End Diaper Need and Period Poverty: Families Need Cash Assistance to Meet Basic Needs

Everyone should have the resources to ensure they can maintain their health and that of their children without sacrificing their financial stability. But even before the COVID-19 pandemic, many families struggled to afford their material basic needs, including diapers and menstrual products.

A study conducted by Yale University researchers found that nearly 3 in 10 of the nearly 900 parents with low incomes surveyed in New Haven, Connecticut, could not afford diapers; a small study of about 200 women with low incomes in St. Louis, Missouri, found that nearly two-thirds reported they had struggled to afford period products in the previous year. The struggle to afford material basic necessities is a growing public health crisis in the United States; industry-funded national studies on diaper need and period poverty echo the findings of the smaller academic studies.

Diaper Need and Period Poverty Force Difficult Choices

Diaper need. When families struggle to afford diapers, it forces them to choose between their children’s health and other needs:

• Families may keep diapers on for too long or empty solids and reuse disposable diapers, resulting in rashes, urinary tract infections, or worse.
• Diapers, which cost nearly $100 per month per child, can be a serious burden for parents with low earnings and those who are out of work or unable to work.
• Many child care providers require parents to provide diapers each day. At one diaper bank, 56 percent of parents who needed child care to go to work reported missing work because they lacked diapers.

Diaper need has other implications: one study of 296 low-income women found a correlation between diaper need and maternal depression. The study by Yale University researchers concluded that an adequate supply of diapers could reduce parenting stress.

Period poverty. The cost of menstrual products also can lead people to make difficult choices between their health and other basic needs:

• People facing period poverty may use other household items to manage their period, or ration pads or tampons to make them last longer. This can contribute to poor physical health outcomes such as infections, irritation, and abnormal discharge.
• An inadequate supply of period products impacts other aspects of a person’s life: although data on period poverty are limited, an online study by George Mason University researchers of 472 college-attending women found an association between struggling to afford menstrual products and depression.

Lack of access to hygienic toilets and handwashing spaces combined with anti-period stigma contribute to negative physical, mental, and social outcomes for people with low incomes around the world.

Inequitable Consequences of Diaper Need and Period Poverty

Diaper need exacerbates existing inequality among infants and toddlers and their caretakers.

• Very young children are more likely to live in poverty, partly because younger parents have lower incomes (on average) than people further along in their careers, and families with infants and toddlers often face high costs for child care, making it harder to make ends meet.
• In 2019, 1.7 million infants and toddlers lived in families with incomes below the poverty line, with higher poverty rates among Black and Latino infants and toddlers than white infants and toddlers.

Gender and racial disparities in poverty and hardship mean that period poverty falls more heavily on some groups.

• Women are more likely to be poor than men; Black and Latina women face particularly high rates of poverty.
• Trans people are more likely than cisgender people to face economic challenges that can compound period poverty and menstrual stigma.

Current Public Policy Fails to Meet Material Basic Needs

The existing systems to support individuals, children, and families fail to provide material basic necessities, including diapers and menstrual products.

• Many families’ cash incomes are too low to afford the basics, including diapers and menstrual products. And many public benefits, including the food-based programs Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), do not cover menstrual products or diapers. Medicaid does not cover menstrual products and only covers diapers when they are medically necessary — and this coverage varies by state.
• While diaper banks are a critical resource for families, they rely almost entirely on philanthropy and do not have sufficient funding to meet the overwhelming need in local communities.
• Twenty-seven states impose a sales tax on period products, and 36 states charge sales tax on diapers, despite exempting many other necessities, such as food and medicine.

In recent years, some progress has been made: in the United States, six states require schools to provide free period products, and 13 states mandate their availability in prisons and jails. The CARES Act included a provision allowing health savings and flexible spending accounts to cover menstrual products. In 2017, California’s legislature passed a $30 per child monthly diaper benefit for Temporary Assistance for Needy Families (TANF) participants, and in 2021, four states provided budget funding directly to diaper banks. Legislators in Congress have introduced bills addressing period poverty and diaper need in recent years, particularly as exacerbated by the pandemic.

While this is important progress, far more needs to be done to help individuals and families make ends meet.

Families Need Direct Cash Assistance to Meet Their Material Basic Needs

Direct cash assistance can support families’ budgets, help them afford necessities such as diapers and period products, and enable them to choose how to allocate funds to meet their basic needs. Policymakers should:

Expand TANF cash assistance: TANF cash assistance can be used to purchase diapers and period products because it is provided as cash grants to families. But TANF fails to reach most families in poverty, and benefits in every state are insufficient to meet a family’s basic needs; at nearly $100 per month, diapers alone would consume more than one-quarter of the monthly benefit for a family of three in 20 states. States should expand TANF, increasing benefits and easing accessibility, to ensure families can afford personal care products.

Continue the landmark expansion of the Child Tax Credit: The Child Tax Credit, recently expanded to support families with the lowest or no incomes, will be a key source of regular income for families in 2021 (monthly payments started in July 2021). This expansion is projected to cut child poverty by more than 40 percent. The monthly payment structure — rather than the previous lump sum payment, which makes budgeting for basic needs difficult — better enables families to purchase the products they need on a regular basis. Policymakers should ensure that the American Rescue Plan’s temporary expansions to the Child Tax Credit are continued so families with children can have reliable cash support for their basic needs.

Provide more adequate assistance for adults without children: Adults without children struggle to afford menstrual products but have access to very little assistance if their incomes are low. For adults (who aren’t over age 65 and don’t have disabilities) without children, there is no federal cash assistance program and state programs are limited or nonexistent; their SNAP benefits can be taken away after just three months if they are out of work and aren’t in a training program (when certain pandemic-related provisions aren’t in place). And in states that have failed to adopt Medicaid expansion, these adults often have no access to health coverage through Medicaid even if their income is below the poverty line. Prior to this year, the Earned Income Tax Credit (EITC) for adults without children who have low earnings was tiny. The EITC was expanded in the American Rescue Plan for just one year, so extending that expansion is a key way to help this group.