Employed

Per Capita Income

Above Poverty

Economic

Preschool Enrollment

Bachelor's Education

High School Enrollment

Education

Voting

Census Response

Social

Automobile Access

Active Commuting

Transportation

Insured Adults

Healthcare Access

Retail Density

Park Access

Tree Canopy

Neighborhood

Severely Cost Burdened Low-Income Renters

Severely Cost Burdened Low-Income Homeowners

Housing Habitability

Uncrowded Housing

Homeownership

Housing

Ozone

Fine Particulate Matter (PM2.5)

Diesel Particulate Matter

Safe Drinking Water

Clean Environment

Extreme Heat

Impervious Surfaces

Outdoor Workers

Public Transit Access

Sea Level Rise

Two Parent Households

Alcohol Availability

Supermarket Access

Decision Support

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.

 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.

 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.

 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.

 Communities with low social support may also be more prone to discrimination and violence.

 For children, having two adult caregivers can provide a protective effect and ensure they have the social and emotional support needed to be healthy,

 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.

 Early childhood education is linked to increased life expectancy and reduced chronic disease rates, infant mortality and other negative health outcomes.

 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.

 Yet preschool is not universally available or required in California, and students without the resources to attend may fall behind from a young age.

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

Robert Wood Johnson Foundation. Issue Brief #4: Income, Wealth and Health. 2011. Available at: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf70448.

Salmon J, Owen N, Bauman A, Schmitz MK, Booth M. Leisure-time, occupational, and household physical activity among professional, skilled, and less-skilled workers and homemakers. Prev Med. 2000;30(3):191- 199.

Adkins CL, Premeaux SF. Spending time: The impact of hours worked on work–family conflict. J Vocat Behav. 2012;80(2):380-389.

Health Impact Partners, UCLA Labor Center and Restaurant Opportunities Center- Los Angeles. Health Impact Assessment of the Proposed Los Angeles Wage Theft Ordinance. 2014. Available at: http://www.irle.ucla.edu/publications/documents/wage_theft_report_082514_KF.pdf.

Centers for Disease Control and Prevention. Healthy Places Website. Available at:http://www.cdc.gov/healthyplaces/about.htm.

Schweinhart, “The High/Scope Perrry Preschool Study Through Age 40: Summary, Conclusions, and Frequently Asked Questions.”

Executive Office of the President of the United States, “The Economics of Early Childhood Investments,” 2014, https://obamawhitehouse.archives.gov/sites/default/files/docs/the_economics_of_early_childhood_investments.pdf.

United States Census. American Community Survey, 2015 One Year Estimates.

“The Family Economic Self-Sufficiency Standard for California | Insight,” accessed January 10, 2017, http://www.insightcced.org/past-archives/insight-networks/building-economic-security-for-all-besa/californians-for-economic-security-cfes/the-self-sufficiency-standard-for-california/.

UCLA and UC Berkeley Center for Labor Research and Education, “Enforcing City Minimum Wage Laws In California: Best Practices and City-State Partnerships,” 2015, : http://laborcenter.berkeley.edu/pdf/2015/minimum-wage-enforcement.pdf; U.S. Department of Labor, “The Social and Economic Effects of Wage Violations: Estimates for California and New York,” December 2014.

San Francisco Department of Public Health and Health Impact Partners, “A Health Impact Assessment of the California Healthy Families, Healthy Workplaces Act of 2008,” July 2008, http://www.humanimpact.org/downloads/healthy-workplaces-act-report-2008/.

National Bureau of Economic Research, The Correlation of Wealth Across Generations; Kerwin Kofi Charles and Erik Hurst; Working Paper 9314: http://www.nber.org/papers/w9314 (October 2002)

Pew Research Center. “Wealth inequality has widened along racial, ethnic lines since end of Great Recession”. 2014. Available at: http://www.pewresearch.org/fact-tank/2014/12/12/racial-wealth-gaps-great-recession

Harvard University Center on the Developing Child, “The Foundations of Lifelong Health Are Built In Early Childhood” (Harvard University Center on the Developing Child, 2010), http://developingchild.harvard.edu/wp-content/uploads/2010/05/Foundations-of-Lifelong-Health.pdf.

Centers for Disease Control and Prevention, “Early Childhood Education.”

California Child Care Programs Local Assistance—All Funds. California Department of Finance, 2014–2015 Budget Act.

American Institutes for Research, “Early Learning Needs Assessment Tool,” 2010.

