To help low-income kids with cancer have better treatment outcomes, a researcher tries a different innovation: Cash
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'What this showed us is that poverty exposure needs to be targeted in the same way that we think about targeting mutations,' Bona said.
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The launch of Bona's study in late June came weeks before
Advertisement
The results put into question the efficacy of basic income, which has been heralded as a potential tool to alleviate poverty. But researchers and proponents of cash transfer programs in Massachusetts say the results have not dampened optimism here about the role they can play in supporting low-income families.
Instead they say 'Baby's First Years' demonstrates the need for more research into just how much money and other resources and services is needed to pull people out of poverty. It also sharpens the question of what researchers, program managers, funders, and policymakers consider a valuable result.
'These programs are held to unrealistic standards, that this has to be some transformative, life-altering intervention, or it's not worth anyone's time or effort or concern,' said Richard Sheward, a director at Boston Medical Center's Children's HealthWatch, who has
'It would be a major failure if we focused on this one thing and lose sight of the fact that we also need to protect our safety net programs, like SNAP and WIC and other programs that help families thrive and move up the economic ladder, as they are
Massachusetts has been a leader in piloting cash programs. Since 2020,
Unlike 'Baby's First Years,' these programs focus not on whether the cash transfers impact childhood development markers, but whether they allow families, particularly low-income families, to weather economic storms, spend more on healthy food, and spend more time together, especially during a child's crucial early years.
Advertisement
Early results of the 'Baby's First Years' study were promising,
Robert Rector, a senior research fellow at the conservative Heritage Foundation and a critic of cash transfer programs,
But while 'Baby's First Years' didn't show significant developmental changes, it did show that women who received the cash transfers spent the money on food and clothing for their children, not on things like alcohol or cigarettes, which had long been a concern of conservative critics of such programs. The women also spent more time with their children.
'That's dismissed, because we thought we would see these developmental changes,' said Margaret Anne McConnell, a professor at Harvard School of Public Health. 'But think about what that means. A small amount of cash means people got to spend more time with their children. That's incredibly important.'
Jennifer Valenzuela is the executive director of Children's Trust, which just finished a program that offers cash transfers during home visits for some new moms in Springfield. She said cash assistance programs can be tremendously helpful for parents who would otherwise be stressed and cash strapped when trying to figure out how to buy basics like food, gas, and utilities.
Advertisement
'All those things make an impact on who we can be as parents and how we can engage with a child,' Valenzuela said. 'What would it mean if you weren't able to do some of the basic things that we think about as a parent, things that should be a norm, that many parents don't get to do.'
In addition to outcomes, the amount of cash given varies greatly across programs. 'Baby's First Years,' for example, offered $333 a month to moms, regardless of how many children they have. The Unconditional Cash Study, which took place in Illinois and Texas, offered low-income individuals $1,000 per month.
During COVID, the federal
child tax credit expanded, offering what was essentially a cash transfer of several thousand dollars at once, depending on family size and children's age. As a result of the expanded credit, childhood poverty
'['Baby's First Years"] is a valuable study because it challenges us to be more thoughtful about how we design and implement these programs,' said Sheward. 'It just shows us the context matters, the amount matters, what we measure matters, very deeply.'
Bona's study, which offers up to $1,000 twice a month per
family, is the first of its kind to consider how cash transfers may impact pediatric cancer outcomes for low-income families.
It's taking place in multiple sites across the country, is in the early stages, and will last four years. Bona is certain of the relationship between poverty and poorer clinical outcomes. But she isn't clear on the drivers of unequal outcomes, or on how to fix these.
Advertisement
'Will this be the right dose? Is it for the right duration in cancer treatment? Will we have to repeat it later on in cancer treatment? We don't know yet,' she said. But if the study shows that cash injections alter a family's food security, reduce parents' psychological distress, and allow sick kids to stay on a clinical trial for longer, 'it will be one of the 'cheapest' interventions we could possibly imagine in the cancer space — far cheaper than most drugs."
