A Holistic Approach to State Policymaking That Strengthens Families by Advancing Equity

A multi-state laboratory explores the interconnectedness of programs and policies to find ways for all families to thrive.

Families don’t live in silos—one silo for health care, one for child care support, and yet another for food assistance. They need all those things—and more—to build strong and healthy futures for their children.

That’s why at the Robert Wood Johnson Foundation (RWJF), we're supporting a multi-state laboratory for advancing policies that strengthen families across a range of issues. The Center on Budget and Policy Priorities (CBPP) is the hub for this initiative. We are administering $2.65 million in grants to state-based organizations working to ensure that children and families get the support and resources needed to raise healthy kids through policy and systems change.

That means instead of addressing one issue at a time—e.g., child care supports or family leave—an array of issues are being addressed simultaneously. These include child care and family leave and minimum wage and job training and other policies that can help families get ahead. These policy levers are interconnected, playing off each other, which is why a holistic approach is needed to make real progress in families’ lives.

With technical assistance and other support from CBPP, states are working both offense and defense—driving policy conversations on, for example, the need to improve cash supports for working families while defending core safety net programs like SNAP that are under attack in many states.

Working Within an Equity Frame

Equity is key to this work. Every project in the initiative seeks to reduce disparities and structural barriers to opportunity while promoting inclusion across race, ethnicity, gender, socio-economic status, and citizenship lines.

In Virginia, the work of The Commonwealth Institute (TCI) is a good example of a state grantee working to advance equity across multiple issues simultaneously, including paid family and medical leave, a state refundable earned income tax credit (EITC), and a minimum wage raise.

“Virginia has made major strides in recent years in terms of improving health care access through Medicaid expansion, but more needs to be done,” says Laura Goren, TCI’s research director. “We’re looking across the social determinants of health for ways to help stabilize families—such as EITC and other types of income supports, which have big effects on the health of families and children.”

TCI has committed to an explicit focus on equity—addressing race and disparities across all its policy work.

“In Virginia, the conversation is always about race, even if nobody’s saying the word,” Goren says. “If we do not engage openly in that conversation, then we allow it to be used as the silent dog whistle. We are better off if we engage honestly and explicitly on policy changes that we can make to increase opportunities for communities of color and on how that helps all everyday Virginians.”

For example, Virginia’s “upside-down” tax system places unfair burdens on low-income African-American and Latinx families, who wind up paying disproportionately high shares of their income in state and local taxes—a result of Virginia’s sales and excise taxes, property taxes, and relatively flat income tax.

Refundable tax credits for families with low and moderate incomes, like EITC and the Child Tax Credit (CTC) can help correct this unfairness. These credits not only increase incomes and reduce poverty but have been linked to improvements in birth outcomes, maternal health, and, for children’s school achievements.

But Virginia doesn’t have a refundable EITC. As a result, working families in Virginia—and particularly families of color—can’t fully access these benefits or the full value of what they’ve earned.

Family and medical leave is another example. Everyone should be able to care for themselves and their loved ones without risking their jobs or financial wellbeing. But in Virginia, 70 percent of Latinx workers and 60 percent of African-American workers either don’t qualify for unpaid family and medical leave or can’t afford to take it. A statewide paid family and medical leave program would give more families a chance at a healthier and more prosperous future—especially families headed by women of color, who tend to earn low wages while often facing significant caretaking responsibilities.

Context is Key to Understanding Challenges

Freddy Mejia, TCI’s health care policy analyst, says legislators need to understand not only that racial disparities exist but why they exist.

“As a policy organization, it’s easy to just point out the differences in outcomes, but it’s vitally important to explain why those outcomes look they way they do,” he says. “We have to let people know who we’re talking about and the historical and present-day barriers they’re fighting.”

Most of TCI’s work involves educating policymakers, businesses, and other influencers, using its own research and real-life stories of the challenges so many families face.

In addition, TCI is holding a series of listening sessions in communities of color to get a better understanding of their everyday challenges and of the policy changes that would benefit them most. The first session engaged teenagers and young adults in Petersburg, an older, predominantly African-American city that has suffered from disinvestment in recent decades. Health outcomes there are poor and the high school dropout rate is high.

These kinds of meetings help researchers and advocates make the connection between policy and “real life.”

 “That’s hard for us as policy wonks to get sometimes—how to make policy problems that hit close to home feel more relatable to people,” says Goren.

That kind of understanding is also critical to reshaping the narrative about what working families need to live with dignity and set their kids on paths toward healthy and productive lives.

Through the multi-state initiative, RWJF has invested $1.64 million in 21 “rapid response” grantees around the country with resources and intensive, tailored technical assistance on policy opportunities at the state level. In addition, the initiative’s Focus State Fund supports three states—Georgia, Kansas, and New Mexico—with more intensive investments to strengthen their policy, organizing, and advocacy capacity to develop and drive longer-term safety net agendas.

Each state is a different story, with a unique set of challenges and historical and contextual factors. While the overarching goal is to build a Culture of Health where all families can thrive, the strategy and tactics for achieving that goal may differ from state to state.

We hope that, through this initiative, family advocacy groups at the state level can learn from each other’s experiences and successes.

We invite you to share your ideas and lessons learned about how policy and advocacy can advance equity with us.