Childcare Costs Consume 20% of Household Income in South Carolina, Threatening Economic Security

COLUMBIA, S.C. (April 27, 2022) — Beaufort ranks the healthiest in South Carolina and Dillon is the least healthy county in the state, according to new County Health Rankings data from the University of Wisconsin Population Health Institute (UWPHI). The Rankings are available at

For more than a decade, the Rankings’ data, evidence, guidance and stories have broadened the nation’s understanding of the multiple factors that shape health. This year, we introduce seven new actionable measures that local communities can consider as they work toward improving health for everyone. As the nation recovers from a generation-defining crisis, this year’s Rankings explore what it takes to rebuild in ways that ensure economic security and health for everyone.

“Working together, we can transform public goods such as affordable and accessible childcare, quality public schools, and jobs that treat people with the dignity they deserve and the wages that will support their families,” said Marjory Givens, co-director of the County Health Rankings & Roadmaps. “This would not only ensure a just recovery from the pandemic for families and communities today but greater economic security, better health and well-being for generations to come.”

Economic security allows for families to do things like pay rent, access education and obtain childcare, which all contribute to their health and well-being. The pandemic exacerbated the economic struggles of families with children and finding affordable childcare was particularly difficult.

The South Carolina report reveals that for a family with two children, on average, 20% of household income goes to childcare. When a single expense consumes the majority of a paycheck – especially one as essential as childcare – families are unable to afford other necessities. The impact of the childcare cost burden is even more stark when exploring differences in household income by race and ethnicity. When we look at median household income by race, a Black family in South Carolina has a median household income of $36,271, while an Asian family’s median household income is $74,108. These income disparities demonstrate how economic security is not equally accessible to all people living in South Carolina.

"According to the Center for the Study of Child Care Employment, South Carolina has over 353,000 children ages 0-5 but only 12,350 people in the early childhood teaching workforce — a workforce with a poverty rate of 14.3%. Affordable, accessible childcare is vital to strengthening our communities," said Maya Pack, executive director, South Carolina Institute of Medicine and Public Health (IMPH) “At IMPH, we work to collectively inform policy to improve health in South Carolina in part by addressing social determinants of health, including childcare, and are committed to doing our part to demonstrate and address the significant racial and ethnic inequities in health status and outcomes in our state. We must prioritize making childcare more affordable, while properly supporting and compensating our early education workforce."

"It's clear that these rankings show across several factors that we have wide disparities in South Carolina between more affluent counties and counties with less access to the social and economic factors that positively influence South Carolinians’ ability to reach their best health,” said Dr. Brannon Traxler, public health director, S.C. Department of Health & Environmental Control. “Our goal at DHEC is to eliminate health disparities by working together with our partners and communities to reduce inequities in the health determinants, leading to a healthier South Carolina."

The pandemic was hard on working families, revealing gaps across the nation in childcare affordability. The U.S. Department of Health and Human Services’ benchmark suggests that childcare is no longer affordable if it exceeds 7% of a household’s income. As it stands, there is not a single county in the country where childcare costs for two children are at or below the affordability benchmark.

Affordable, high-quality childcare is vital to building healthy communities. It lays a solid foundation for academic achievement for children, allows parents and caregivers to more fully participate in the workforce, and puts the nation on a path to a fair and just recovery.

This year’s What Works for Health includes a curated list of actionable strategies related to family and social supports, income and education that can support local changemakers as they work to expand economic opportunity. Each strategy is rated for its evidence of effectiveness and likely impact on health disparities. The Take Action Center also provides valuable guidance for communities who want to move from data to action.

About the County Health Rankings & Roadmaps

The County Health Rankings & Roadmaps is a program of the University of Wisconsin Population Health Institute (UWPHI) supported by the Robert Wood Johnson Foundation. The Rankings, available at, provides local communities with data on more than 90 health-influencing factors such as housing, education, jobs, and access to quality health care.

About the University of Wisconsin Population Health Institute

The University of Wisconsin Population Health Institute advances health and well-being for all by developing and evaluating interventions and promoting evidence-based approaches to policy and practice at the local, state, and national levels. The Institute works across the full spectrum of factors that contribute to health and equity. The Institute promotes an exchange of expertise between those in academia and those in the policy and practice arena. The Institute leads the work on the County Health Rankings & Roadmaps. For more information, visit

About IMPH

The South Carolina Institute of Medicine & Public Health (IMPH) is a nonpartisan, nonprofit organization working to collectively inform policy to improve health and health care in South Carolina. In conducting its work, IMPH takes a comprehensive approach to advancing health issues through data analysis and translation and collaborative engagement. IMPH seeks to achieve its mission by convening a diverse group of stakeholders around health issues important to South Carolina. Learn more at