take-up of the Federal and state Earned Income Tax Credits among participants in the Special Supplemental Food Program for Women, Infants and Children (WIC). The two-year project, “Advancing health equity by alleviating poverty: A multi-level, evidence-based pilot trial to increase take-up of the Earned Income Tax Credit,” started October 1, 2022, and was made possible with funding from the Blue Shield of California Foundation. This project builds on previous work by Gosliner, Hamad, and Fernald as part of their Assessing California Communities' Experiences with Safety Net Supports study, which showed barriers to Federal and state EITC uptake.