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Vox
08-05-2025
- Lifestyle
- Vox
Why grandparents are more important than ever
is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed. Grandparents today are more active and able to play with their kids, experts say. lemono via Getty Images This story originally appeared in Kids Today, Vox's newsletter about kids, for everyone. Sign up here for future editions. We often hear about the isolation of contemporary American family life — the parents forced to go it alone, the kids stuck inside, the disappearing village. But there's another trend pushing American childhood in a more communal direction: Grandparents are playing a larger and more enduring role in kids' lives. For starters, there's a demographic shift at play. As birth rates fall, the average number of grandchildren per grandparent has fallen as well. Susan Miller, a 67-year-old grandma in the Washington, DC, area, told me that while her mom had 13 granddaughters, she has four grandchildren. Having fewer grandkids 'gives you more time with them,' she said. Longer life expectancy also means kids actually get more years with their grandparents than they used to, even though people are having kids later in life, according to Ashton Verdery, a sociologist at Penn State University. These trends are 'likely leading to deeper relationships between grandchildren and grandparents,' Verdery said. Miller and her husband spend the summers in Minnesota with their grandkids, cooking, crafting, roughhousing, and putting on plays and puppet shows. Her 11-year-old granddaughter has 'my husband really wrapped around her finger,' she said. 'He'll dress up,' Miller said. 'He'll pretend to be a ballerina.' Beyond participating in impromptu ballet performances, grandparents provide a host of benefits for kids. Across cultures, spending more time with grandmothers and grandfathers is linked to better educational and mental health outcomes, Verdery said. They can also offer kids a fresh perspective and sometimes come at child care with a more relaxed outlook than their stressed-out adult children, said Susan Kelley, a professor emerita of nursing at Georgia State University who has studied grandparents raising grandchildren. But grandparents are also increasingly stepping in to plug holes in America's crumbling child care system, a role they're not always excited about filling. Experts say policymakers should embrace reforms that allow grandmothers and grandfathers to spend time with their grandkids because they want to — not because their families have no other choice. Why grandparent relationships are changing Close relationships between grandparents and grandchildren are far from new. 'Intergenerational caregiving by grandparents, especially grandmothers, reaches back to the dawn of our species,' Tobi Adejumo, a doctoral candidate at the University of Colorado Denver who has studied grandparent care, told me. Multigenerational households have long been common in many communities, with Asian American, Black, and Latino families all more likely than white ones to have grandparents and grandkids under one roof. Still, the idea that grandparents used to provide a lot of child care isn't necessarily accurate, as Faith Hill reports at The Atlantic. In the early US, people often became grandparents while still raising their own young kids, limiting how much time they could spend with grandkids. But today, smaller families and later childbirth mean grandparents are less likely to still be actively parenting. While the falling birth rate may be bad news for older adults who want lots of grandkids to spoil (or for those who end up not having grandchildren at all), it also means grandmothers and grandfathers have more quality time to spend with each child. While white grandfathers born in 1880 had an average of nine grandchildren, grandpas born in 1960 have fewer than six. The drop for Black men has been even steeper, from around 11 to around six. The way grandparents and grandchildren relate to each other is also shifting. Older adults are more active than they once were, making them more able to play with their grandkids, said Donna Butts, executive director of Generations United, a nonprofit that works to connect children and older people. They're also richer — prior to the 1960s, older age groups had the highest rates of poverty, but now they have the highest rates of wealth, Verdery said. So not only can grandparents buy their grandkids presents, but they can also take them on outings and travel to visit them more easily. Meanwhile, skyrocketing child care costs and parents' increasingly demanding jobs have led to an increased need for help from grandma and grandpa, said Jennifer Utrata, a sociologist at the University of Puget Sound who studies grandparenting. More grandparents are responding to this need by providing child care on a regular basis, sometimes stepping in for multiple days per week, a phenomenon some call 'intensive grandparenting.' While grandparent care has historically been more common in communities of color and immigrant communities, it's now on the rise among white, middle-class families, Utrata said. One 2023 poll found that more than 40 percent of working parents relied on their children's grandmother for child care, Hill reports. Miller, the DC grandma, often cares for her grandchildren in the summer and on visits, including staying with them while their parents took a two-week trip. Her granddaughter becomes 'like a child, almost' rather than a grandchild when her parents are away, Miller said. 'She's comfortable with us.' Grandparents aren't a policy solution In addition to taking some pressure off parents, grandparents can have a big impact on kids' worldview, experts say. They can serve as role models but may also be less focused on work than parents in the middle of their careers, and more able to make kids the center of attention, Kelley said. Spending time with grandparents can also transform a child's view of aging. People who have close relationships with grandparents will often say they 'don't look at older people as icky' but rather as 'vibrant,' Butts said. Of course, grandparents can also offer high-quality, trusted care at a time when that's hard to come by. But regular caregiving can also be hard on grandparents, even if they're in good health. The demands of intensive grandparenting fall disproportionately on grandmothers, who can struggle to balance their own needs with those of their grandkids, Utrata said. Some grandparents retire early to help with grandchildren, which can be a financial strain, especially in low-income families, Adejumo said. Many grandparents pay for necessities like food and diapers while watching their grandkids, adding to the financial stress. Vice President JD Vance has suggested that grandparents could 'help out a little bit more' as a way of addressing the high cost of day care. But 'we should not be foisting our child care challenges on an older generation,' Utrata said. Grandparents want to help out, but they want it to be a choice, not 'the only way that their daughters are going to be able to work for pay.' Affordable, accessible child care would help grandparents be involved in their grandkids' lives without pressure or exhaustion, Utrata said. Paid parental leave would also help since many grandparents are called in to be with babies when their parents have to return to work, Adejumo said. In California and other states, grandparents can receive subsidies for taking care of grandchildren, but they are often too low to cover the real cost of care, Adejumo said. One sentiment she's heard a lot from grandparents: 'I would really appreciate a living wage.' There's a growing recognition in American society that making sure parents are healthy and financially stable also benefits kids. Now, experts say, it's time to extend that understanding to grandparents, too. What I'm reading The Trump administration's tariffs are indeed hitting baby goods, with stroller manufacturer UPPABaby announcing price hikes. Trump, meanwhile, says all costs are down, except for 'the thing you carry the babies around in.' He also says tariffs might mean American kids have 'two dolls instead of 30.' Federal grants for STEM education and mental health support in schools have been terminated, which advocates say compromises education and services for kids. My older kid and I just read the first book in the Lightfall series, about a young girl searching for her missing grandfather, a pig-wizard, in the mysterious realm she calls home. From my inbox Thanks so much to all of you who responded to my question a few weeks back: What do the kids in your life want to be when they grow up? What do they want to do in the world? If you'd still like to weigh in, we've created a Google Form to make it easier – feel free to share! And as always, you can still reach me anytime at
Vox
05-05-2025
- Health
- Vox
What if menopause were optional?
