Promoting health equity through poverty alleviation policy: Factors associated with receipt of the 2021 US Child Tax Credit in a nationwide sample

Introduction: The 2021 temporary expansion of the U.S. Child Tax Credit (CTC) was a potent policy that addressed poverty as a critical social determinant of health. Yet policies can only have their intended effects if they are implemented appropriately, and it is well known that not all who were eligible for the CTC received it. In this study, we investigated which individual-and state-level factors were correlated with receipt of the 2021 expanded CTC among eligible families.Methods: We used data from the U.S. Census Bureau Household Pulse Survey and included 76,994 CTC-eligible individuals. We used multivariable logistic regressions to evaluate individual-and state-level factors associated with self-reported CTC receipt during July-December 2021.Results: Roughly two-thirds of the CTC-eligible sample reported CTC receipt. CTC receipt was higher among eligible individuals who were female, aged 35-44 years (relative to younger individuals), Black, and married. Receipt was also higher among those with at least some college education, two or more children, and family income above $25,000, and among recipients of the Supplemental Nutrition Assistance Program (SNAP) and Medicaid. For state-level factors, SNAP and Medicaid caseloads and the state earned income tax credit rate were associated with decreased receipt.Conclusion: As Congress debates whether to make the CTC expansion permanent, this study provides timely evidence to inform poverty alleviation programs to increase participation among eligible and marginalized groups and achieve health equity.