The intergenerational transmission of inequality: maternal disadvantage and health at birth

Abstract

Health at birth is an important predictor of long-term outcomes, including education, income, and disability. Recent evidence suggests that maternal disadvantage leads to worse health at birth through poor health behaviors; exposure to harmful environmental factors; worse access to medical care, including family planning; and worse underlying maternal health. With increasing inequality, those at the bottom of the distribution now face relatively worse economic conditions, but newborn health among the most disadvantaged has actually improved. The most likely explanation is increasing knowledge about determinants of infant health and how to protect it along with public policies that put this knowledge into practice.

Fig. 1. Differences in the percent of U.S. infants with birth weight <2500 g, by maternal characteristics, 2011

Data was calculated by using singleton births to mothers age 19 to 39 years from the U.S. National Individual-Level Natality Data (birth records). The following states are excluded because education is inconsistently coded over time: Alabama, Alaska, Arizona, Arkansas, Connecticut, Hawaii, Maine, Massachusetts, Minnesota, Mississippi, New Jersey, Rhode Island, Virginia, and West Virginia. We focus on singleton births because multiple births are much more likely to be low birth weight, and many multiple births result from assisted reproductive technology. Sample sizes are printed over each bar. Given the large sample sizes, SEMs are very small (<0.15 percentage points).

Fig. 2. Trends in percent low birth weight by maternal socioeconomic status (SES)

The sample is defined as in Fig. 1. Disadvantaged is defined as African American, less than a high school education, and unmarried. Advantaged is defined as white, college education, and married.

Fig. 3. Differences in maternal health and behavior by maternal SES, United States 2011

The sample is defined as in Fig. 1. Disadvantaged is defined as African American, less than a high school education, and unmarried. Advantaged is defined as white, college education, and married. Given the large sample sizes, SEMs are very small (<0.2 units).