is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed. Will my generation be the last to go through menopause? Just a few years ago, that would've seemed like a bizarre question — I've always assumed that I and every other human being with ovaries would eventually experience what my grandmother called 'the change of life.' But now, researchers are calling into question what once seemed like basic facts of human existence. 'What if menopause happened later?' they are asking. 'What if it never happened at all?' In recent years, patients have gained access to a wider variety of medications to treat menopausal symptoms like hot flashes and vaginal dryness. But newer treatments, one already in clinical trials, go deeper: The goal is not just to treat the symptoms, but to actually slow down ovarian aging so that the hormonal changes associated with midlife happen later — or maybe even never. 'For the first time in medical history, we have the ability to potentially delay or eliminate menopause,' Kutluk Oktay, an ovarian biologist at Yale University, said in a release last year. I cover reproductive health, and my inbox has been filling up for months with news of research like this. As an elder millennial barreling toward the uncertainty of perimenopause (which some research suggests can start as early as one's 30s), I've received these updates with interest, sure, but also with a fair amount of trepidation. On the one hand, the loss of estrogen that comes with menopause is associated with a host of illnesses and conditions, from cardiovascular disease to osteoporosis. Delaying the menopausal transition even five years 'would result in an enormous improvement in terms of women's health and decreased mortality,' Zev Williams, the chief of reproductive endocrinology and infertility at Columbia University Irving Medical Center, told me. 'It's a really exciting opportunity.' On the other hand, the idea of getting rid of menopause can feel like yet another way of insisting that women remain young and fertile forever. At a time when JD Vance is talking dismissively about the 'purpose of the postmenopausal female,' I'm unsettled by the prospect of treating women's aging out of their childbearing years, in particular, as something that must be cured. If the idea of stopping menopause is a fraught one, though, it's also an opportunity to think about what we want from our later lives, and to consider what it would look like to balance the real medical concerns of midlife and beyond with the fact that women are flesh-and-blood human beings who, like everyone else, get old. As Ashton Applewhite, author of the book This Chair Rocks: A Manifesto Against Ageism, put it to me, 'you can't stop aging, or you're dead.' To understand menopause, it helps to understand a little bit about ovaries, the human reproductive organs that store and release eggs. Starting in puberty, these glands ramp up their production of estrogen, a hormone that leads to breast development and a host of other changes to the body. Throughout the reproductive years, the ovaries make estrogen and other hormones according to a monthly cycle to help prepare the body for potential pregnancy. Starting around a person's late 30s, however, estrogen production starts to drop off. By the mid-40s, people typically enter perimenopause, which means 'around menopause.' This period is characterized by unpredictable ups and downs in estrogen, though on a general downward trend (Mary Jane Minkin, an OB-GYN who teaches at the Yale School of Medicine, likens the pattern to the stock market during the Great Recession). That hormonal decline can lead to symptoms like irregular periods, hot flashes, and night sweats. A lot of the symptoms most commonly associated with menopause actually start in perimenopause, and they can range from annoying to devastating. Perimenopause has been getting a lot of media attention lately, along with more focus from brands who may want to sell you stuff to help you manage it. Problems like hot flashes and brain fog can cause women to miss work, resulting in $1.8 billion in lost work productivity in the US per year, according to one study. The loss of estrogen can cause vaginal dryness, which can cause discomfort during sex and, in some cases, constant pain. At some point, the ovaries stop producing eggs, and menstruation stops entirely. This is menopause, and it's diagnosed when someone has gone without a period for a full year. It happens at an average age of 51, though Black and Latina women reach menopause earlier than white and some Asian American women. Though some symptoms, like dryness, persist after menopause, others, like hot flashes, often resolve, Minkin told me. Hormonal changes in the body around menopause are also linked with increased risk of cardiovascular disease, Stephanie Faubion, director of the Mayo Clinic's Center for Women's Health and medical director of the Menopause Society, told me. Blood pressure and cholesterol tend to rise during this time, as does insulin resistance, a condition that can lead to diabetes. Bone density also falls during and after the menopause transition, increasing the risk of osteoporosis. Some experts believe that menopause is part of the reason women spend more time than men living with chronic diseases. 'Women live longer than men,' gerontology professor Bérénice Benayoun told Vox last year, 'but they usually do so in a much more frail state.' Given all this, it's reasonable that more experts are looking at menopause and wondering, what if we could just…not? Hormone therapy — typically estrogen taken on its own or with progesterone, sometimes in the form of birth control pills — already exists to treat the symptoms of menopause. The treatment was stigmatized for decades after a 2002 study linked it to breast cancer and other ailments, but doctors now say the benefits often outweigh the risks. Taking estrogen can dramatically reduce hot flashes, and even reduce cardiovascular risk while patients are on the medication. When you look at illnesses and conditions like dementia, heart disease, and stroke, 'there's a much, much lower rate in women compared to men, until ovarian function stops. Then they start to catch up,' Williams said. 