Jeffrey D. Colvin, MD, FAAP
Director, Research, General Academic Pediatrics; Medical Director, Center for Family & Community Connections; Medical Director, Legal Services Clinic at Broadway; Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Clinical Associate Professor of Pediatrics, University of Kansas School of Medicine
Full BiographyHank T. Puls, MD
Director, Pediatric Hospital Medicine Research; Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Clinical Assistant Professor of Pediatrics, University of Kansas School of Medicine
Full BiographyJeffrey Colvin, MD, JD, General Academic Pediatrics, and Hank Puls, MD, Pediatric Hospital Medicine, received a five-year, $2,430,100 R01 grant from the National Institutes of Health (NIH)’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The federal grant is for their project “Explaining State Variability in Pediatric Hospitalizations and Reported Child Maltreatment,” and covers the project period of Sept. 15, 2025-July 31, 2030 (Award No. 1R01HD116843-01A1).
The rate of pediatric hospitalizations and child maltreatment are higher in families with low socioeconomic status (SES) than those with higher SES. However, these rates show a considerable variation across states. Drs. Colvin and Puls believe this could be due to differences in state safety net policies supporting low-income families.
This study will examine state safety net policies to identify whether they improved the health and wellbeing of children in families with low SES. The team will research four policies including state earned income tax credits, state child tax credits, state child and dependent care tax credits and state minimum wage. Simultaneously, pediatric hospitalizations, child maltreatment reports and pediatric emergency department visits will be analyzed quarterly over a 15-year period to understand any associations with these state policies.
Drs. Colvin and Puls preliminary data has shown that there is a connection between safety net policies and lower child maltreatment reports at the state-level. However, this data is limited to state-level and may be contingent on the type of policy. The team plans on analyzing two types of state policies — “bolus” and “continuous” — at a deeper level to determine whether the different types affect the wellbeing of children. State tax credit policies provide “bolus” income, meaning they distribute a large lump-sum payment annually, while minimum wage policies provide “continuous” income, supporting individuals with smaller payments throughout the year.
This is the first study to analyze different types of safety net polices and their relationship to pediatric hospitalizations, emergency department visits and reports of child maltreatment, while avoiding limitations of previous studies by researching information in smaller geographical areas. This study will expand awareness and understanding on the understudied area of state safety net policies and their effect on the health and wellbeing of children.
“While these policies are not primarily intended to impact children's health, measuring any unintended spillover effects on the wellbeing of children would be valuable,” said Drs. Colvin and Puls.
Co-investigators on this study are Donna Ginther, PhD, University of Kansas; Paul Chung, MD, MS, Kaiser Permanente; Matthew Hall, PhD, Children’s Hospital Association; Michelle Johnson-Motoyama, PhD, Ohio State University; and Scott Burris, JD, Temple University.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.