McConnell, at the Harvard School of Public Health, recently launched a similar study, considering how cash transfers impact time that low-income mothers of premature babies can spend with their children hospitalized in the neonatal intensive care unit.
McConnell isn't measuring the long-term outcomes of the children or the moms. Instead, she's measuring outcomes that may indicate a baby's longer-term health: provision of breast milk and skin-to-skin contact.
'The work I'm doing is to see how to ease the financial strain of having a NICU baby, not replace people's income or lift people out of poverty,' she said.
Although her study is designed differently and measuring something different than 'Baby's First Years,' she thinks that everyone can learn from it — even if it has a null result.
'I think you can learn a lot from a study like this, it shows how complex and challenging it is to address child development, without drawing the conclusion that you've learned
everything
," she said. 'Any time you have one study that's a definitive answer to a question is unfortunate. It sets up any intervention to fail.'
Advertisement
This story was produced by the Globe's
team, which covers the racial wealth gap in Greater Boston. You can sign up for the newsletter
.
Mara Kardas-Nelson can be reached at
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Chicago Tribune
a day ago
- Chicago Tribune
Illinois SNAP Education program eliminated amid federal cuts: ‘It's heartbreaking'
In a makeshift classroom in a Roseland low-income housing complex, nine women watched nutrition educator Denetria Adams saute a glistening mix of carrots, celery and onion. Tammy Spivey, 60, raised her hand from the back row. 'What's worse, cooking oil or lard?' 'Lard,' Adams answered, stirring the steaming mirepoix with practiced ease. 'It clogs your arteries.' Across the room, fellow educator Christine Davis jumped in. 'We always want to make sure we're being cognizant of the type of fat that we're putting into our bodies.' She rattled off a list of healthier alternatives. Sunflower oil, olive oil, avocado oil. Spivey jotted down the names on her note sheet, then underlined each word twice. It was the sixth session of a cooking class run by the Supplemental Nutrition Assistance Program Education initiative, or Snap-Ed. For weeks, Mercy Housing residents gathered to cover nutrition basics, build kitchen skills and learn how to stretch their food stamps. It might also be one of the last. In July, the federal program was abruptly cut under President Donald Trump's sweeping One Big Beautiful Bill Act, leaving thousands across Illinois in the lurch. For decades, SNAP-Ed has partnered with dozens of Chicago organizations — from food pantries to public schools — to address the root causes of health disparities. Now, with just a few months' notice, staff are dismantling a 30-year program carefully woven into the city's social safety net. 'It was an absolute gut punch,' said Daylan Dufelmeier, who heads SNAP-Ed locally as the director of the Chicago Partnership for Health Promotion at the University of Illinois Chicago. 'The work that we do is so important and so critical, so when we got caught in political crossheads, it was brutal.' It's the latest in a flurry of welfare cuts under the Trump administration. The president's recent tax-and-spending legislation has slashed billions in federal food benefits and significantly reduced Medicaid access. Spivey, a former quality control technician, has relied on food stamps and disability checks for as long as she can remember. When she used to cook for her now-grown daughter, both were essential to keep food on the table. She couldn't always afford to prioritize nutrition. 'They cutting out the wrong things,' Spivey said. 'It's not right.' In addition to nutrition education classes, SNAP-Ed programming includes food access directories, social media campaigns and advocacy work. According to staff, those initiatives prevent more than 5,000 cases of obesity and nearly 600 cases of food insecurity across Illinois each year. For many low-income families, budgeting for healthy food options can be a challenge, experts say. That can lead to long-term health issues, including chronic diseases and nutritional deficiencies. But nonprofit research organization Altarum estimates that every dollar invested in the Illinois program returns between $5.36 and $9.54 in health care savings. 'People want to be healthier, they want to be physically active, but they don't have the resources,' said educator Adams, as she spooned out heaps of rice. Despite its documented success, the Republican-led House Committee on Agriculture said in May that the program has yielded 'no meaningful change' since its inception in 1992, wasting taxpayer money. Funding will officially run dry Sept. 30, the end of the federal fiscal year. This fiscal year, Illinois received nearly $20 million in funding for the program. About $5 million went to UIC, and the rest was funneled to the University of Illinois Urbana-Champaign for statewide work. With the funding slashed, roughly 250 staff members will lose their jobs across the U. of I. system. 