'If we have a way of extending the ovarian lifespan in a way that's safe, then you're allowing the ovary to provide all these incredible health benefits' for a longer period of time. Estrogen therapy can replace some of the estrogen a person's ovaries are no longer producing, but it doesn't actually stop those organs' decline. To do that, some researchers are looking at more involved procedures. In one recent study, Oktay, the Yale biologist, and his team used a mathematical model to predict how a technique called ovarian tissue cryopreservation might work in healthy patients. The process, typically used in cancer patients undergoing treatment that could harm their fertility, involves removing a section of ovary, freezing it, and reimplanting it at a later date. This technique, if used in healthy patients under 40, 'would result in a significant delay in menopause,' according to the study. Oktay and his team have begun preserving ovarian tissue from healthy patients, with the goal of reintroducing it when the patients are close to menopause. Since the women are still young, the team will have to wait years for real-world results, Oktay told me. But the technique does work to restore ovarian function in cancer survivors, he said. About 10 percent of women enter menopause at age 55 or older, Oktay told me, and they tend to have longer life expectancy and less risk of osteoporosis and diabetes than people who go through the transition earlier. 'We're saying, why not make everybody that lucky?' Williams, the Columbia endocrinologist, and his team are working on a different, less invasive option. They're currently in the midst of their first human trial of rapamycin, an oral medication typically used as an immunosuppressant in higher doses. Rapamycin has been found to extend lifespan in some animal studies, suggesting to some that it might help humans live longer. Williams and his team have also found that the drug can extend ovarian function and fertility in mice. The Columbia researchers are now monitoring 50 women between the ages of 35 and 45 who have taken either rapamycin or a placebo, asking them questions about their mood, memory, and sleep quality, as well as checking their ovarian function through blood work and ultrasounds. They don't have results yet, but they've seen no serious side effects so far. The goal isn't just to extend fertility, though 'as a fertility specialist, that's obviously something that I think about all the time,' Williams said. It's also about extending the benefits that ovaries provide to women's health, potentially reducing their lifetime risk of chronic illness. Research like Williams's has generated significant excitement, as the idea of pushing back menopause starts to move into the mainstream. Toward the end of the Biden administration, Jill Biden launched a women's health initiative dedicated to studying the idea. The ovaries are 'the only organ in humans that we just accept will fail one day,' Renee Wegrzyn, director of the agency in charge of the first lady's initiative, told the New York Times last year. 'It's actually kind of wild that we all just accept that.' Some are skeptical, though, that delaying or eliminating menopause would be an entirely good idea. For one thing, the link between menopause and illness isn't completely clear-cut. People who go through menopause later tend to have better health outcomes, 'but is it chicken or egg?' Faubion asked. 'Do their ovaries last longer because they're otherwise in better general health than the other people that go through menopause early?' Prolonging ovarian function — and thus increasing people's lifetime exposure to estrogen — could also come with risks of its own, like increases in breast cancer or blood clots, which have been linked to the hormone, Faubion said (going through menopause after age 55 is associated with an increased risk of breast cancer). For some, the tradeoffs might be worth it, but it's not necessarily true that later menopause would mean better health across the board. With more invasive treatments, there are also other questions to consider. 'What are the ethics of taking out a healthy organ from a healthy person' — a surgical procedure that could fail — 'all in the name of 'delaying menopause?'' Faubion asked. Oktay, the biologist studying ovarian tissue cryopreservation, told me the procedure is a minimally invasive laparoscopic surgery, and can be performed at the same time as another abdominal surgery like a C-section. Many participants in his study have a family history of severe menopause complications or conditions that can worsen with menopause, he said, giving them a reason to want to delay the transition. For Minkin, the Yale gynecologist, the experimental treatments are intriguing if they can extend fertility. But for dealing with the physical challenges of menopause, she's not sure they're necessary: 'There are plenty of easy ways to give people hormones.' Some people, including survivors of certain cancers, aren't able to take hormones, and new treatments could be helpful for them. Meanwhile, some experts see delaying menopause as most beneficial for people who experience the transition early. About one percent of women go through menopause before age 40, and five percent before age 45. Cancer treatments or autoimmune conditions can cause early menopause, but sometimes, the cause is unknown. Since early menopause is associated with elevated health risks, a new way to treat it 'would probably result in a net benefit for population health,' Nanette Santoro, a professor of obstetrics and gynecology at the University of Colorado School of Medicine, told Time. Going through menopause early can be deeply upsetting to people, especially (though not exclusively) if they're hoping to have children. But when it happens at the average time, this stage of life can come with social and emotional benefits, despite the physical challenges. 