Closing the Diaper Gap in Oregon

Sh*t should only do one thing when it comes from a baby — hit a clean diaper.

Sh*t should only do one thing when it comes from a baby — hit a clean diaper. But, the existence of diaper privilege means that’s not true for every child. If you went for a walk around the Pearl District, you’d encounter diaper privilege, likely from two parents dishing on their diaper strategies. They may be using Earth Baby, a compostable diaper delivery service. Or they might prefer diapers designed by Kristen Bell. Parents in other parts of town would be having a different conversation. They’d likely complain about the high cost and low availability of diapers, especially with supply chain issues mounting. And, if they knew that the State of Oregon was putting barriers in front of parents searching for affordable diapers, those parents would surely be yelling rather than just talking.

One Pediatrics study of urban parents documented that one in three could not afford diapers, which can come to nearly $100 per month per child; the percentage of parents unlikely to meet that diaper budget is likely higher among Portland parents. The monthly costs to support a family of four in the Portland-metro area surpasses $8,000. For a single-parent household relying on a minimum wage job in Oregon, the stakes are even higher; infant care costs can top 58.8% of their income, according to the Economic Policy Institute.

Inadequate access to quality diapers can lead to a whole lot of messes. Beyond the obvious ones, diapers that are changed too infrequently or reused too regularly can result in costly outcomes. The increased incidence of rashes, urinary tract infections, or worse can force families to pursue ever more expensive interventions, such as doctor’s appointments and prescriptions. 

Access to diapers is essential because they’re often required for another core aspect of parenting — child care. Absent diapers for their child, parents may have their child care options reduced to a few, lower-quality settings. If child care becomes inaccessible, then a parent’s employment prospects may decline. At one diaper bank, more than half of parents who rely on child care to attend work reported having missed days because of a dearth of diapers. 

Beyond the professional, physical, and financial costs, diaper-related issues can pose mental issues to parents. Researchers in a Health Equity study detected a positive correlation between a need for diapers and maternal depression.

This diaper divide can and should be closed. Limits on what social safety net funds can go toward diapers ought to be lifted. For instance, a California family relying on Medi-Cal for basic services cannot use such funds for diapers until the child is five years old — five years too late. Even if the child met the age threshold, the family would only qualify if the diapers were “prescribed by a physician for use in chronic pathologic conditions that cause the recipient’s incontinence,” according to the Medi-Cal guidance sheet. In Oregon, parents must receive prior authorization from a medical provider to receive support for diaper purchases. These barriers reflect fears that lowering barriers to diapers will result in waste and scams. Those fears have not been realized. That’s why in Colorado parents enrolled in Denver Health Medicaid Choice receive a two-month supply of diapers at birth and then additional supplies every time they visit the doctor. No clandestine diaper exchanges have emerged in the Rockies.

The Obama White House tried to raise this issue but the diaper shortage rages on. Wealthy parents use their Costco memberships to grab a hot dog for a $1.50 and discounted diapers for $0.16 per diaper. Meanwhile, low income families may pay twice as much per diaper because of a lack of access to bulk-buying options. At the state level, leadership from Assemblywoman Lorena Gonzalez Fletcher in California back in 2017 resulted in greater state subsidization of diapers for low-income parents, but we're capable of going further to ending this divide. Despite the political capital being spent on this issue and resulting newspaper coverage, there’s still a need to raise awareness of this issue. 

Closing the diaper divide isn’t the sort of thing that requires a cost-benefit analysis, engagement with lobbyists, and a feasibility study, we simply need to guarantee access to clean diapers. State legislators can help close the divide by changing their respective state medicaid requirements to ensure parents can more easily qualify for financial assistance with diapers. The philanthropic community can also play a role. Foundations and well-endowed individuals can and should invest more in no-strings-attached diaper disbursement by doubling the number of diaper banks, with a priority on doing so where infant care costs are highest. There’s three NDBN-member diaper banks in Oregon, with sufficient awareness and funds, these banks can become as accessible and efficient as ATMs.

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Kevin Frazier edits The Oregon Way between classes at the UC Berkeley School of Law. He grew up in Washington County and looks forward to returning home after graduation and a clerkship.

Photo credit: "do we need to buy any diapers today? 'NO!' - DSC03377" by sean dreilinger is licensed under CC BY-NC-SA 2.0