Work

The Impact of the 2021 Child Tax Credit on Perinatal Health: Evidence From the Expansion and Postexpiration Periods

Year: 2026

Type: article

Abstract: INTRODUCTION: The perinatal period is a pivotal life stage that profoundly influences lifelong health and well-being. In 2021, the U.S. temporarily expanded the Child Tax Credit, providing monthly payments during July-December 2021 and the remaining lump-sum payment during the 2022 tax season. This study examines the impact of the 2021 expansion on perinatal health among low-income families. METHODS: Data were drawn from national birth certificate data (January 2021-December 2022) and were restricted to women covered by Medicaid, who are likely to be low income. A quasi-experimental event-study design was used to compare perinatal outcomes over time between women with and without previous live births, who had different exposure patterns to the 2021 expansion (N=2,485,813). Analyses were conducted in January-May 2025. RESULTS: The Child Tax Credit expansion was associated with increased appropriate-for-gestational-age births and decreased small-for-gestational-age and large-for-gestational-age births. Effects were most pronounced immediately after expiration of monthly payments (1.17 percentage points; 95% CI=0.45, 1.88)-potentially reflecting the cumulative impact of 6 months of income support-and several months after the lump-sum distributions, waning by the end of 2022. For maternal outcomes, an increased likelihood of hypertensive disorders of pregnancy and a decreased likelihood of no/late prenatal care were observed during the monthly payments period and persisting through the end of 2022. Sensitivity analyses supported the robustness of the findings. CONCLUSIONS: These results suggest that the expanded Child Tax Credit had positive effects on certain perinatal outcomes among low-income families, highlighting the potential of income support policies to reduce health inequities during a critical life stage and informing policymaking.

Source: American Journal of Preventive Medicine

DOI: 10.1016/j.amepre.2026.108360

Authors: Guangyi Wang, Kaitlyn E. Jackson, Rita Hamad

Institutions: Harvard University, University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies

Language: English

Topic: Maternal and Neonatal Healthcare

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Estimated APC paid: $3,300