This article is part of a series from San Diego Foundation that provides voters with an independent and objective explanation of the issues Measure B focuses on and how it could affect San Diego County communities.

In Brief

• The San Diego child care crisis reflects a widening gap between what quality care costs to provide, what families can afford and how much licensed care is available.
• Statewide, licensed child care is available for only 26% of children with working parents or guardians, according to the California Child Care Resource & Referral Network.
• Infant care in San Diego County can cost roughly $25,000 annually at mid-range rates and more than $33,200 in some parts of the county, according to YMCA of San Diego County Child Care Resource Service data.
• Child care shortages affect children’s development, family finances, parents’ ability to work, employer productivity and the broader economy.
• Infant and toddler care is especially difficult to find: YMCA of San Diego County’s 2026 supply mapping found that 75% of county census tracts qualify as child care deserts for children under age 2.

What Is the Child Care Crisis?

The child care crisis refers to a widening gap between the cost of providing quality child care and what families can afford to pay for it—a mismatch that leaves parents struggling to find care, providers struggling to stay in business and children missing out on early learning opportunities. Researchers and advocates often call this a broken market: one where providers are underpaid even as families face costs that rival a mortgage payment.

In San Diego County, 77% of parents say finding child care is a significant challenge, according to regional cost and access data by The RAPID Survey Project, based in the Stanford Center on Early Childhood. An estimated 66% of families live in a “child care desert,” meaning there are at least three children for every one licensed child care slot. Nearly half of working parents with children under age 5 have no available licensed care options at all, per a University of San Diego Nonprofit Institute report that describes the local sector as being “in crisis.”

It isn’t only parents who are struggling. More than 4 in 10 child care center employees—the people with whom our region’s youngest children often spend most of their waking hours—rely on at least one public safety-net program to meet their own basic needs, according to San Diego County’s most recent early care and education workforce study.

Why does this keep happening? Because child care is a labor-intensive business with high fixed cost and thin margins. Providers are often forced to choose between charging parents what care actually costs, or what families can actually afford—and neither option is sustainable on its own.

Why Does Child Care Matter?

Child care matters because it directly affects all of us, whether or not we have children. It shapes children’s development, parents’ ability to work, employers’ productivity and retention, community stability and the strength of the regional economy. The sections below examine those impacts in more detail.

As one 2025 Stanford Center on Early Childhood study put it: “Predictable and nurturing caregiving contributes to positive early childhood development, and more work is needed to support families with infants and toddlers looking for child care.”

Why Is Child Care So Expensive?

Child care is expensive because it is a labor-intensive service with high operating costs, limited revenue per classroom and a subsidy system that often does not cover the full cost of care. Safety and quality requirements, including adult-to-child ratios, are an essential part of providing appropriate care, but they also shape the economics of how many children a provider can serve.

Child Care Requires Significant Staffing

Staffing is one of the largest costs for child care providers because young children require close supervision and hands-on care.

California law requires licensed providers to maintain specific adult-to-child ratios—1:4 for infants and toddlers, and 1:12 for preschoolers, according to state licensing requirements. These minimum ratios are important for protecting children’s health and safety and for providing developmentally appropriate care.

They also shape how child care businesses operate. A provider can only enroll a limited number of children for each staff member, which limits how much tuition a classroom can generate.

This is especially significant for infant and toddler care. Younger children require more staff per child, more hands-on supervision and additional supplies such as formula, diapers and other essentials. As a result, infant and toddler classrooms are generally more expensive to operate even though providers can charge higher tuition.

Labor Costs Are High

Because staffing is tied directly to enrollment and ratio requirements, labor makes up the majority of a child care facility’s operating costs.

In San Diego’s high cost-of-living market, providers face a difficult balance: they need to pay workers enough to recruit and retain qualified staff without raising tuition beyond what families can afford.

The median wage for a center-based lead teacher is $24 per hour; assistant teachers earn a median of $20 per hour; family child care assistants earn a median of $18 per hour, according to the 2025 San Diego early care and education workforce study.

An earlier San Diego County study put average annual wages for child care workers around $29,280, below what’s considered a self-sufficiency wage in San Diego.

The workforce challenges are significant. Between 70% and 93% of providers report difficulty hiring qualified staff. More than a third report difficulty retaining staff, and annual turnover is estimated at 24% to 30%. Nearly half of family child care providers earn so little they rely on public assistance themselves.

Subsidized Care Doesn’t Cover the Real Cost

Government subsidy programs help eligible families pay for child care, but demand far exceeds available funding.

