Originally published on FRAC’s ResearchWire newsletter.

After the holidays, people tend to do two things: make New Year’s resolutions and schedule an appointment for their annual checkup. Checkup appointments not only look at the current status of a patient’s health, but also provide an opportunity for clinicians to advise a patient on how to maintain or improve his or her health.

The city of Baltimore, like other cities, needs to seize this opportunity. Children’s HealthWatch recently did a “checkup” of Baltimore families with young children (0 to 4 years of age) and offered policy and practice prescriptions for improving the health and well-being of these families.

Based on interview data collected during a child’s primary care appointment between January 2012 and January 2017 at the University of Maryland Medical Center, 45 percent of families were hardship-free. Hardship-free means that families were food secure, stably housed, had adequate energy resources to heat or cool their homes, did not forgo seeking medical care or filling prescriptions due to cost, and did not have to choose between paying for health care costs or other basic needs.

The Children’s HealthWatch data also found that when caregivers were in hardship-free families, they were 175 percent more likely to be in good or excellent health, and 82 percent less likely to report depressive symptoms (among female caregivers) when compared to caregivers with one hardship. Young children in hardship-free families were 93 percent more likely to be in good or excellent health, 25 percent less likely to have been hospitalized since birth, and 38 percent more likely to meet developmental milestones when compared to families with two hardships. In short, children and caregivers in hardship-free families had better health.

How do we increase the number of hardship-free children and families in Baltimore and other communities? By advancing the following policies and strategies that provide opportunities for all families with children to become hardship-free and for entire communities to be healthy.

• Screening for economic hardships in clinical settings using validated screening tools. Clinicians then can use the screening results to connect at-risk families to community-based resources.
• Increasing the number of eligible people enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This would enable thousands of eligible women and children to receive the nutrition they need for healthy growth and development.
• Increasing the number of “hunger-free schools.” Currently, 242 of Maryland’s high-needs schools have opted to use the federally funded Community Eligibility Provision (CEP) to provide free breakfast and lunch to all their students. Increasing school participation in CEP would ensure that more students receive the nutrition they need to learn and more families have the resources they need to afford food at home.
• Increasing investments in affordable housing. Nearly three-quarters of renters in Maryland with extremely low incomes, i.e., households with incomes less than