'These are people that are their communities building trust,' said Germán Bollero, dean of the U. of I. College of Agricultural, Consumer and Environmental Sciences. 'That is at the core of our mission: transforming society to be a better place. It's heartbreaking.' Each year, SNAP-Ed is estimated to reach about one million Illinois residents, working with more than 1,800 community partners. About 1.9 million people in the state receive SNAP benefits, according to the Illinois Department of Human Services. At Mercy Housing, Alma Watson, 63, flipped through the pages of her workbook, filled with lines of her cursive handwriting. She scanned a list of recipes — turkey tacos, skillet chicken breasts and baked sweet potatoes — each paired with nutritional information. 'People don't know, and some people really need it. Like me, for one,' Watson said with a laugh. It's her second time taking the eight-week course at Mercy, where she's lived for 15 years. Participants receive boxes of fresh produce and poultry to re-create recipes at home, enough to last Watson for days. But the real joy is being in the classroom again, she said, learning alongside peers. Most of them also depend on SNAP benefits. 'I love this setting. The people are really nice,' Watson said. 'I just love everything so far.' For SNAP-Ed staff, that positive feedback makes the impending shutdown harder. Educators Adams and Davis are set to lose their jobs in a few weeks, but their greatest concern, they said, is for the communities they serve. Through the window, Davis pointed to a weathered convenience store across the street. Its neon posters advertised tobacco and soda. 'Most of the (nearby) grocery stores aren't really grocery stores. They're markets like that,' she said. '(Residents) don't have much of an option.' Food deserts — areas more than a mile from a grocery store — have plagued the Chicago area for years, particularly on the South Side. While SNAP benefits are an immediate solution, SNAP-Ed helped chip away at those broader systemic issues, Dufelmeier said. After funding runs out, operations will likely cease immediately. 'The impacts from the cuts to our programs you may not see next week, but it's a long-term impact,' Dufelmeier said. After the lesson, each participant received a paper plate with sauteed vegetables, chicken, rice and soy sauce. The room had buzzed with laughter, but it was quieter as everyone ate. One resident ambled to the front of the room for seconds. Adams smiled and dished out another helping. 'Here you go, honey.'
Boston Globe
a day ago
- Boston Globe
To help low-income kids with cancer have better treatment outcomes, a researcher tries a different innovation: Cash
Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up 'What this showed us is that poverty exposure needs to be targeted in the same way that we think about targeting mutations,' Bona said. Advertisement The launch of Bona's study in late June came weeks before Advertisement The results put into question the efficacy of basic income, which has been heralded as a potential tool to alleviate poverty. But researchers and proponents of cash transfer programs in Massachusetts say the results have not dampened optimism here about the role they can play in supporting low-income families. Instead they say 'Baby's First Years' demonstrates the need for more research into just how much money and other resources and services is needed to pull people out of poverty. It also sharpens the question of what researchers, program managers, funders, and policymakers consider a valuable result. 'These programs are held to unrealistic standards, that this has to be some transformative, life-altering intervention, or it's not worth anyone's time or effort or concern,' said Richard Sheward, a director at Boston Medical Center's Children's HealthWatch, who has 'It would be a major failure if we focused on this one thing and lose sight of the fact that we also need to protect our safety net programs, like SNAP and WIC and other programs that help families thrive and move up the economic ladder, as they are Massachusetts has been a leader in piloting cash programs. Since 2020, Unlike 'Baby's First Years,' these programs focus not on whether the cash transfers impact childhood development markers, but whether they allow families, particularly low-income families, to weather economic storms, spend more on healthy food, and spend more time together, especially during a child's crucial early years. Advertisement Early results of the 'Baby's First Years' study were promising, Robert Rector, a senior research fellow at the conservative Heritage Foundation and a critic of cash transfer programs, But while 'Baby's First Years' didn't show significant developmental changes, it did show that women who received the cash transfers spent the money on food and clothing for their children, not on things like alcohol or cigarettes, which had long been a concern of conservative critics of such programs. The women also spent more time with their children. 