The annual expense of child care for an infant exceeds the annual cost of in-state tuition at a public four-year university in 34 states, according to the most recent data from the Economic Policy Institute. The cost of child care can be a key influencer in decisions about entering or leaving the workforce, and especially in health care where women make up the majority of the front-line workforce (66%) and managers (59%), according to research from McKinsey. In Pennsylvania, infant care costs as a share of public college tuition are 81.5%. Average annual cost of infant care is $11,842, while Pennsylvania’s in-state tuition for four-year public college is $14,534, one of the highest tuition rates in the country. Infant care costs as a share of median family income is 17.5% with a median family income: $67,828.