'It's liberating,' Applewhite told me. 'No more mood swings, no more worries about getting pregnant.' 'I don't know any woman, including yourself, who wants to be bleeding every single month,' Denise Pines, creator of the menopause summit WisePause, told me. Indeed, research has found that women often become happier as they age, especially after midlife — potentially because they're less consumed with caring for children and other family members. Some anthropologists believe that female humans, unlike other animals, live beyond their reproductive years to help care for grandchildren (it's called the 'grandmother hypothesis'). But Minkin offered a more expansive view of this theory: In early human settlements, pregnant people couldn't do heavy labor like moving rocks around. The grandmother was 'somebody who moves the rocks,' she said. She also described postmenopausal women as 'shooting saber-toothed tigers.' Even the troublesome symptoms of menopause, such as hot flashes and night sweats, can be a useful 'disruptor' in people's lives, Pines said. 'Where women have been so giving and outwardly focused, suddenly you have to focus on yourself.' 'That gives you a chance to reset everything else around you,' from relationships to career, Pines said. 'It's such a great time to really reimagine who we are.' Applewhite welcomes the recent surge in awareness around menopause, and says hormone therapy to treat its symptoms can be helpful — 'I'm not saying, keep your body pure and avoid the temptations of Western medicine.' But when it comes to putting off menopause or eliminating it entirely, she said it's concerning 'when inevitable transitions of aging are pathologized.' That's especially true for women's aging, which is doubly stigmatized in American culture. 'Under patriarchy, a woman's value is linked to her reproductive value,' Applewhite said. It's why there's so little research into the health of older women: 'because we are no longer reproductively useful.' As appealing as the idea of extending a person's healthy lifespan is, I can't quite get past the ovary of it all. I, too, have heard from post-menopausal people about the liberation they feel when they exit their reproductive years. I, too, have at times been frustrated by doctors' focus on my reproductive capacity over other aspects of my health. I want to be healthy as I get older, but I also want to accept my aging (and for the people around me to accept it), rather than feeling constant pressure to stave it off. Applewhite wants women of all ages to see 'later life as a time of enormous power and liberation and possibility,' and I'd like to see it that way too, not as something to be avoided at all costs. When I shared some of these concerns with Williams, he asked me if I'd feel the same trepidation around treatments that focused on other areas of the body. 'You want to extend normal heart function, liver function,' he said. But 'for some reason, if you say, we want to slow ovarian aging, that touches on a very different note.' It's a fair point, especially since a lot of the health outcomes he and others are trying to promote aren't about fertility or attractiveness or any of the attributes our culture demands that women maintain in our quest to remain forever young — they're about things like cardiovascular and mental health. I want those! Williams argued that understanding ovarian aging might actually remove some of the negative messages around menopause and getting older more generally. He also studies recurrent miscarriage, which 'has always had a tremendous amount of stigma associated with it.' What's helped reduce that stigma has been 'when it goes away from this realm of myth and taboo and folklore, and we start to understand the process,' he says. It's worth noting that research into menopause, like so much work on reproductive health and indeed health in general, is imperiled under the Trump administration. When I tried to visit the website for Jill Biden's menopause initiative, I found that it was gone. Renee Wegrzyn, the head of the initiative, was fired in February. In a time when a lot of medical research is simply disappearing, it's hard to look askance at treatments that could improve people's lives. After talking to Williams and other experts, I'm not against the idea of a medication that could help people live longer without heart attacks or cognitive decline. But as I get older, I'm also keenly aware that what happens outside our bodies can affect our health as much as what happens inside them. When I asked Pines what she'd like to see for people in perimenopause and menopause right now, she said she wants a future when people in this stage of life 'are not dismissed,' when 'we can talk about menopause the same way we talk about puberty.' She'd also like to see workplaces support women experiencing perimenopause symptoms, including by offering insurance plans that cover the treatment of them. And she wants OB-GYNs, internists, and other doctors to be specifically trained in perimenopause and menopause, something that's often lacking.
Vox
01-05-2025
- Politics
- Vox
Would a baby boom be good for kids?
