The Little Rock data collection site for Children’s HealthWatch, in the Emergency Department of Arkansas Children’s Hospital, sees hundreds of young children whose health is negatively affected by economic hardship.

CHW, a nonpartisan organization of pediatricians, public health researchers and policy experts, facilitates scientific research and advocates for advancements in public policy to achieve health equity for young children in the United States and promote the health and economic well-being of children and their families. 

The comprehensive findings from CHW research help legislators and the public better understand the social determinants of health that impact child well-being across the country, thus enabling well-informed policy decisions. 

Social determinants of health are economic and social conditions like food insecurity, unstable housing, energy insecurity, etc. that greatly impact an individual’s health. 

These socioeconomic factors have a larger impact on child health than long-lasting, protective interventions, clinical interventions, or information and support, according to CHW. 

CHW Founder Deborah Frank highlighted in a 2023 CHW podcast that public policies in the U.S. are ultimately “written on the bodies of babies,” emphasizing that CHW’s data reflects the conditions of real children in America and the policies that directly affect their health. 

CHW currently has active research sites at hospitals in Boston, Massachusetts, Minneapolis, Minnesota, Philadelphia, Pennsylvania and Little Rock, Arkansas. Little Rock is one of the original CHW research sites and has played a particularly important role in CHW’s research throughout the organization’s history due to its unique position for data collection.

Arkansas is one of the lowest-ranking states in the U.S. in terms of child well-being, according to the 2022 Kids Count Data Profile by the Annie E. Casey Foundation, and Arkansas ranks 49th in food security, making it one of the most food-insecure states in the country, second only to Mississippi, according to 2021 data from the U.S. Department of Agriculture. 

“CHW collects data that links these conditions to health care outcomes and to availability of public support to mitigate these conditions and protect the health of the youngest children in the most sensitive developmental period,” Frank said.

Frank said the Little Rock data collection site is vital to CHW’s work because “Arkansas Children’s Hospital covers a whole state, has representation from rural and suburban families, and has a greater representation of children with special health care needs, and of children who are non-Hispanic white.” 

Richard Sheward, Director of System Implementation Strategies at CHW, said the organization strives to present a “nationally representative data set and findings.”

The Little Rock research site contributes to that goal by providing a distinct data set. 

Patrick Casey, the founder of CHW’s Little Rock research site, said Little Rock has been the organization’s only data collection site in the southern U.S. throughout its 25 years of research. 

“We are in a region that is very different from Boston and Minnesota and Philadelphia,” Casey said. “Our data is different.” 

Sheward said, “Understanding how hardships and policies affect infants and toddlers in very different states makes our work valuable and unique to national decision-makers and policymakers.”

Besides providing distinctive opportunities for data collection, Sheward said one of the unique features of the Little Rock research site is its policy context. 

“Arkansas is a politically conservative state, which offers a contrast to the policy dynamics found in states like Massachusetts and Minnesota,” Sheward said. 

Collecting data from both politically liberal and politically conservative states better enables CHW to identify connections and trends between policy dynamics and child health outcomes. 

“One area where Arkansas has challenges that children in other states experience to a lesser degree is the strength of its social safety net and infrastructure,” Sheward said. “Arkansas imposes stricter provisions on many of its assistance programs like SNAP, and in other cases, lacks safety net programs altogether, such as a state-level Earned-Income Tax Credit.”

EITC “helps low- to moderate-income workers and families get a tax break,” according to the IRS.

Sheward said CHW’s research and that of others has “shown the importance of EITC in promoting positive health outcomes and reducing poverty among households with children.” 

“In 2019, we published a Health Impact Assessment to estimate the public health impacts if Arkansas were to create a state-level EITC and found that it would likely reduce child poverty and improve child health outcomes,” Sheward said. 

CHW has had success in advocating to expand state-level EITC in Massachusetts, but has found it difficult to advance EITC policy in Arkansas, according to Sheward. 

Casey said CHW has been unsuccessful in advocating for state-level EITC in Arkansas because of the state’s conservative approach to policy. 

“It would be nice if the state could be more attentive to the needs of children, especially poor children, and be willing to look at information and act on it to make things better,” Casey said.

Frank said state legislative measures to protect poor families in Arkansas are much weaker than in other states, but “many of these issues are remediable given political will and public investment.” 

CHW has seen many legislative wins in the past 25 years at both the state and national level. 

“Some of our work has influenced national policy, it has influenced SNAP. That is pretty cool, that you can do research and advocate for change using objective information, and make change occur,” Casey said. 

In 2021, CHW successfully advocated for “investments and policy changes” in the American Rescue Plan Act, in 2022, President Biden cited research co-authored by CHW on “the benefits of the Child Tax Credit in reducing food insufficiency” in a speech at the White House Conference on Hunger, Nutrition, and Health, and in 2023, CHW launched the Healthy Families Tax Credits Coalition Campaign in Boston to “boost family incomes and improve health for children and families” through “improvements to state refundable tax credits,” according to CHW’s website.

Sheward said creating a state-level EITC in Arkansas continues to be an important policy priority for CHW. 

More information about CHW can be found online at childrenshealthwatch.org.