From seven years of annual polling in Tennessee and Georgia, and a nationally representative study in JAMA Health Forum, these five issues have consistently elevated — regardless of where parents live or how they vote. Policy recommendations are in development and will be tested with parents before they are finalized.
In Georgia, nearly one in three families with children report food insecurity. In Tennessee, we found similar rates — year after year. Parents describe adjusting meals, going without themselves so their children can eat, and navigating benefit systems designed to screen people out.
This is not a marginal issue. Food insecurity is associated with worse school performance, higher rates of chronic illness, and long-term economic harm to children. The research on consequences is overwhelming. The policy response has not matched it.
91% of Georgia parents support free school meals for all children — a figure that holds across income, race, and political affiliation. Universal free school meals is among the clearest areas of bipartisan consensus we have documented.
These directions have emerged from our research. We will test them with parents before they become part of the formal Same Sky agenda.
Food insecurity in childhood is associated with significantly increased risk of chronic conditions including diabetes, obesity, and behavioral health disorders — all of which are more expensive to treat than to prevent. Every dollar invested in child nutrition returns an estimated $3 in reduced healthcare and social costs.
The mental health gap — between children who need care and those who receive it — is among the largest we measure. Nationally, children need mental health services at nearly twice the rate they access them. Wait times of months are common. In many rural communities, providers are simply unavailable.
In our Tennessee polling, 37% of parents cited children's mental health as their top concern — more than any other issue. That number has held for seven consecutive years. The pandemic accelerated the crisis; it did not create it.
This is a bipartisan issue. Parents across party lines agree that children cannot access mental health care quickly enough, affordably enough, or in their own communities.
These directions have emerged from our research. We will test them with parents before they become part of the formal Same Sky agenda.
Untreated childhood mental health conditions are strongly associated with school dropout, substance use, incarceration, and reduced lifetime earnings. The economic burden of pediatric mental illness — including lost productivity and downstream healthcare costs — is estimated in the hundreds of billions annually.
Parents describe long drives to find a provider, insurance coverage that vanishes without warning, and waiting months for specialist appointments. Rural families face the largest barriers. Children with Medicaid are disproportionately affected by coverage gaps and provider shortages.
In our nationally representative voter survey, 66% supported consistent Medicaid coverage for all children — a majority that crosses party, income, and geography. The challenge is not public will. It is administrative fragmentation, inadequate provider payment rates, and coverage instability.
Preventive care in particular suffers. Well-child visits, developmental screenings, and dental care are all underutilized relative to both need and the evidence on their long-term impact.
These directions have emerged from our research. We will test them with parents before they become part of the formal Same Sky agenda.
Children without consistent coverage are more likely to delay care, use emergency departments for primary care needs, and develop complications from untreated conditions. Medicaid coverage gaps in early childhood have measurable effects on educational attainment and adult health outcomes decades later.
One in 100 infants in the United States enters foster care. Parents who know families touched by the child welfare system — especially in communities affected by the opioid crisis — describe a system that separates before it supports, and that struggles to reunify even when reunification is appropriate.
In our polling, majorities across party lines support treatment over family separation for parents with substance use disorders. They support expanded kinship care. They support earlier intervention before a crisis reaches the removal threshold.
Foster care youth and children with special health care needs are among the most underserved by existing policy, and among the least represented in national advocacy. Same Sky explicitly includes them in its measurement and its agenda.
These directions have emerged from our research. We will test them with parents before they become part of the formal Same Sky agenda.
Children who experience foster care have significantly elevated rates of mental health disorders, educational disruption, homelessness, and involvement with the justice system. The intergenerational costs of child welfare system contact — when family preservation is feasible — are among the highest of any social policy failure.
Firearms are the leading cause of death among children and adolescents in the United States. This is not a contested finding. It has been replicated across multiple surveillance systems and research groups.
In our nationally representative voter survey, 79% supported child firearm safe storage laws — a majority that holds across party affiliation. Safe storage is among the clearest areas of bipartisan consensus in our entire evidence base.
Same Sky does not take a position on the Second Amendment or on broader gun policy. Our focus is narrow and supported by the evidence: children are dying preventably, safe storage reduces those deaths, and voters overwhelmingly support it.
These directions have emerged from our research. We will test them with parents before they become part of the formal Same Sky agenda.
An estimated 54% of firearm deaths among children occur with weapons that were stored unlocked in the home. Safe storage, when implemented, reduces pediatric firearm injury and death. The cost of inaction is measured in preventable deaths — at a scale that dwarfs many other child health priorities receiving more federal attention.
Parents raised them. The data confirmed them. The policy agenda is being built from there.