July 5, 2022

Tax Prep Services at Child Wellness Visits Linked to Better Health Outcomes

Drazen Zigic, Getty Images

New study reaffirms that caregivers want financial service programs that are easy to access and embedded in a trusted institution.

The Bottom Line

Parents and guardians want easily accessible financial services in institutions they trust, which builds upon their own efforts to foster a better economic future for themselves and their children. Medical settings can meet these needs by embedding financial services within clinics and community settings to help create economic mobility, like Boston Medical Center’s StreetCred program.


Many families, especially those historically marginalized like impoverished communities and communities of color, do not have access to financial services that allow them to plan for their families’ futures. This means that, especially in a world-class city like Boston, the racial wealth gap is astronomical. The StreetCred program at BMC makes it easy for parents, who may not have had physical or educational access to financial services, to utilize them at the pediatrician’s office.

A new study from researchers at Boston Medical Center, published in The Journal of Developmental Behavioral Pediatrics sought to address this gap, and understand how likely caregivers were to use a financial institution that was embedded in a trusted setting like a hospital or school.

Study Objective

To understand a head of household’s experiences with or aspirations of economic mobility and whether they would use a financial service embedded in a setting like a hospital or school.

The Details

In this study, StreetCred offered free tax preparation to 18 English-speaking parents or guardians at Epiphany School, a community school in Boston for children from economically disadvantaged households. Parents or guardians were interviewed prior to and after filing their 2019 taxes (with roughly half who chose to file using the StreetCred tax service) for information about how they saw financial strain impacting their family’s future, their efforts to create economic mobility and stability, and their experiences with and perceptions of the StreetCred tax service and other financial services.

Almost all the parents or guardians identified as being of color, primarily Black or African American, and were able to give important insights into factors that contribute to racial and socioeconomic inequities in child health and development, including racial stigmatization by financial service personnel. At least half of the participants were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the Supplemental Nutrition Assistance Program (SNAP), and utilized subsidized or public housing.


Researchers developed the following grounded theory model based on their 5 key thematic findings to describe the acceptability and use of financial services within the context of parents’ lived experiences and pre-existing efforts to build economic mobility:

  1. Families experience multi-level barriers to economic mobility.
  2. Despite these barriers, parents are already proactively working to build economic mobility by empowering the next generation with knowledge, skills, and assets and
  3. Resiliently pursuing economic goals.
  4. As a result, parents will accept empowering, nonjudgmental, expert, and trustworthy financial services that contribute to their existing efforts.
  5. To move from acceptance to use, financial services must be effectively publicized, accessible, and supportive.

The findings of this study align with previous literature that found poverty is associated with additional social and mental health stressors that negatively affect parenting and maternal-child health. This means that services like StreetCred, which are embedded in institutions, need to offer consistent support to adequately manage an individual’s financial future and sustain their engagement with the program.  

Pull Quote

“Participants endorsed the StreetCred tax service as a much-needed, empowering, trustworthy, and accessible alternative to the for-profit tax preparation industry. Providing a bundled, bi-generational approach supports families’ ability to build long-term economic mobility more than providing tax preparation services alone.”


Alexander, S. P., Kim, I. (C., Hatcher, C., Suh, H. S., Ha, Y., & Marcil, L. E. (2022). Embedding financial services in frequented, trusted settings: Building on families’ pre-existing economic mobility efforts. Journal of Developmental & Behavioral Pediatrics, Publish Ahead of Print. https://doi.org/10.1097/dbp.0000000000001091

Blair, C., & Raver, C. C. (2016). Poverty, stress, and Brain Development: New Directions for Prevention and Intervention. Academic Pediatrics, 16(3). https://doi.org/10.1016/j.acap.2016.01.010

Boston Medical Center. (2022). Embedding Financial Services in trusted settings addresses poverty and improves health equity. Boston Medical Center: Press Releases.

Florant, A., Julien, J. P., Stewart, S., Yancy, N., & Wright, J. (2021). The case for accelerating financial inclusion in Black Communities. McKinsey & Company.

Rios, S. (2021). $8: The complicated story behind one of the most repeated statistics about Boston. $8: The Complicated Story Behind One Of The Most Repeated Statistics About Boston | WBUR News.

Street Credit: About. Street Cred. (2021). Retrieved from https://www.mystreetcred.org/about#our-model

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