Researchers have found an increase in infant health inequality between educated, economically advantaged mothers and economically disadvantaged mothers without a high school degree. This suggests a reversal in the previous trend that indicated that the infant health inequity gap was narrowing.

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Being born at full-term and having a healthy birth weight can be vital components in an infant’s immediate and future health outcomes.

As Dr. Hitesh Deshmukh notes in an article in the journal Infectious Diseases in Children, “Babies who are born prematurely are at risk of cardiovascular disease and increased high blood pressure that can persist into adulthood.”

Additional research in the B.E. Journal of Economic Analysis & Policy indicates that a low birth weight or preterm birth can lead to cognitive delays, behavioral issues, and a lower likelihood of attaining higher education and gainful employment.

In a new study, researchers Emily Rauscher, an associate professor of sociology, and David Enrique Rangel, an assistant professor of education — both of whom are from Brown University in Providence, RI — investigated trends in infant health inequality from 1989 to 2010 in the United States.

The team found data indicating a reversal of a pre-2010 infant health trend that showed that the health gap between infants born to married, highly educated white mothers and those born to unmarried Black mothers without a high school degree had steadily narrowed.

They recently published their findings in the journal Social Science & Medicine – Population Health.

The study authors noticed a possible shift in trends while analyzing data on how a mother’s education level impacts infant health, along with previous information on the impact of maternal race.

To investigate further, they examined 22 million U.S. births using administrative birth certificate data from 1989 to 2018. They identified gaps in infant health categorized by the mother’s race, marital status, and educational level.

The researchers also gathered data on infant health gaps between economically advantaged mothers and those who were the most financially disadvantaged.

After evaluating the information, the researchers found that after 2010, gaps in health between Black and white infants remained relatively stable. However, the health inequality gap increased between infants born to married and unmarried mothers and between infants born to college-educated mothers and those who did not have a high school degree.

The research showed that among married mothers, the rate of preterm births declined after 2010 by 1.6%, after steadily increasing by 0.6% per decade before that year.

However, premature births in unmarried mothers had decreased by 0.7% per decade before 2010, then increased by 1.1% per decade after that year.

Among mothers without a high school degree, after 2010, low birth weight rates increased by 1.4% per decade, while very low birth weight rates increased by 0.2% in that same time frame. This was following a relatively stable rate in the previous 20 years.

In mothers with a college degree, the rate of infants born with a very low birth weight decreased by 0.1%, and the preterm birth rate decreased by 1.7% per decade after 2010. This is after slight increases in low birth weights and preterm births in the previous 2 decades.

The most noticeable difference in infant health status after 2010 was between infants born to white, married, and college-educated mothers and those born to Black, unmarried mothers without a high school degree.

“The fact that we found the steepest increase in inequality when we isolated for education level suggests to us that moms without a high school degree have become increasingly marginalized in American society.”

— Emily Rauscher

The researchers explain that one limitation of their research was their inability to gather maternal income or financial status information. They also indicate the need to examine infant mortality rates for similar disparities.

The investigators say that possible reasons for the adverse shift in infant health trends over the past 10 years may be economic, demographic, or political in nature.

Some other factors they note are limited access to affordable, nutritious food and exposure to harmful chemicals that may exist where economically disadvantaged mothers may reside.

Future research should investigate how the population of unmarried Black mothers without high school degrees has changed over time. “That could be because the population of Americans without a high school degree is becoming smaller and smaller — so as education levels rise, those with the lowest levels of education face more of a disadvantage in every respect,” explains Rauscher.

As for solutions, she and Rangel suggest making positive policy changes that ensure that all expectant mothers receive appropriate healthcare in the first 6 weeks of pregnancy, providing academic support to those at risk, and implementing a universal basic income.