is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed. Would kids be happier if there were more kids in the world? Getty Images/fStop This story originally appeared in Kids Today, Vox's newsletter about kids, for everyone. Sign up here for future editions. The pronatalists have entered the White House. Today, however, I want to look at pronatalist policies through a slightly different lens: whether they benefit kids. People who want to boost birth rates generally talk about the importance of children to society as a whole: We need more kids, they often say, to pay into Social Security and take care of us when we're old. But what about the kids themselves? Are pronatalist policies, and pronatalism in general, in their best interest? In some cases, these questions can be easily answered with data. In others, they're more about values. Is a world with more kids inherently better for kids? Is championing childbirth the best way to show kids that they're valued? The answers to these questions are complex, but the experts I spoke to were clear about one thing: If the United States aims to be a pro-child country, we have a long way to go. The idea that really helps kids Of all the pronatalist policies reportedly under consideration, one is straightforwardly good for kids, experts told me. That would be the one where the government gives parents money. Five thousand dollars may not pay for day care — and it may not substantially boost birth rates — but it could be enough to allow a parent to stay home for a few more weeks with a new baby, said Karen Guzzo, a family demographer and director of the Carolina Population Center at the University of North Carolina at Chapel Hill. That extra leave would benefit baby and parents alike, research suggests. The money could also help defray the costs of a birth (often expensive even with insurance) and of necessities like car seats and strollers (which could be about to go up in price). If it helps keep families solvent during a time of financial upheaval, a baby bonus could benefit children in the long run, since financial stability is good for kids' health and learning. 'I'm all for giving families money,' Guzzo said. In fact, a similar policy already had impressive results. During the Biden administration, the American Rescue Plan expanded the child tax credit from a maximum of $2,000 to between $3,000 and $3,600 per child per year, and made it fully available to poor families. As a result, child poverty dropped to the lowest level on record, and the number of kids going hungry appeared to decrease as well. However, the expanded child tax credit lapsed at the end of 2021, and child poverty immediately spiked again. Republicans are reportedly interested in bringing the expanded credit back, but the path for any legislation remains unclear. For now, 'it is frustrating to hear that we are thinking of giving one-time bonuses when we already had a plan that worked' to reduce child poverty, 'and we got rid of that,' Guzzo said. Is it better to be one of many? Other policies reportedly under consideration, like giving a medal to moms with more than six children or reserving a certain percentage of Fulbright scholarships for married people or parents, are unlikely to do much of anything for kids or birth rates, according to Philip Cohen, a sociology professor at the University of Maryland who studies demographic trends. But more broadly, it's worth thinking about whether the pronatalist project in general — producing more births — is good for children. Some observers argue that certain countries with low birth rates have become actively anti-child. In South Korea, for example, hundreds of restaurants, museums, and other public spaces bar children from entering. These 'no-kids zones' make life difficult for parents, who have begun to campaign against them, but they arguably limit kids' opportunities to enjoy and learn about the world as well. 'We don't fund school systems, we don't fund child care, we do not fund leave programs. We are so not pro-family in the United States.' — Karen Guzzo, director of the Carolina Population Center at UNC at Chapel Hill If pronatalism led to more children and therefore more tolerance of children in public space, or even to child-friendly urban design, it could benefit kids. For example, child-centric neighborhoods where kids were able to 'flow out their doors' and form 'their own little society' would be both fun for kids and beneficial for them as adults by potentially making them more self-sufficient and able to advocate for themselves, Trent MacNamara, a history professor at Texas A&M University who has written about fertility rates, told me. Some experts worry about the decline of autonomy and free play among children today, and for MacNamara, it's possible to imagine that having more children around could bring some of that freedom back. 'Maybe if you do build a more child-centered society, it's easier for parents to think of kids as running their own show,' he said. There are also intangibles to think about — the joys (and trials) of growing up with a lot of siblings, or a lot of cousins, or as part of a big generation. Having a lot of kids around helps both adults and other children get in touch with 'their wilder side' and 'let go a little bit,' MacNamara said. However, because pronatalism often goes hand in hand with patriarchal values, it's not necessarily great for the roughly half of children who happen to be girls, Cohen noted. It's also not completely clear that a world with more births is always a better one for kids. Around the world, 'the decline of fertility has been a key part of rising living standards' for kids and adults alike, Cohen said. Fewer kids can mean more resources per kid — for example, falling birth rates in the US are one reason that state and local governments have been able to expand publicly supported preschool. Birth rates falling below a certain point could be bad for kids — if, for example, their schools close. But when it comes to policy, the most pro-child ideas aren't necessarily the ones advocates typically bring up to increase birth rates. Kids need food, housing, health care, and education, and they need 'the confidence that those things will be there for them in the future, and that their families will be there for them in the future,' Cohen said. Policies that would bring stability to parents and kids include robust paid leave, access to health care before and after birth, and subsidized high-quality child care, Guzzo told me. Some pronatalists have pushed for such supports, but right now, they feel out of reach in many parts of the country. 'We don't fund school systems, we don't fund child care, we do not fund leave programs,' Guzzo said. 'We are so not pro-family in the United States.' What I'm reading Three children who are US citizens were sent to Honduras last week along with their mothers, who were deported. One is a 4-year-old with Stage 4 cancer who was removed from the country without his medication, advocates say. Cuts to the federal government have had a profound effect on programs serving kids, affecting everything from education to safe drinking water. My little kid and I have been reading Nothing's Wrong! a picture book about an anxious rabbit and the bear friend who makes him feel better. My kid refers to this only as 'the cool book,' for reasons that remain unclear. From my inbox Last week, my story about mental health days for kids reached Sean, a reader who is a high school student in California, when he was, in fact, taking a mental health day. 'There is a freedom in knowing that when I take on things outside of school to boost my college resume, I can also alleviate some of the pressure that school puts on me,' he wrote. 'Yesterday, the thought of going to school made me feel zombified and my usual motivation had melted away, but by the time Monday rolls around, I expect to feel at least somewhat motivated to go.'
Vox
24-04-2025
- Health
- Vox
Should kids get mental health days?
