Building blocks: how a lack of childcare infrastructure is hurting children and their parents

In mid-March, The Daily Yonder published a piece detailing social worker and filmmaker Laura Norton-Cruz’s efforts to bring awareness to the lack of childcare infrastructure in rural Alaska. Norton-Cruz is intimately familiar with the shortage of childcare, and the problems this shortage creates for rural Alaskan families. The Daily Yonder writes:

Norton-Cruz remembers finding out that she was pregnant and feeling like she’d just been “thrown to the wolves.”  “What am I going to do about child care?” she asked. “What am I going to do about breastfeeding and pumping at work? What am I going to do about paid leave?"

Over a decade after becoming a single mother, Norton-Cruz enlisted the help of filmmaker Joshua Branstetter and created At Home/In Home: Rural Alaska Childcare in Crisis, a documentary that would provoke Alaska’s state legislature.

Norton-Cruz’s documentary focuses on Kotzebue, Alaska, a rural town of 3000 residents, primarily Alaskan Native people. More than 500 children under the age of five reside in Kotzebue, yet the town does not have a single licensed childcare facility. 

Unfortunately, Kotzebue is not unique. According to a December 2024 report from the Alaska Governor’s Task Force on Child Care, 61% of Alaskans have limited or no access to licensed childcare facilities, even though over half of young children live in households where all parents are employed and need childcare.

The documentary portrays parents who are forced to leave jobs in childcare deserts, employers who cannot find employees, public officials who track the economic damage of the childcare crisis, and residents who battle the state childcare licensing system as they try to establish a home-based childcare facility.

Childcare deserts are not just present in rural Alaska. In fact, nearly two-thirds of American rural families live in a childcare desert. Childcare deserts are defined as areas where there are more than three young children for every licensed childcare slot available. 

Additionally, rural Americans spend more money and travel farther for childcare arrangements. On average, a rural family spends 12.2 percent of their income and travels 7.5 miles for childcare while urban families spend 10.8 percent of their income and travel 3.5 miles for childcare. (Read more about rural childcare here and here).

The lack of infrastructure to support women and children is a recurrent problem in rural areas, and expands beyond a lack of childcare. A 2023 CDC report found that only 31% of rural municipalities had some type of paid maternity leave in 2021 compared to 41.2% of urban areas, and 42.3% of rural municipalities provided break time and space to pump breast milk versus 55.4% of urban municipalities.

It is well documented that rural areas are also lacking in maternal care. As of 2024, 59% of rural counties qualify as maternity care deserts. As a result, rural women have consistently higher predicted probability of maternal mortalities, with 37.9 pregnancy-related deaths per 100,000 occurring in rural areas in 2020 and 31.2 deaths per 100,000 in micropolitan areas, compared to 29.9 per 100,000 in large metropolitan areas. (Read more about rural maternal health care here and here).

Alaska is a particularly challenging place to deliver health and human services due to its vast size, sparse population, extreme climate, and the unique needs of its diverse communities, including Native populations. As such, rural Alaskan populations often face even more extreme disparities in healthcare access and outcomes.

Thankfully, Norton-Cruz’s film has prompted the Alaskan governor to set up the Alaska Child Care Task Force, which has allowed Kotzebue residents to erect a home-based non-profit early learning program. Although residents admire the program’s progress, the early learning program only serves eight of the 500 children under the age of five in Kotzebue. Clearly, there is still much work to be done. 

Norton-Cruz continues to document the Task Force’s progress. She states:

We have to keep paying attention to this issue and keep the pressure on…because that’s what leads to changes in funding and changes in policy. We need to help employers, legislators, and leaders see that this is the most important part of child development and the most abandoned policy issue of our time.