Health Aff (Millwood). 2026 Aug;45(8):915-924. doi: 10.1377/hlthaff.2025.01656.
ABSTRACT
The 2021 expansion of the Child Tax Credit provided advance monthly cash transfers to most US households with children. Although prior evaluations documented overall improvements in household well-being, less is known about variation by household structure. This study examined policy-period changes in parental mental health and material hardship among female-headed households. Using data from 1.3 million respondents to the Census Bureau’s Household Pulse Survey (2020-25) and an intersectional framework, we applied difference-in-differences and multilevel models to estimate changes in parental mental health and material hardship before, during, and after expanded Child Tax Credit implementation. Non-female-headed households showed improvements in depression, anxiety, and housing insecurity, whereas female-headed households, particularly those with low incomes and Black, Hispanic, and Asian households, showed smaller or no comparable gains. Food insecurity did not improve across groups. Intersectional analyses showed that the highest burdens and smallest improvements were concentrated among low-income, female-headed households across racial and ethnic groups. Findings suggest that the expanded Child Tax Credit did not fully close baseline disparities, underscoring the importance of household structure and intersecting social positions in policy design and evaluation.
PMID:42546234 | DOI:10.1377/hlthaff.2025.01656
