New York is one of the wealthiest states in this country. And yet its child poverty rate — over 20% — is one of the highest in the country. As a pediatrician in Albany for the past 20 years, I have seen firsthand the damage poverty does to children’s health. Poverty is not just an economic issue; it is a public health emergency.
Children in poverty — my patients — face higher rates of chronic illnesses, mental health challenges and developmental delays, all of which have devastating and lasting impacts on their futures. Addressing child poverty is not just pragmatically best for public health in our communities; it is a moral imperative.
Every day in my practice, I care for children in poverty with uncontrolled asthma living in housing conditions that expose them to environmental hazards that worsen the disease. I see children with advanced dental disease struggling to find a dental provider that will see them. I comfort children suffering from undernutrition while their families struggle with food insecurity. The truth is that children in low-income households are significantly more likely to suffer from conditions like asthma, heart disease, dental disease and elevated lead levels. And as a pediatrician, I know preaching healthy eating sometimes feels hollow — even absurd — when a family lives in a healthy food desert and their only grocery store is a gas station.
Children living in poverty are at greater risk of delayed language, cognitive and motor skills, largely due to limited access to quality early education, health care and resources like enriching activities and safe play places. I can encourage parents of young children to participate in outdoor play to build social-emotional skills, but that recommendation is lofty and impractical when safety and affordable transportation cannot be secured.
As a public health professional, I am tasked with offering solutions to improve lives — but advice means little when systemic barriers and resource gaps make action impossible.
The mental health effects of poverty are equally dire. The chronic stress of financial instability, food insecurity and unsafe living conditions increases the likelihood of anxiety and depression. Growing up in poverty is an adverse childhood experience, which raises the risk of long-term, lifelong impacts on mental health. I see adolescent patients who grew up in these households and who are now struggling with debilitating mental health conditions — and also struggling to find access to therapists. I feel an obligation to prevent those consequences in toddlers who are growing up in poverty.
For many low-income families, accessing health care is a major challenge. Specialists and preventative care often require long travel, and parents earning hourly wages rarely get paid time off. Their children miss vital medical visits. Their diagnoses get delayed. Their health worsens. And the disparities for those in poverty accelerate.
Gov. Kathy Hochul recently announced a plan to expand the Empire State Child Credit. That is a definite step in the right direction, but we can do even more. It’s time to finally identify poverty as a public health emergency so that we can use public health solutions to address this problem.
Research shows that investing in children early can significantly buffer the effects of poverty. We need to continue, then, to expand programs we already know lead to evidenced-based improvements — state and federal anti-poverty and safety net programs, Medicaid access, quality early childhood education, tax credits and critical nutrition support programs like WIC, SNAP and universal school meals.
This could not be more urgent. We are in the midst of an assault on anti-poverty efforts with the new federal administration. It is incumbent upon us to pass bold legislative action on the state level to mitigate it.
As a pediatrician, I was trained to advocate for the health of children. Today, that means looking beyond the clinic walls and toward the levers of power in Albany. New York lawmakers have an opportunity to set an example for the nation, to prove that we value our children’s health and their potential, to realize this state’s promise as a beacon of opportunity. This is our moment to do just that.
Rebecca Butterfield is a pediatrician in Albany and a member of the Guilderland Board of Education.
March 6, 2025
Read the full piece on the Times Union website here.