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Advancing Health and Wealth Integration in the Earliest Years

The Health & Wealth Connection

for Young Children

Annie Harper, Ph.D.
Program for Recovery and Community Health
Yale School of Medicine

Children in the earliest months and years of life are impacted by the bidirectional health-wealth connection more intensely than any other age group.
While many factors determine a young child’s future health, their family’s socioeconomic and educational status are by far the most significant.


Children are affected by their parents’ stress levels, even before they are born. As children grow to be adults, the effects of their early life stresses may be transmitted through biological mechanisms to their children, continuing the cycle of adversity.
Toxic stress that is long-lasting or frequently repeated can have serious, long-term negative effects on growing children’s bodies and brains, particularly when the adults in their lives are overwhelmed themselves.

One of the conditions causing toxic stress for both children and adults is the accumulated burden of economic hardship over time.

Families that are economically secure are less likely to experience toxic stress, thereby avoiding a cycle of negative health-wealth impacts that crosses generations.


Wealth inequality in the U.S. is far more pronounced than income inequality; the top 1% own 35% of the total wealth.

Historical and ongoing structural racism, including discriminatory practices in education, employment, credit markets, and criminal justice, is a root cause of the extreme racial wealth inequality in the U.S.
Even in equal economic circumstances, living with the effects of structural racism and discrimination and related anxiety can cause toxic stress.
Single mothers, particularly women of color, are most likely to lack assets to get through these crucial life moments.
Families without assets are more likely to take on high-cost debt. Parents who are stressed due to debt may work long hours, be preoccupied, and be less patient. They are more likely to experience stress, anxiety, and depression, particularly if they have taken on unsecured debt, and to engage in short-term coping strategies with harmful, longer-term financial and health consequences.
The effects are multi-generational. Even more than income, wealth begets wealth in the next generation.
The advantages of wealth accumulate across future generations; similarly, the disadvantages of low wealth compound over the years.

Promising Practices

Alongside supporting the health, development, and wellness of small children, government agencies, asset-building organizations, and health providers are offering timely and tailored services to parents to increase financial stability and assets. Common programmatic elements include:

  • Meet parents with limited time and resources where they are

  • Connect to new parents through trusted advisers

  • Build on existing strategies that are already working


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Bold, new investments are needed for meaningful financial inclusion and equity that support improved health outcomes for our youngest.

Building on but going beyond programmatic interventions, change is needed at the systems level to support families struggling with low wealth and the persistent negative impacts of historical and structural racism, and to prevent our future children from suffering the negative impacts of low wealth and poor health. The current health and economic crises has revealed that many families are living at a precarious financial edge.

  • Families need higher, more stable, and predictable incomes.
  • Families without assets, particularly families of color whose opportunity to build wealth has been stymied, need injections of assets to provide a foundation on which to build equitable wealth.
  • Families need access to affordable, healthy housing.
  • Working parents need good employee benefits and access to paid family leave and affordable child care to enable them to balance work-life obligations.
  • Young parents and their children need access to quality, affordable and unbiased health care to ensure good health in-utero and beyond.
  • Children can benefit from quality, early educational and behavioral health interventions to help mitigate the impact of earlier stresses.
  • Across this continuum of services is a need for trauma-informed systems and services, given the prevalence of toxic stress and trauma in families with low wealth.


The following are strategic recommendations for investing in integrated health-wealth strategies for young children and their families.

To spark the thinking of potential and existing grantees, and support the actions listed below, funders can:
  • Change grant guidelines or applications to be more intentional about health-wealth integration.
  • Add reporting requirements that reflect the health-wealth framework and impacts.
  • Promote collaboration or aligned efforts in communities.

Build capacity and expand scope of trusted entities.

Replicate proven and promising strategies.

Connect more families with supports that increase financial stability and asset building, and expand on those supports.

Promote policy and systems changes that create healthy conditions in which children can grow and thrive.

Support innovative research focusing on pregnant women, new mothers, and young children.

Invest in achieving equity.

Children’s first years set the stage for the rest of their lives. Because they are still growing and developing, the bidirectional health-wealth connection impacts young children intensely. We have an obligation to provide our youngest with the opportunity to reach their full potential.

The Asset Funders Network (AFN) is a membership organization of national, regional, and community-based foundations and grantmakers strategic about using philanthropy to promote economic opportunity and financial security for low- and moderate-income Americans.
AFN works to increase the capacity of its members to effectively promote economic security by supporting efforts that help low- to moderate-income individuals and families build and protect assets.
Through knowledge sharing, AFN empowers foundations and grantmakers to leverage their resources to make more effective and strategic funding decisions, allowing each dollar invested to have greater impact.