is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed. This story originally appeared in Kids Today, Vox's newsletter about kids, for everyone. Sign up here for future editions. It's a stressful time to be a kid. Young people are watching environmental disasters, school shootings, and economic and political uncertainty, all with a level of media (or at least social media) coverage that would have been unimaginable for previous generations. Against this backdrop, they're also expected to have their lives figured out by an early age, and rack up a laundry list of achievements to cite in an increasingly lengthy and comparison-filled college application process. 'You almost have to start working on your college career in middle school,' Jennifer Rothman, director of youth and young adult initiatives at the National Alliance on Mental Illness, told me. Related The new burnout generation Given all this, it's perhaps no surprise that kids need a break. Mental health days — a day off to deal with depression or anxiety, or simply to tend to mental well-being, gained currency among adults during the early part of the Covid-19 pandemic — and they've taken off among young people as well, with at least 12 states passing laws allowing excused absences for mental health reasons. But as chronic absenteeism remains a problem around the country, some school officials are worried that giving kids mental health days could encourage an attitude that school attendance is optional. 'There's a lot of misconceptions about how important it is to be in school — if I didn't come to school at all in the pandemic, why do I urgently have to keep coming to school now?' Kent Pekel, superintendent of Rochester Public Schools in Minnesota, said during a webinar last year, according to EdWeek. While concerns about mental health are far from gone, they're also being joined by fears of learning loss and the acknowledgement that missing even a few days of school can be detrimental to kids' education. There's also a widespread worry that students are reaching college, the job market, and the ballot box without basic skills like reading. Some experts also caution that taking a day off for the wrong reasons could actually make matters worse. 'When you get yourself in the trap or downward slide of school avoidance, that's really hard, and it happens really quick,' Sarah Cain Spannagel, a clinical psychologist in Cleveland who works with children and families, told me. How can kids, families, and educators navigate all this? How do we support kids through a time that's often scary even for adults, while also making sure they get an education? I posed these questions to experts this week, and the answers I got suggested that while a day off won't cure a kid's depression or anxiety (sadly, that doesn't work for grown-ups, either), time for reset and recovery can help protect kids from getting to a crisis point in the first place. A day off could even show families and schools what's missing from a kid's life, leading to less stress and pressure in the future. A mental health crisis for teens Doctors and teens alike have been especially concerned with young people's mental health in the last five years, with Vivek Murthy, the US surgeon general under President Joe Biden, warning in 2021 of a mental health crisis among adolescents. More recent surveys have shown some improvement in the prevalence of teen sadness and depression, but clinicians are still seeing 'alarming rates' of anxiety and depression, as well as suicidality and self-harm, Amber Childs, a psychiatry professor at Yale School of Medicine who works on youth mental health, told me. Allowing mental health days can also help destigmatize mental illness, and encourage young people to be open about any struggles they're going through, rather than hiding them, kids and experts say. Among teens, mental health days have emerged as a popular coping strategy. Students began advocating for them even before Covid hit, and lawmakers in states from Oregon to Utah have agreed, giving kids a designated number of mental health days per year, or simply changing the definition of an excused absence to include psychological reasons. While hard numbers on how many days kids are actually taking are hard to come by, the practice seems to be increasing, perhaps driven by a growing awareness that psychological well-being is as important as physical health, Spannagel said. The concept of a mental health day might sound pretty foreign to previous generations. Growing up, 'I never got any days off,' Rothman of the National Alliance on Mental Illness, who has three teenagers, told me. 'Your parents were kind of like, you either have to have a fever or you're throwing up, that's the only way you're staying home.' But adults today need to understand 'how different the world is now for our kids than it was for us,' Rothman said. Because of social media, young people today don't have much downtime from social interaction, news, or, well, anything really, Childs told me. Being able to unplug 'not only from our digitally enabled lives, but also from the routine things that happen in the social and academic space' can be positive, 'whether or not something bad is happening.' Allowing mental health days can also help destigmatize mental illness, and encourage young people to be open about any struggles they're going through, rather than hiding them, kids and experts say. The right way to use mental health days However, the way we often think about mental health days might not be the most helpful for kids. Rather than using them when a child is already in crisis — 'taking the release valve off of the pressure cooker,' as Childs put it — families and schools should use them as 'a preventative tool' to keep that pressure from building up in the first place. Ideally, parents can look ahead to a time when kids might have a lot of stressful events coming up, like big exams or performances, then schedule a day off ahead of time. They should also plan how to use the day well. 'A mental health day doesn't equate to chilling on a couch for eight hours straight binging TikTok and television,' Childs said. Instead, Rothman suggests getting outside, reading, drawing, or playing card games — 'whatever is calming and helps them feel more like themselves.' For teenagers especially, a day off could be a time to just catch up on sleep, something they're often lacking due to early high school start times. What kids feel the need to do on a mental health day can also give adults 'clues about what might be crowded out during a typical school day or week,' and help build those activities back in on ordinary days so kids don't get as stressed out and depleted, Childs said. (If kids keep taking days off to sleep, it might be time for the school to consider a later start time.) Taking a day off shouldn't be a way for kids to avoid something they're anxious about, like a class, a difficult friendship, or school in general, experts say. Childs suggests that parents look for patterns — if kids keep asking for a mental health day on a Monday, it's an opportunity to delve deeper into what's happening at school on Mondays that might be stressing them out. If requests for a day off are very frequent, or if feelings around them are intense, it could be a sign that 'you're getting avoidance of a problem that most likely is going to be there in two days' when the kid goes back to school, Spannagel said. Meanwhile, if symptoms like stress or sadness are going on for more than two weeks, or parents see major changes to behavior like eating or sleeping, it could be time to reach out to a child's primary care doctor to have them evaluated for mental health conditions, Rothman said. Kids with ADHD, autism, or learning differences might need the reset of a mental health day more than the average kid, to help them recover from sensory overload or fatigue, Spannagel said. At the same time, a kid frequently feeling too exhausted or overwhelmed to go to school could mean they need additional help with executive functioning or social skills, or that the accommodations they have at school aren't meeting their needs. When it comes to concerns about absenteeism and academics, families and teachers can have a conversation about making up any work a child misses on an occasional day out, Spannagel said. And while some fear that allowing mental health days could encourage kids to skip school, that concern is 'giving me like, if we talk about sex with them, they're going to want to have more sex,' Childs said. 