In California, only 16% of eligible children are enrolled in state-funded programs. In San Diego County, the rate is somewhat higher at 22%, but still far below need.

A county needs assessment found more than 75,000 San Diego children eligible for subsidized care, with fewer than 3,000 enrolled in state-funded slots.

Even when families qualify, the reimbursement rates paid to providers are based on outdated cost methodologies that don’t reflect the true cost of providing care.

Parent fees typically cover only about half the actual cost of high-quality infant care and roughly two-thirds of preschool care, with providers absorbing the difference or seeking additional funding.

Transitional Kindergarten is Reshaping the Market

California’s expansion of Universal Transitional Kindergarten is also changing the economics of child care.

As more four-year-olds move into free UTK classrooms, child care providers are losing a segment of enrollment and shifting toward serving more infants and toddlers—a costlier and lower-margin population to serve, reshaping the business model for many providers.

How Does the Child Care Crisis Affect Children?

Access to quality child care can affect brain development, school readiness and outcomes that last into adulthood. The first five years of life are the foundation for lifelong development, and the brain develops faster during this period than at any other point in life, according to Harvard’s Center on the Developing Child. Those early years form the neural connections children rely on for communication, emotional regulation and motor skills.

That development is shaped largely by the environments and relationships surrounding a child. Consistent, warm interactions through what researchers called “serve and return” engagement with a trusted adult reinforce healthy brain architecture. Chronically stressful early environments, by contrast, can produce effects that last into adulthood, according to research on toxic stress.

Quality early learning is linked to measurable, long-term benefits. Children who participate in high-quality early education are more likely to graduate high school, complete more years of school and report better adult employment, income and health outcomes, with the strongest effects for children from low-income communities, according to research summarized by the Learning Policy Institute and the Heckman Equation, drawing on economist James Heckman’s research on the long-run returns to early investment. Studies of specific programs in Boston and New Jersey’s Abbott preschool districts reinforce that early access to quality learning supports school readiness and academic success, particularly in early grades.

Universal Transitional Kindergarten—California’s rollout of free, public preschool for all four-year-olds—is expected to help address access gaps.

How Does the Child Care Crisis Affect Families?

Infant care in San Diego County can cost roughly $25,000 annually at mid-range rates and more than $33,200 in some parts of the county, according to YMCA of San Diego County Child Care Resource Service data. A family with both an infant and a preschooler can pay upward of $33,000 to $34,000 annually without subsidies. For a median-income married couple, infant care consumes more than 15% of household income; for a single parent, that figure jumps to 47%—far above the 7% affordability threshold used by the U.S. Department of Health and Human Services. Single mothers without subsidized care may spend up to half their income on child care alone.

Waitlists compound the affordability problem. As of mid-2025, more than 2,000 eligible San Diego children were on formal waitlists for subsidized slots, with tens of thousands more eligible but not on any list at all.

The affordability gap pushes parents—especially mothers—to reduce their participation in the workforce. San Diego has the second-lowest rate of female labor force participation among major U.S. cities, according to regional cost and workforce data by the California Child Care Resource and Referral Network.

Some 94% of San Diego parents involuntarily working part-time because of child care issues are women. Nationally, 70% of women with young children participate in the labor force, compared with 95% of men with young children. Research shows a $100 quarterly increase in child care costs is associated with a measurable decline in mothers’ employment. Nearly a quarter of parents shift schedules, reduce hours or stop working altogether to accommodate child care needs—a rate that climbs to 37% for single parents. Only 9% of fathers cite lack of child care as a reason for not working, compared with 25% of mothers.

The flip side: when subsidized, full-day care is available, the economic effects can move in the other direction. A study of an extended-day universal pre-k program in Connecticut found a 21% increase in parents’ earnings that persisted for six years, with each dollar invested yielding an estimated $10 in community benefit.

A separate study of expanded full-day Head Start data found a similar pattern, with mothers’ earnings increasing by 6.5%, according to data by the National Bureau of Economic Research, or NBER.

How Does the Child Care Crisis Affect Employers?

Inadequate infant and toddler care costs U.S. employers an estimated $23 billion a year in direct productivity losses, part of a broader $122 billion national toll in lost family earnings, employer productivity and tax revenue, according to the Council for a Strong America / ReadyNation.

For employers, child care instability can translate directly into absenteeism, turnover and lost productivity.