'That's dismissed, because we thought we would see these developmental changes,' said Margaret Anne McConnell, a professor at Harvard School of Public Health. 'But think about what that means. A small amount of cash means people got to spend more time with their children. That's incredibly important.' Jennifer Valenzuela is the executive director of Children's Trust, which just finished a program that offers cash transfers during home visits for some new moms in Springfield. She said cash assistance programs can be tremendously helpful for parents who would otherwise be stressed and cash strapped when trying to figure out how to buy basics like food, gas, and utilities. Advertisement 'All those things make an impact on who we can be as parents and how we can engage with a child,' Valenzuela said. 'What would it mean if you weren't able to do some of the basic things that we think about as a parent, things that should be a norm, that many parents don't get to do.' In addition to outcomes, the amount of cash given varies greatly across programs. 'Baby's First Years,' for example, offered $333 a month to moms, regardless of how many children they have. The Unconditional Cash Study, which took place in Illinois and Texas, offered low-income individuals $1,000 per month. During COVID, the federal child tax credit expanded, offering what was essentially a cash transfer of several thousand dollars at once, depending on family size and children's age. As a result of the expanded credit, childhood poverty '['Baby's First Years"] is a valuable study because it challenges us to be more thoughtful about how we design and implement these programs,' said Sheward. 'It just shows us the context matters, the amount matters, what we measure matters, very deeply.' Bona's study, which offers up to $1,000 twice a month per family, is the first of its kind to consider how cash transfers may impact pediatric cancer outcomes for low-income families. It's taking place in multiple sites across the country, is in the early stages, and will last four years. Bona is certain of the relationship between poverty and poorer clinical outcomes. But she isn't clear on the drivers of unequal outcomes, or on how to fix these. Advertisement 'Will this be the right dose? Is it for the right duration in cancer treatment? Will we have to repeat it later on in cancer treatment? We don't know yet,' she said. But if the study shows that cash injections alter a family's food security, reduce parents' psychological distress, and allow sick kids to stay on a clinical trial for longer, 'it will be one of the 'cheapest' interventions we could possibly imagine in the cancer space — far cheaper than most drugs." McConnell, at the Harvard School of Public Health, recently launched a similar study, considering how cash transfers impact time that low-income mothers of premature babies can spend with their children hospitalized in the neonatal intensive care unit. McConnell isn't measuring the long-term outcomes of the children or the moms. Instead, she's measuring outcomes that may indicate a baby's longer-term health: provision of breast milk and skin-to-skin contact. 'The work I'm doing is to see how to ease the financial strain of having a NICU baby, not replace people's income or lift people out of poverty,' she said. Although her study is designed differently and measuring something different than 'Baby's First Years,' she thinks that everyone can learn from it — even if it has a null result. 'I think you can learn a lot from a study like this, it shows how complex and challenging it is to address child development, without drawing the conclusion that you've learned everything ," she said. 'Any time you have one study that's a definitive answer to a question is unfortunate. It sets up any intervention to fail.' Advertisement This story was produced by the Globe's team, which covers the racial wealth gap in Greater Boston. You can sign up for the newsletter . Mara Kardas-Nelson can be reached at
Boston Globe
2 days ago
- Boston Globe
Draft of major MAHA report calls for more education, less regulation — and offers few policies
