On October 11, 2021, I will take part in the 125th Boston Marathon alongside 20,000 fellow runners. Why am I doing this? The reasons are many, but the one that matters most to me is being able to raise money for the amazing organization I work for, Children’s HealthWatch at Boston Medical Center.

I’ve been part of Children’s HealthWatch for the past 8 years, only a fraction of the 23 years its Principal Investigators, leadership, staff, and volunteers have been working toward one singular goal – to improve the health of young children and their families by informing equitable policies that address and alleviate economic hardships. Since 1998, we’ve interviewed over 75,000 families with infants and toddlers across 5 hospitals and clinics in US cities. Through all of this data collection, we are able to better understand how hardships like food insecurity and housing instability, as well as policies that make up our social safety net like the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and housing subsidies interact with one another and ultimately impact the health and development of young children during the first three years of life. The more I think about Children’s HealthWatch and the work we do, the more I realize how much it shares in common with the marathon.

The marathon is an event that requires no small amount of planning, preparation, and skill. Training for what will be my third marathon, I still feel like there is so much to learn and so many variables to consider, that I find myself wondering whether my goals will match reality come October. Will 12 weeks of preparation and training runs amount to the race day I hope for? As Peter Bromka has said, “the marathon doesn’t owe you anything,” and deep down I know that pouring everything into something that doesn’t owe you anything can maybe one day result in something beautiful – bigger than what you thought was possible. So, what does any of this have to do with Children’s HealthWatch and the research, analysis, and policy outreach we do? Simultaneously everything and nothing.

For many, there is a science behind running. Similarly, at Children’s HealthWatch we seek to test our hypotheses by collecting data, conducting a series of analyses, interpreting and discussing the findings, and reporting our results in the peer-reviewed literature and in policy-oriented publications. For all the similarities between marathon training and the work of Children’s HealthWatch, there is one major difference – Children’s HealthWatch research informs decisions and public policies that impact the lives of millions of children and their families, whereas running is an individual pursuit with little consequence at the end of the day. This fall, my finish line will be on Boylston Street overlooking Copley Square, but the finish line of Children’s HealthWatch is more aspirational. We will continue running this marathon until every family has the resources they need to ensure children are healthy and capable of reaching their highest potential. That’s why I’m proud to say that over the course of 23 years my colleagues have demonstrated the vision, passion, dedication, professionalism, and rigor that any elite marathoner would envy.

Children’s HealthWatch was formed in 1998 as a response to welfare reform and the end of guaranteed cash assistance for families. When this group of pediatricians and researchers saw that infants and toddlers stopped growing after their parents were cut off of “welfare as we know it,” they did what they were trained to do. They laced up their shoes, founded Children’s HealthWatch, and started the marathon of documenting the impact of public policies on the health and well-being of children in order to ensure that no child is forgotten by our nation’s policy makers. Over the years, our research has consistently demonstrated that hardships harm child and maternal health, and programs and policies like the federal nutrition programs, stable housing, affordable health care, and quality child care can ameliorate these hardships and buffer children’s health.

Now decades after welfare reform took place – nearly a marathon’s distance in years! – my colleagues and I were over the moon to see the passage of the American Rescue Plan in 2021, which included a major expansion to the Child Tax Credit (CTC). The CTC now provides monthly checks to millions of American families in “the biggest anti-poverty program undertaken by the federal government in more than half a century.” The monthly CTC payments, which started in July, will help families make ends meet in so many ways. We hear from families every day that they will use this money to put healthy food on the table, buy diapers and clothes that fit, and afford child care so they can continue to work. After years of Children’s HealthWatch research, publications, testimonies, presentations to policymakers, and collaboration with other researchers, policy experts, and advocates, this transformational shift in social policy feels a little bit like crossing the finish line of a marathon.

But just like the marathon – it’s not really about the finish. The work inevitably continues. In the case of runners, it’s the deeply-ingrained drive to push your limits again and again. In the case of Children’s HealthWatch, it’s knowing that (for now) the CTC expansion is temporary, and research and analysis are still needed to make changes that will one day improve children’s health. So, we keep going and we keep showing up. We know we cannot run this race alone. We need your support to climb Heartbreak Hill, to press on when fatigue sets in, and to finish this race and transform our country into one where all children can succeed.

By Richard Sheward, Director of Innovative Partnerships at Children’s HealthWatch

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