In San Diego specifically, 92% of parents say reliable child care is essential to their ability to work, and 90% of working parents say they want greater schedule flexibility to accommodate care needs, according to a San Diego Foundation workforce survey. Nearly 40% of voters say their own ability to work is affected by coworkers’ child care challenges. Among small businesses, 1 in 3 report dealing with multiple child care-related issues in the past year, and 38% of small business owners say workforce reliability has suffered because of child care shortages. Yet only about 9% of San Diego companies currently offer on-site child care.

How Does the Child Care Crisis Affect the Economy?

The child care crisis costs the U.S. economy an estimated $122 billion to $172 billion annually in lost earnings, productivity and tax revenue, according to a 2026 ReadyNation report.

California’s share of that national toll is estimated at roughly $17 billion a year, based on the state’s roughly 14% share of national GDP applied to the $122 billion infant-toddler figure, according to analysts.

Despite chronically low wages for its workforce, the child care sector itself contributes an estimated $63 billion in gross output to the U.S. economy—about 0.3% of GDP, according to the U.S. Chamber of Commerce Foundation. Separate Chamber research has found that states across the country are losing billions in annual economic opportunity due to child care gaps.

Economists who study early childhood investment consistently find outsized returns relative to cost. The Heckman Equation, drawing on decades of longitudinal research, is frequently cited as evidence that early childhood investment produces some of the highest returns of any public investment, largely because it reduces downstream costs in remedial education, healthcare and the justice system while increasing future earnings and tax contributions.

According to a 2026 Stanford Institute for Economic Policy Research policy brief, investments in high-quality early childhood care and education can generate about $3 in broader benefits for every dollar invested, while expanding access to affordable care can also increase parents’ workforce participation and contribute to economic growth.

How Does the Child Care Crisis Affect San Diego County?

San Diego County’s licensed child care supply has shrunk in recent years even as demand keeps rising.

As of December 2025, the county had 4,057 licensed family child care homes and 880 licensed centers, according to the YMCA of San Diego County’s child care supply map—nearly 100 fewer centers than in 2021.

An earlier county-commissioned analysis found the region lost 364 providers and nearly 2,000 child care slots between 2019 and 2022, concentrated in family child care homes. The sector has continued to shed providers since: an estimated 535 providers, or roughly 12% of the county’s total, have closed since the Covid-19 pandemic began, as tobacco-tax revenue that has historically helped fund early childhood programs has also declined.

On the demand side, San Diego County has 33,709 children ages 0-12 enrolled in subsidized child care out of 155,400 who are eligible—a 22% enrollment rate. That’s up from just 16% in 2023 and more than double the county’s 2021 rate, a faster pace of improvement than the state as a whole.

Even so, roughly 10% of all subsidized child care enrollment statewide is concentrated in San Diego County, reflecting both the scale of local need and the relative strength of the county’s provider network and community-based organizations in deploying available resources.

An estimated 66% of San Diego families live in a child care desert, while shortages are even more severe for infants and toddlers. YMCA of San Diego County’s 2026 supply mapping found 75% of census tracts qualify as deserts specifically for children under two, representing about 48,850 infants and toddlers.

Countywide, an estimated 81% of children cannot be served by licensed providers due to a lack of available slots.

Eligibility for subsidized care is also unevenly distributed by race and ethnicity: 61% of Black children and 45% of Latino children in San Diego County are eligible for subsidized care, compared with 33% of children countywide overall.

What Solutions Are Experts Pursuing?

Experts and advocates are pursuing a range of approaches, and there is no single strategy that addresses every part of the child care crisis. San Diego County’s own Child Care Blueprint, developed with local providers and stakeholders, lays out a locally grounded roadmap. Broadly, proposed solutions fall into four categories:

For the Workforce

Raising educator wages and benefits to improve recruitment and retention; expanding access to business coaching, loans, grants and facilities financing for child care operators; building professional development pipelines, including apprenticeships and paid training pathways; reducing administrative or regulatory burdens where possible without compromising safety or quality; and increasing subsidy reimbursement rates to reflect the true cost of care.

For Families

Expanding paid family leave and flexible work arrangements; increasing investments in subsidy programs, and expanding income eligibility so more working families qualify—some states, including New Mexico and New York, have moved toward eligibility for all families; and continuing to fund universal transitional kindergarten in ways that do not destabilize the broader child care market.

For Employers

Expanding employer-sponsored benefits such as child care stipends, dependent-care flexible spending accounts and on-site or near-site child care facilities.

