Flint has one of the highest rates of child poverty in the United States at nearly 60%, triple the national average. The simplicity of this program for expectant mothers simplifies enrollment, reduces stigma and administrative friction, and perhaps most importantly, builds trust — critical in the maternal‑infant period when economic shocks are common and improvements to early development are most effective.
Spending Trends
In a May 2024 survey, mothers reported these household choices:
- Improved healthcare access (59%)
- Strengthened household finances (80%), and increased parental confidence (80%)
Notably, 70% of respondents reported an annual income under $10,000.
These spending patterns address a common concern about “misuse.” In the first months, households directed the cash to core needs that stabilize infant care, housing, and access to medical appointments — investments that compound over the child’s first year and beyond.
Early Outcomes
Beyond the survey, the Maternal Wellbeing Research Study compared self‑reported outcomes before and after Rx Kids launched, and inside versus outside Flint. Among low‑income respondents, key findings:
- Housing stability – Flint families in 2024 (the Rx Kids cohort) were more likely to be current on rent/mortgage and owed substantially less if behind. Critically, no low‑income Rx Kids families reported an eviction postpartum—a reversal from 2023, when Flint families were more likely to report eviction than non‑Flint families.
- Material hardship – Improvements on 8 of 9 hardship indicators for Flint 2024 vs. Flint 2023, including an 8.2‑point increase in reporting “enough of the kinds of foods we want.” Several differences were statistically significant at p < 0.05.
- Mental health – Compared to 2023 Flint births, 2024 Flint mothers were ~10 percentage points less likely to screen positive for depression (CES‑D‑10 ≥10) and 6 points less likely to screen positive for anxiety (GAD‑2 ≥3). Mothers were also more likely to rate their mental health as excellent/very good and to report feeling loved, hopeful, valued, and respected. Several effects reached p < 0.05 in the difference‑in‑differences models.
In its first months, Rx Kids reduced hardship, improved housing stability, and strengthened maternal mental health—all during the period when families face the steepest drop in income and the highest costs of caregiving.
Methodology
- Cohorts – The evaluation surveyed mothers (18+) who gave birth at Hurley Medical Center between July 2023–June 2024, grouping them into four cohorts: 2023 non‑Flint, 2024 non‑Flint, 2023 Flint (pre‑Rx Kids), and 2024 Flint (Rx Kids).
- Data sources – Participant survey (GiveDirectly) and Maternal Wellbeing study; outcomes are self‑reported; findings are preliminary pending peer‑reviewed publication.
- Survey operations – >2,000 mothers invited; >1,000 completed (51% overall response; 54% among 2024 Flint).
Learnings
Pregnancy‑to‑age‑1 is an important lever. Concentrating cash in this critical early window produced rapid, measurable gains on hardship, housing, and maternal wellbeing. Counties can adapt this “maternal and infant direct cash transfer” to local birth volumes and costs, while also dramatically improving impact per contributed dollar.
- Universal design at this critical juncture is essential. The simplicity and lack of barriers fosters trust, uptake, and dignity — ensuring near‑total coverage of newborns, while reducing ongoing administrative burden.
- Consistent spending on essentials. The spending profile data on essentials (baby items, food, rent, utilities, transportation) in Flint demonstrates compelling alignment with infant stability and parental capacity goals.
- Pair cash with measurement. The Rx Kids evaluation shows that county‑grade evidence is possible quickly with difference‑in‑differences and clear, validated survey instruments—an attractive proposition for results-oriented donors.
References
Hanna, Mona, and Luke Shaefer. “Results from the Rx Kids Participant Survey & Maternal Wellbeing Research Study,” Methodology (Hurley Medical Center cohorts; difference‑in‑differences). Rx Kids, 2024. https://RxKids.org.