While the document, titled 'Make Our Children Healthy Again Strategy,' retreads key MAHA ground like the need to cut artificial food dyes and encourage physical activity, it also offers a more expansive view of where Kennedy plans to steer his agency. Details of the report, which was delivered to the White House on Tuesday but not made public, were first published by The New York Times. They have yet to be authenticated by White House officials. Childhood vaccine schedule reform is on the agenda, though the report offers no details on how Kennedy will change the list of recommended childhood vaccines, if at all. He has for years cast suspicion on vaccines, often citing flawed research, and promoted the idea that early shots are harming children. The report similarly calls for 'addressing vaccine injuries.' Advertisement 'Together, this strategy will translate the work of the MAHA movement to policies that make a transformative and lasting impact for Americans and end the childhood chronic disease crisis,' says a draft document, dated Aug. 11 and published by Politico. Advertisement The strategy notably avoids mention of the 'This report has one overriding implied message: More research needed,' Marion Nestle, a leading nutrition researcher and professor emeritus at New York University, said via email. But, she said, 'we already know the problems. It's way past time to start addressing them.' Perhaps the most forceful regulatory proposals in the report have to do with marketing. One recommends the Health and Human Services Department work with other federal agencies to enforce direct-to-consumer advertising of prescription drugs, including among social media influencers and telehealth companies. The move falls short of the full ban Kennedy previously talked about. A separate recommendation would create new industry guidelines to 'limit the direct marketing of certain unhealthy foods to children,' though it seems those rules would still be voluntary. (Some of the largest food and beverage companies currently self-regulate under a 'Though still light on specifics, these draft recommendations are a bit of a mixed bag,' said Andrew Binovi, director of government affairs for the Physicians Committee for Responsible Medicine. Advertisement Among the ideas is Nestle says the first Trump administration tried to implement a similar plan with pre-packed food boxes distributed through food banks and other organizations, which was 'a disaster for small farmers initially recruited to do these labor intensive and perishable boxes. It makes much more sense to make sure people have enough money to buy food.' Trump's recent tax cut bill The report also suggests the government should incentivize more breastfeeding, either through the WIC program or other routes. There is little mention of ultra-processed foods, or UPFs, which are expected to be a focus of the Dietary Guidelines for Americans, due later this year. HHS is also crafting a definition of what constitutes a UPF.'It appears that big food lobbyists have been busy and successful,' said Jerold Mande, CEO of the nutrition nonprofit Nourish Science, who previously held senior policymaking roles at the FDA and USDA under the George H.W. Bush, Clinton, and Obama administrations. 'Who expected the MAHA report to do more to get whole milk in schools than to get UPF out?'The report also says that the USDA will 'prioritize precision nutrition research,' a line of research that aims to provide people with more personalized recommendations by taking into account their body's individual needs and responses to certain foods. Former NIH nutrition researcher Kevin Hall Advertisement The draft report is 'the most ambitious federal plan yet to confront childhood chronic disease,' said Marty Irby, president and CEO at Capitol South and Competitive Markets Action, who previously lobbied for ranchers and farmers. 'Still, there are gaps: the USDA school lunch program continues to force dairy on many children — particularly kids of color — who are lactose intolerant, with little to no alternatives, and the plan offers little to promote local, farm-to-table food in schools.' Aviva Musicus, science director for the Center for Science in the Public Interest, criticized the report as embodying 'the idiosyncratic beliefs' of one person, Kennedy. 'He might be right about food dyes, but the report's recommendations to alter our vaccine framework, restructure government agencies, and promote meat and whole milk are going to promote disease, not health,' Musicus said. While the draft report is not a budget document, it is unclear how much funding would be needed for the various efforts or where it would come from. Already, Congress Advertisement Many of the proposals involve Medicaid, WIC, Instead of regulation, the administration plans to run public awareness and education campaigns aimed at adolescents about physical fitness, screen time, substance use, vaping and 'root cause issues that impact adult infertility.' Another initiative aims to train school and library workers on how to handle overdoses, and expand their access to the overdose-reversal medication Narcan, per the report. States will be encouraged to re-adopt the Presidential Fitness Test, which grades students on their ability to do things such as complete a mile run. HHS will also establish an 'infertility