This indicator measures the percentage of children with two married or partnered parents or caregivers.

Every child, regardless of the size of their household, should have the economic, social and emotional support needed for a healthy life. Living in a home with two married or partnered adults or caregivers can help ensure that children grow up with the support and resources they need to be healthy. For the purposes of this policy guide, the term two parent household will be used and encompasses married, partnered adults or two adult caregivers. While this guide is focused on two parent households, it does not mean to diminish or stigmatize households with a single parent or other family structures, which can also have the same benefits if there is adequate support, or to promote two parent households where there could be unhealthy relationships, health prohibitive behaviors, violence or other issues. Research has shown there are economic, social, and educational benefits of living in a two parent household, which can extend to other family structures if the same factors are present.

One of the most researched and documented benefits of two parent households is that they have two adults that can generate income. Economic opportunity is one the most powerful predictors of good health, and these impacts on health are especially pronounced for people in or near poverty. When families face economic challenges, adults often work long hours and/or multiple jobs, making it more difficult to spend time with family and friends, cook healthy meals, engage with their communities, go to medical appointments, and participate in physical activity and other healthy activities.^{8, 9, 10} Insufficient income also makes it more difficult to afford to live in places with healthy community conditions like parks, good schools, employment, clean air, and safe streets.^{1, 11} It should be noted that some low income households may have two parents working for low wages, and that some single parents may have a high income, so the economic benefits of two parent households can vary.

Second, living with two married or partnered adults provides additional social and emotional support for children, as well as for the adults themselves. Research has shown that social support is a strong predictor of overall health and well-being.⁸ Social support can come from many sources, including parents, extended family, community members, friends, and fellow students. When people do not have adequate social support networks, they may be at risk of poor health outcomes.⁹ Communities with low social support may also be more prone to discrimination and violence.¹⁰ For children, having two adult caregivers can provide a protective effect and ensure they have the social and emotional support needed to be healthy,¹¹ yet these benefits can also extend to single parents and other family structures where similar levels of support are present. It is important to note that some two parent households are negative environments for children - where violence, health prohibitive behaviors or other interpersonal issues may be barriers to healthy growth and development.

Finally, the additional economic and social resources that two parent households bring make it more likely that children will be exposed early on to cognitive stimulation, to cultural, educational, and other learning opportunities that shape their future health and well-being.¹ Early childhood education is linked to increased life expectancy and reduced chronic disease rates, infant mortality and other negative health outcomes.²⁵ Education contributes to health in many ways: high school graduates are more likely to find quality jobs with living wages and decent working conditions; school-based learning contributes to the knowledge and cognitive skills necessary to make healthy choices; and students learn social and physiological benefiting skills including problem solving, teamwork, self-control, social support, and life skills. Quality preschool is especially important, and has been associated with lifelong educational, economic and health benefits.²⁵ Yet preschool is not universally available or required in California, and students without the resources to attend may fall behind from a young age.

Every child, regardless of the size of their household, should have the economic, social and emotional support needed for a healthy life. Children residing in homes with two adult parents or caregivers may benefit from additional household income, social and emotional support, and exposure to cognitive stimulation and varied learning opportunities early in life. Yet many children are living and thriving in single-parent households, which may face additional economic strain. A priority policy approach to aid all families would focus on policies that help support the economic livelihoods of adults and the educational needs of children. Households that have historically and currently face discrimination based on race, ethnicity, sexual orientation, income levels or legal status need to be thoughtfully considered and/or prioritized in order to ensure equitable implementation of any policy.

First, communities should focus on increasing access to economic opportunity and ensuring households are economically secure. Despite the economic success of this state, approximately nine million families and two million children live in poverty in California.¹⁶ While the problem is solvable, its scale and intractability indicate action must be taken multiple fronts to address poverty. In the short term, local governments can Raise Wages and Benefits to help low-wage workers stay out of, or exit, poverty. The single largest predictor of wealth in the United States is the wealth of one’s parents, meaning that both wealth and poverty are often replicated across generations, and carry forward both past and current inequities.²² In fact, the median white family currently has 13 times more wealth than a median Black family and 10 times more than the median Latino family, and this gap is growing.²³ Local governments can help families keep what they earn and Build Wealth to reduce this gap and address poverty. In the longer term, governments should Build Workforce Development and Pathways to increase the number, quality, and accessibility of jobs to local residents.

Second, communities should improve quality and access to educational opportunities, especially children. The preschool and childcare system in California is fractured, expensive and difficult to access for many families, particularly low- and moderate-income households. To address these conditions jurisdictions should Create Opportunities for Early Learning by supporting affordable and universal opportunities for preschool and early childhood education. Infancy and early childhood are crucial periods for brain development, and children need parental care and additional support for healthy development.²⁴ Jurisdictions should support Early Childhood Wellness with programs targeting the needs of young children and caregivers. Yet even the best childcare and education programs cannot be successful without attention to the broader community conditions that shape child development and health. Jurisdictions should Foster Community and Parent Participation to ensure that education and childcare systems are responsive, relevant, powerful, and integrated with broader community transformation initiatives.

There should also be a focus at the community level to improve the health of all households. Jurisdictions should seek broader community transformation to address the root causes of poor health including a focus on stable housing, safety, and stable housing. Jurisdictions should also Improve Transportation Access to Economic Opportunity so that all households can get to and from their homes, jobs, schools, and other essential destinations in a safe, affordable, and convenient manner.

Finally, communities need to provide households of all sizes with adequate social support. Social support is a strong predictor of overall health, and is especially important for single-parent households and communities that face discrimination or violence. Jurisdictions should Support a Strong Community Fabric, which involves nurturing health-supportive community networks, and supporting community voice and power to improve the conditions that shape health through strategies like community organizing and capacity building. Local governments can also Create a Participatory Political Process to create opportunities for meaningful political participation in government decisions about the community conditions that impact health.