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Why does the Cost of Child Care Matter for Children’s Health?

High quality child care is the cornerstone of a healthy community. With access to quality care, parents can go to work knowing that their children are safe and supervised. Children in quality care can build the skills and habits they need to live healthy, vibrant lives. For many families, the alarmingly high cost of child care puts high quality options, and their health benefits, far out of reach.


The immediate benefits of healthy child care are obvious. Children eat nutritious food, breathe air that is free of pollution, play on safe, clean equipment and forge the nurturing relationships and problem-solving skills they need to build healthy minds and bodies. Many high-quality programs offer regular developmental assessments to make sure that kids are growing properly and parents know where to get help if a problem emerges. The healthy habits that children learn in child care—washing hands, eating good foods, getting their hearts pumping and learning how to be caring and well-behaved kids—are habits that last a lifetime.

What we don’t often talk about though is how much those healthy, quality child care environments impact long-term health and education. Children who attended high quality child care programs go farther in school, have higher incomes, and are less likely to use drugs or be involved in the criminal justice system. . Children who eat healthy food and are in the habit of getting up to 60 minutes of active play each day are less likely to be on a path that leads to diabetes, heart disease, cancer or stroke. Children who have had positive, consistent, nurturing caregivers are less likely to have behavioral problems and more likely to thrive in school. Early education settings influence what we call “social determinants of health”—the opportunities, resources, and living conditions that affect whether people are as healthy as they can be. 

The high-quality care that children need to grow up healthy does not come cheap. Safety is a top priority for parents and providers, but ensuring a safe environment is costly. Low staff-to-child ratios, safe equipment, and adequate space are huge drivers of the cost of child care, but they are absolutely necessary for keeping kids safe and healthy—not just because they supervise kids from injury and illness, but because it means they are also more able to have positive, meaningful interactions with children. These interactions are linked to better educational outcomes. . Staff need training and materials to develop high quality learning activities and provide children the social and emotional support they need to reach their potential. Hiring, training, and retaining good staff is a significant and essential expense for child care providers.  

Across the United States, the cost of child care is staggering. The US Department of Health and Human Services recommends that families should not pay more than seven percent of their household income to cover the cost of child care. Child Care Aware of America’s signature annual report Parents and the High Cost of Child Care: 2017 found that the average family in every state is paying far more than that. In every region of the country, average child care fees for an infant in a child care center are more than the average amount that families spend on food and transportation combined. Child care fees for two children in a child care center are higher than the annual median rent payments in every state.

We know that high quality care is essential to positive child development, particularly for children from low income families. We also know that it is far too expensive for most families. So what can we do? The Cost of Care report highlights several strategies that can raise the quality of care while also making it more affordable for more families.

  • Estimating the cost of quality and building incentives for programs to meet higher standards
  • Strengthening child care businesses by forming alliances for shared services
  • Funding early childhood education through taxes and fees for services and commodities
  • Pass legislation to support working families

Another important way to raise quality is to raise the standards that child care programs must meet in order to be licensed or to earn a high-quality rating in state QRIS. We need to be sure that as we do so, we talk about how health in many forms—social emotional health, environmental health, physical health, nutrition—must be included in definitions of quality and that we fund training and supports for teachers, directors, family child care providers and families on how to keep kids healthy. Voices for Healthy Kids funding is available for advocates who are working to create healthier child care environments. To learn more, visit