Deborah Phillips, “10 Years Post- Neurons to Neighborhoods: What’s At Stake and What Matters in Child Care?,” October 19, 2010.

United States Department of Labor, Bureau of Labor Statistics, “Occupational Employment and Wages,” 2009.

Learning Policy Institute, “Understanding California’s Early Care and Education System” (Palo Alto, CA, 2017), https://learningpolicyinstitute.org/sites/default/files/product-files/Understanding_CA_Early_Care_Education_System_REPORT.pdf.

First Five Association of California, “A Health Beginning for Young California Kids: Universal Developmental and Behavioral Screening,” n.d., https://www.childrennow.org/files/9314/2912/4344/dev-screening-infographic.pdf.

American Academy of Pediatrics, “Poverty and Child Health in the United States: Policy Statement,” Pediatrics 137, no. 4 (2016).

Right Start Commission, “Rebuilding the California Dream,” April 2016, https://www.commonsensemedia.org/sites/default/files/uploads/kids_action/csm_rightstartcommission_final_single-pages_o.pdf.

Jelleyman, T. and N. Spencer. (2008). Residential Mobility in Childhood and Health Outcomes: A Systematic Review. Journal of Epidemiology and Community Health

Gilman, S. E., Kawachi, I., Fitzmaurice, G. M., & Buka S.L. (2003). Socio-economic Status, Family Disruption and Residential Stability in Childhood: Relation to Onset, Recurrence and Remission of Major Depression. Psychological Medicine, 33 (8), 1341-1355.

Cohen, R., & Wardrip, K. (2009). Should I Stay or Should I go? Exploring the Effects of Housing Instability and Mobility on Children. Center for Housing Policy. Retrieved from http://www.nhc.org/media/files/HsgInstablityandMobility.pdf

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.

 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 

 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.

 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.

 Local governments can help families keep what they earn and 

 to reduce this gap and address poverty. In the longer term, governments should 

 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 

 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.

 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 

 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 

, 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 

 to create opportunities for meaningful political participation in government decisions about the community conditions that impact health.

Support affordable and universal opportunities for preschool and early childhood education.

Equity

Strong Evidence

Universal Low or No-Cost Preschool and Childcare

Early Childhood Education

Sufficient Evidence

Transitional Kindergarten

Promising

Outreach Campaigns

Workforce Development and Retention

Engaged communities and families ensure that education and childcare systems are responsive, relevant, powerful, and integrated with broader community transformation initiatives.

Community Power and Connection

Parent Engagement and Advocacy Programs

Collective Impact Initiatives

Create opportunities for meaningful participation in decisions about the community conditions that impact health.

Participatory Local Government

Campaign Finance Reform

Capacity Building and Civic Education

Transportation to jobs, schools, and other essential destinations is fundamental to getting and keeping jobs, learning the skills necessary for employment, and accessing economic opportunities. 

Transportation for Economic Opportunity

Help households of all sizes build and maintain wealth so that they can afford the necessities of life and save for their futures and children.  

Emerging

Financial Coaching (Emerging Practice)

Homeownership Programs

Tax Preparation and Outreach Programs

Individual Development Accounts/Matched Savings Accounts

Homeownership Programs 

Flexible, Low-Cost and Supportive Financial Products

Transform the community conditions that shape child development and quality of life.

Physical Activity

Violence Prevention and Safety

Safe, Stable, and Affordable Housing 

Equitable Economic Development

Increased Funding for Public Health Infrastructure

Promote Maternal Health and Reduce Infant Mortality

Developing Community-Based Approaches to Public Safety

Ensure that all people have pathways and training to good jobs that provide sufficient income to support their household.

Health Career Recruitment for Minority Students

Job-Focused Basic Skill Training Programs

Industry Driven, Sector-Based Training Programs

Climate

Paid Job Training and Placement Programs for Groups that Face Barriers to Employment

Nurture health-supportive community networks, and support community voice and power to improve the conditions that shape health.

Youth Development and Advocacy Programs

Community Organizing

Support healthy development with programs designed for young children and caregivers. 

Home Visiting Programs

Free Development Screening

Caregiver Protections

Raise workplace standards and wages to ensure that households of all sizes can stay out of poverty.

Policy Guide

Two Parent Households

Create Opportunities for Early Learning

Foster Community and Parent Participation

Create a Participatory Political Process

Improve Transportation Access to Economic Opportunity

Build Wealth

Community Transformation

Build Workforce Development and Pathways

Support a Strong Community Fabric

Early Childhood Wellness

Raise Wages and Benefits