139 lines
4.7 KiB
YAML
139 lines
4.7 KiB
YAML
abstract: 'Policy Points Policies that increase county income levels, particularly
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for middle-income households, may reduce low birth weight rates and
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shrink disparities between Black and White infants. Given the role of
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aggregate maternal characteristics in predicting low birth weight rates,
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policies that increase human capital investments (e.g., funding for
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higher education, job training) could lead to higher income levels while
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improving population birth outcomes. The association between county
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income levels and racial disparities in low birth weight is independent
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of disparities in maternal risks, and thus a broad set of policies aimed
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at increasing income levels (e.g., income supplements, labor
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protections) may be warranted. Context Low birth weight (LBW; <2,500
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grams) and infant mortality rates vary among place and racial group in
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the United States, with economic resources being a likely fundamental
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contributor to these disparities. The goals of this study were to
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examine time-varying county median income as a predictor of LBW rates
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and Black-White LBW disparities and to test county prevalence and racial
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disparities in maternal sociodemographic and health risk factors as
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mediators. Methods Using national birth records for 1992-2014 from the
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National Center for Health Statistics, a total of approximately 27.4
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million singleton births to non-Hispanic Black and White mothers were
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included. Data were aggregated in three-year county-period observations
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for 868 US counties meeting eligibility requirements (n = 3,723
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observations). Sociodemographic factors included rates of low maternal
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education, nonmarital childbearing, teenage pregnancy, and advanced-age
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pregnancy; and health factors included rates of smoking during pregnancy
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and inadequate prenatal care. Among other covariates, linear models
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included county and period fixed effects and unemployment, poverty, and
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income inequality. Findings An increase of \$10,000 in county median
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income was associated with 0.34 fewer LBW cases per 100 live births and
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smaller Black-White LBW disparities of 0.58 per 100 births. Time-varying
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county rates of maternal sociodemographic and health risks mediated the
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association between median income and LBW, accounting for 65\% and 25\%
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of this estimate, respectively, but racial disparities in risk factors
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did not mediate the income association with Black-White LBW disparities.
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Similarly, county median income was associated with very low birth
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weight rates and related Black-White disparities. Conclusions Efforts to
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increase income levels-for example, through investing in human capital,
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enacting labor union protections, or attracting well-paying
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employment-have broad potential to influence population reproductive
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health. Higher income levels may reduce LBW rates and lead to more
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equitable outcomes between Black and White mothers.'
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affiliation: 'Curtis, DS (Corresponding Author), Univ Utah, Dept Family \& Consumer
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Studies, Alfred Emory Bldg 228, Salt Lake City, UT 84112 USA.
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Curtis, David S.; Carlson, Daniel L.; Wen, Ming, Univ Utah, Salt Lake City, UT USA.
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Fuller-rowell, Thomas E., Auburn Univ, Auburn, AL 36849 USA.
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Kramer, Michael R., Emory Univ, Atlanta, GA 30322 USA.'
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author: Curtis, David S. and Fuller-rowell, Thomas E. and Carlson, Daniel L. and Wen,
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Ming and Kramer, Michael R.
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author-email: david.curtis@fcs.utah.edu
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author_list:
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- family: Curtis
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given: David S.
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- family: Fuller-rowell
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given: Thomas E.
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- family: Carlson
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given: Daniel L.
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- family: Wen
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given: Ming
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- family: Kramer
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given: Michael R.
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da: '2023-09-28'
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doi: 10.1111/1468-0009.12532
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earlyaccessdate: OCT 2021
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eissn: 1468-0009
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files: []
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issn: 0887-378X
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journal: MILBANK QUARTERLY
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keywords: 'low birth weight; health disparities; health equity; median income;
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fundamental cause theory; US counties'
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keywords-plus: 'RACIAL RESIDENTIAL SEGREGATION; PRENATAL-CARE UTILIZATION;
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UNITED-STATES; INFANT-MORTALITY; PRETERM BIRTH; SOCIOECONOMIC
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DISPARITIES; HEALTH DISPARITIES; RACIAL/ETHNIC DISPARITIES; FUNDAMENTAL
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CAUSES; STRUCTURAL RACISM'
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language: English
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month: MAR
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number: '1'
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number-of-cited-references: '109'
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pages: 38-77
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papis_id: 0e2e4de09e8cadf796f87daee4b57e96
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ref: Curtis2022doesrising
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researcherid-numbers: Carlson, Daniel/GWU-9165-2022
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times-cited: '2'
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title: Does a Rising Median Income Lift All Birth Weights? County Median Income Changes
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and Low Birth Weight Rates Among Births to Black and White Mothers
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type: article
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unique-id: WOS:000713640700001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '4'
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volume: '100'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2022'
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