training center,' though the report offers limited details on precisely what services would be offered at such a facility. (Kennedy allies have been pushing for widespread use of what's called Medical schools, which have already been pushed by the administration to Advertisement Elsewhere in the department, National Institutes of Health officials plan to launch two new offices, one focused on developing alternatives to animal testing, such as organ-on-a-chip technologies, and another to organize chronic disease research. NIH will also start a new task force on children's health, and create a database of researchers' funding sources, similar to the OpenPayments system run by the Centers for Medicare and Medicaid Services, per the draft report. The commission's recommendations, while largely centered at Kennedy's HHS, also affect the USDA and the Environmental Protection Agency — though not as severely as some in the food and agriculture industries feared. Unlike While calling for more 'innovative growing solutions,' the report also says the government ought to 'ensure that the public has awareness and confidence in EPA's robust pesticide review procedures.' When it comes to air quality — a 'The commission has a historic opportunity to protect America's kids, but only if it resists corporate influence and turns bold ideas into real, accountable action,' Irby told STAT. Here are other highlights from the document: Mental health: More prior authorization Pediatric mental health remains a key focus for Kennedy and his MAHA allies. In February, a White House executive order called mood stabilizers and antipsychotic drugs a ' The draft echoes this language, highlighting the overmedicalization of children as a key challenge to overcome and calling for HHS to form a working group that will evaluate prescription patterns for SSRIs, antipsychotics, stimulants, and other drugs that children take. They also ask the Centers for Medicare and Medicaid Services to work with states to increase prior authorization requirements and tighten prescribing safeguards particularly for ADHD. The draft says the Veterans Administration will provide NIH with de-identifiable data on ADHD, diabetes, and pharmaceutical usage among spouses, dependents and survivors of veterans under 18. It's true that kids can be overmedicalized, said Jennifer Mathis, deputy director for the Bazelon Center for Mental Health Law. But it was 'disheartening, however, that the leaked draft strategy makes no mention of well-established services that are critical for children with significant mental health needs, such as intensive care coordination, intensive behavior support, and mobile crisis services,' Mathis said. Rates of anxiety, depression and ADHD in the U.S. are increasing, but the scientific explanation for their rise is Although the scientific literature on screen use offers Notably absent from the report, however, was the startling rise of youth suicide over the last two decades. Suicide is one of the leading causes of deaths in this demographic and is particularly pronounced among Black teenagers. One in five high school students Fluoride: New scrutiny of water standards In discussing the importance of water quality, the document focuses on one element: fluoride. The document does not directly name other contaminants, like PFAS or lead. The report states that the CDC and USDA will 'educate Americans on the appropriate levels of fluoride, clarify the role of EPA in drinking water standards for fluoride under the Safe Drinking Water Act, and increase awareness of the ability to obtain fluoride topically through toothpaste,' Experts largely agree that fluoridation at the level currently recommended by the CDC is safe, despite some growing concern that higher levels of fluoride intake could be The draft of the report also states the FDA will evaluate liquid drops and tablets. This process has already begun, with a Electromagnetic radiation: Studies ahead The report also says HHS plans to study electromagnetic radiation and health research 'to identify gaps in knowledge, including on new technologies to ensure safety and efficacy.' The report doesn't explain what sources of electromagnetic radiation its authors consider possible cause for concern. But Kennedy has claimed — contrary to scientific consensus — on The But while there's not evidence of a link between cell phones and cancer, it's true that the devices have changed dramatically since the advent of smartphones and that kids' usage has skyrocketed, said Emanuela Taioli, director of the Institute for Translational Epidemiology at Mount Sinai's Icahn School of Medicine, via email. 'Perhaps a new study on kids specifically is worth doing.' Daniel Payne and Chelsea Cirruzzo contributed reporting. If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: Call or text 988 or chat . For TTY users: Use your preferred relay service or dial 711 then 988.