'I think the question is more complex, which is: What about the current environment has lent itself to kids not feeling engaged in school?' Mental health support goes beyond a single day A few mental health days aren't going to fix problems with the school environment, not least because giving a kid a day off in the middle of the school year just isn't possible for every family. Experts don't recommend leaving kids home alone if they're struggling mentally, and many parents don't have the job flexibility to take extra time off with their kids. But schools can help by building aspects of a mental health day into the school week, adding time to shift the focus 'away from academics and performance into exploration of self,' Childs said. Having resources in the classroom, like a quiet corner where kids can take a moment to themselves, can also help support kids' mental health day-to-day, Rothman said. (My older kid's teacher brought this calming dog stuffie to their classroom in the fall, and I honestly would like one for myself.) Talking about mental health in school is also crucial, whether that's part of a formal program or just a teacher 'being open about the things that they're feeling,' Rothman said. 'It fights the stigma around it.' What I'm reading Seventy-four percent of teens say social media helps them feel more connected to their friends, but 48 percent also say the platforms harm people their age, according to a new Pew Research Center survey. The Trump administration is reportedly seeking to eliminate Head Start, the federal program that provides early education to more than half a million kids from low-income families. One graduate calls the program 'one of the few times in my early life where I felt truly loved, seen and supported in a place of learning.' Health and Human Services Secretary Robert F. Kennedy Jr.'s remarks about children with autism who 'will never pay taxes' recall the dark history of eugenics, writes Jessica Grose at the New York Times. My older kid and I are reading the Aster series of graphic novels, about a little girl who moves to the countryside so her mom can pursue her career as a robot-bird scientist, leading to friendships with an 800-year-old woman, a sheep wearing a tie, and three chestnuts who are also knights, among other colorful characters. From my inbox Two weeks ago, I wrote about how tariffs could drive up the cost of items like strollers and car seats, making it harder to have a kid in America. Reader Diana Braley responded, 'As a mom in 2025, I've realized raising kids doesn't have to be as expensive as society makes it seem.' 'Raising children has always required commitment, support, and resilience — not consumerism,' Braley wrote. 'Big companies sell us the idea that spending more makes us better parents. But the truth is, our instincts and community matter more than any fancy product.'
Vox
10-04-2025
- Business
- Vox
Trump just made it harder to have a kid in America
is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed. This story originally appeared in Kids Today, Vox's newsletter about kids, for everyone. Sign up here for future editions. Having a baby is expensive. You need a car seat. A stroller. A high chair. You need the baby shampoo and then the different baby shampoo for when your baby is allergic to the baby shampoo (maybe just me?). All told, it costs about $20,000 to care for a baby for a year in the US, according to BabyCenter. And thanks to the slate of new tariffs announced on April 2 by the Trump administration and imposed in recent days, it's about to get a lot more expensive. Trump reversed some tariffs on Wednesday after markets plunged, but went on to increase tariffs on China to 125 percent, while maintaining a 10 percent baseline tariff on goods from nearly all other countries. The tariffs will affect a wide variety of goods, but experts and advocates have voiced special concern about baby items like cribs and strollers, many of which are manufactured overseas, often in China. These items aren't optional: 'The baby has to sleep somewhere,' Martha Gimbel, executive director and co-founder of the Budget Lab at Yale, told me. Even after Trump's partial reversal, parents could have to contend with myriad price increases for smaller items, from onesies to blueberries. The Budget Lab, which analyzes the impact of federal policy proposals, has estimated the tariffs announced as of April 2 could cost an average household $3,800 per year, or $73 per week, a cost that could hit families especially hard during the early years of parenthood, already a time of enormous financial upheaval. 'The Trump administration maintains regular contact with business leaders, industry groups, and everyday Americans, especially about major policy decisions like President Trump's reciprocal tariff action,' White House deputy press secretary Kush Desai wrote in an email in response to my question about tariffs and costs. 'The only special interest guiding President Trump's decision-making, however, is the best interest of the American people — such as addressing the national emergency posed by our country running chronic trade deficits.' Related Trump threw the economy into chaos because of a bizarre misinterpretation of one statistic Trump's concern with trade deficits is at odds with some of his other stated priorities. He has said 'we want more babies' in America, and advisers and members of his administration have repeatedly advocated for boosting birth rates. But Trump's tariff policies risk making it harder for Americans to have children and forcing families to make difficult choices that could affect kids' quality of life. 'You're taking money away that parents can spend on their children,' Gimbel said. 