For Communities

Investing in child care infrastructure, including new facility construction, converting underused government buildings into child care space, and encouraging developers to integrate child care into new housing—particularly affordable housing—developments. Some jurisdictions elsewhere in the country, including Alameda and Sonoma counties in California, have pursued dedicated local tax measures to fund expanded preschool access, an approach San Diego County stakeholders have also studied.

What Is Measure B, the San Diego County Health and Safety Act?

Among the measures being considered is Measure B, also known as the San Diego County Health and Safety Act, a countywide citizen initiative on the November 2026 ballot that would provide a locally dedicated source of funding for health and safety priorities, including child care and children’s healthy development.

If approved by voters, Measure B could generate approximately $400 million to $450 million annually to help address federal and state budget gaps affecting child care, health care and social services, the Tijuana River sewage crisis and public safety.

The measure specifies that 22% of total measure revenue would support child care and children’s healthy development. The measure specifies 8% for stipends to licensed child care providers, 8% for vouchers that families could use for eligible child care and 6% for early childhood mental and behavioral health services. These funds would be administered by the First 5 Commission of San Diego County.

Like many ballot measures, Measure B raises broader public policy questions. Public discussion includes whether a permanent, dedicated local sales tax is the most appropriate way to fund these investments at a time of heightened cost-of-living pressure on residents, the respective roles of federal, state and local governments in supporting child care and how responsibility for funding should be shared or pursued through existing budget reallocation or continued advocacy for state and federal funding. Additional information about these topics is available at SDFoundation.org/MeasureB.

Looking Ahead

Child care is likely to remain a defining regional challenge over the next five to 10 years, regardless of how any single ballot measure fares. Several trends are already in motion. California has committed to adding new subsidized child care slots—roughly 77,000 more toward a stated goal of 200,000 additional slots by 2027-28—but even that expansion is projected to leave a statewide shortfall of more than 120,000 slots, according to the California Budget & Policy Center. Universal Transitional Kindergarten will continue reshaping provider business models as more preschool-age children move into free public programs, pushing more providers to specialize in the costlier, harder-to-staff infant and toddler segment.

Federal uncertainty around Head Start funding could also affect access to early childhood services for California families, depending on how proposed changes are resolved.

Whatever policy path San Diego County takes, the underlying dynamics—high fixed costs, thin provider margins, an undervalued workforce and demand that consistently outpaces supply—are structural, not temporary, and will require sustained attention from policymakers, employers and the philanthropic community alike.

Frequently Asked Questions

What is the child care crisis?

It’s the growing gap between what quality child care costs to provide and what families can afford to pay, resulting in high costs for parents, thin or negative margins for providers, low wages for child care workers, and a persistent shortage of licensed care—particularly for infants and toddlers.

Why is child care so expensive?

Child care is expensive because it is a labor-intensive service with high staffing and operating costs, while providers have limited ability to increase revenue without raising prices for families. Rising costs for wages, rent and supplies, along with a subsidy system that often does not cover the full cost of care, add to the pressure.

Why is child care important?

The first five years of life are a critical period for brain development. High-quality early care supports school readiness and long-term outcomes for children, while access to reliable care allows parents—especially mothers—to remain in the workforce, supporting family financial stability and the broader economy.

How does child care affect the economy?

Unreliable child care costs the U.S. economy an estimated $122 billion to $172 billion annually in lost earnings, productivity, and tax revenue, with California’s share estimated at roughly $17 billion, according to the Institute for Child Success and Council for a Strong America, respectively. At the same time, economists widely cite early childhood investment as producing high long-term returns.

What is a child care desert?

A child care desert is generally defined as an area where there are at least three children for every one licensed child care slot. An estimated 66% of San Diego families live in a child care desert, with shortages particularly severe for infant and toddler care.

How does the crisis affect employers?

Employers face higher turnover, absenteeism and recruitment costs when workers lack reliable child care. In San Diego, roughly a third of small businesses report multiple child care-related workforce issues annually, and only about 9% of local companies offer on-site child care.

What would Measure B, also known as the San Diego County Health and Safety Act, do if approved?

If approved by voters, Measure B would raise San Diego County’s sales tax by a half-cent, generating an estimated $400 million to $450 million annually for health care, child care, Tijuana River sewage remediation and public safety, including wildfire response. The measure specifies that 22% of revenue would go toward child care and children’s healthy development and safety: 8% for stipends to licensed child care providers, 8% for child care vouchers for families and 6% for early childhood mental and behavioral health services. These funds would be administered by the First 5 Commission of San Diego County.