'It means that parents can invest less in their kids.' Which baby necessities will be most affected by tariffs? Last week, on what he called 'Liberation Day,' Trump announced tariffs of at least 10 percent on all imported goods, with items from some countries, like China, subject to rates of 34 percent or more. He had previously announced (and in some cases walked back) tariffs on products made in China, Canada, and Mexico; steel; cars, and more. On Wednesday, hours after the 'Liberation Day' tariffs went into effect, the White House backed down on some of the highest rates but actually increased the tariff on China. Trump's trade policy remains rife with uncertainties and could certainly change yet again. However, some lawmakers were worried about the impact of tariffs on families even before 'Liberation Day.' On April 1, Rep. Kelly Morrison (D-MN) and 44 other members of Congress sent a letter to Commerce Secretary Howard Lutnick, warning that the proposed tariffs (then just on Canada, Mexico, and China) would 'raise the cost of goods necessary to care for young children, such as car seats, high chairs, strollers, and cribs.' A lot of these items, including popular brands like Chicco and UppaBaby, are manufactured overseas, according to Consumer Reports. They're already expensive, often costing hundreds of dollars; a stroller and car seat are often the most costly items parents buy for a new baby. 'Car seats are not optional; they are mandated by law.' — Dipanjan Chatterjee, vice president and principal analyst at the research firm Forrester It's difficult to know exactly how much tariffs will raise prices, because businesses could respond to higher costs in different ways (and because it's unclear how long the tariffs will stay in place, or whether their size will change). But just to give a sense of what the current tariffs look like in raw numbers, one fairly standard model of Chicco car seat, made in China, retailed for $209.99 at Amazon on Wednesday morning; adding a 125 percent tariff to that would bring the total to $472.48, or about a $262 difference. Even Trump's original proposal of a 34 percent tariff would hike the cost by about $71. Many parents will have no choice but to pay the higher prices, because items like car seats are needs rather than wants. 'If the price of avocados increases, most people will likely buy less — they may skip them entirely, swap queso for guacamole, or invite fewer friends so they have to make less guacamole,' Dipanjan Chatterjee, vice president and principal analyst at the research firm Forrester, told me in an email. 'However, car seats are not optional; they are mandated by law.' Most hospitals require a car seat to even discharge a baby after birth. While the big stuff like strollers and car seats may be the most visible, tariffs could impact a host of smaller items as well. Babies and young kids famously grow out of (and poop all over) their clothes incredibly quickly, necessitating constant replacement. With clothing prices expected to rise, 'the financial burden on parents is significant, and it is one they will have to contend with over and over again,' Chatterjee said. Diapers and formula — two more huge line items in family budgets — are often made in the US, but not always. During our interview, Gimbel discovered that her 9-month-old's diapers were made in Canada and hastily took steps to order more. Then there's food, likely one of the first categories to show price increases due to tariffs, according to Gimbel. Fresh fruit, in particular, is often imported, and tariffs could drive up families' already considerable berry budgets. Families may be able to switch to cheaper options, but young kids are less flexible around food than adults are, and grocery bills were straining many parents' finances even before tariff talk began. High prices will hit families with kids especially hard Higher prices on items like strollers and car seats could push more parents toward Buy Nothing groups and other secondhand solutions, already popular in many urban areas. But that won't work for everything — car seats, for example, have expiration dates after which they're no longer considered safe, and some experts recommend against getting them secondhand. Also, 'you cannot get secondhand diapers,' Gimbel said. Finding a used alternative for other items is also an additional task for overstretched parents. Tariffs will force them to pay more either in money or in time spent sourcing cheaper options, Gimbel said. New parents are also ill-placed to afford sudden price hikes. They tend to have lower incomes than the average American, in part because they're simply earlier in their careers, Gimbel said. Families with babies and young kids also often see their household income drop because one parent takes unpaid time off to care for a child (the US remains the only wealthy country without nationwide paid parental leave). Those most affected by tariffs will be working-class and poor families, because any price increase represents a larger percentage of their income. A $262 price hike on a car seat (or even a $71 hike), for example, is going to hurt a lot more if you make $30,000 a year than if you make $100,000. Lower-income families will have to make more difficult sacrifices if prices rise, said Kimberly Clausing, an economist at UCLA. That could mean skimping on basic necessities like heat, food, or medical care. Low-income families are also more vulnerable if tariffs lead to a recession, something many experts predicted after Liberation Day. 'It's not just 'pay more at the store,' it's the fact that you might lose your job and your livelihood altogether,' Clausing said. Related America may be headed for this rare type of economic crisis And while parents will surely do their best to shield their kids from the impact of higher prices and economic turmoil, suddenly having less money in the house has an effect on kids too. Policies that put money into parents' pockets, like publicly funded child care and child tax credits, can improve outcomes for children, improving high school graduation rates and even boosting future earnings. A policy that takes money away from parents could have the opposite effect, Gimbel said, disadvantaging kids down the road. Supporters of Trump's tariffs have argued that Americans are too accustomed to 'cheap goods.' But the impact for families won't just be about making do with a smaller TV. It could mean sending your kid to school in shoes that hurt, or stopping contributions to a college fund, or foregoing therapy for a child with a disability because you can no longer manage the cost. 'Having more money to be able to spend on and invest in your kid makes a difference to you, and it makes a difference to your kid,' Gimbel said. Having less money will make a difference, too. What I'm reading The Trump administration has gotten rid of an office responsible for overseeing child care centers in federal buildings, which could lead to higher costs and center closures. A second child has died as the measles outbreak that began in Texas continues to spread. In better news: About two weeks ago, a mother and three children — a third-grader, a 10th-grader, and an 11th-grader — were taken into immigration custody in Sackets Harbor, New York, the small town where Trump 'border czar' Tom Homan lives. But after hundreds protested and the principal of the children's school wrote a letter emphasizing 'how long every hour feels for a third grader in a detention center,' the family was reportedly released this week. My older kid and I have been reading The Legend of Brightblade, a graphic novel about a society rebuilding itself after a period known as 'the dark years.' From my inbox I've been thinking a lot about young kids and the future recently, and how talking to them can force us to step outside the confines of our current moment and consider how different the world could look in 10 or 20 years. In the coming weeks, I'm planning a newsletter on kids' hopes and dreams, and I'd love to hear from you: What do the kids in your life want to be when they grow up? What do they want to do in the world? Let me know at
