Magazine article The American Prospect

From One Generation to the Next: Poor Health at Birth Is One Key Channel through Which Economic Status Is Passed from Parent to Child. Smart Policies Can Lift Kids beyond the Poverty of Parents

Magazine article The American Prospect

From One Generation to the Next: Poor Health at Birth Is One Key Channel through Which Economic Status Is Passed from Parent to Child. Smart Policies Can Lift Kids beyond the Poverty of Parents

Article excerpt

THE U.S. TAKES PRIDE IN BEING A land of opportunity, and Americans maintain the core belief that hard work and determination are rewarded. But, how level is the intergenerational playing field, and what factors underlie the intergenerational transmission of economic status and well-being? If we hope to reduce the transmission of poverty from one generation to the next through effective policy interventions, we need to know the answers.

Compared to most other high-income countries, the United States today has an unusually low level of intergenerational mobility. Successful parents tend to have successful children; their earnings typically are highly predictive of their children's income as adults. Research by American University economist Tom Hertz, among others, has shown that mobility from one generation to the next in the U.S. is now lower than in France, Germany, Canada, and the Scandinavian countries. Only the United Kingdom is less mobile than our own society. How can this be?

Education and race are among the variables that help predict mobility. So, too, is health. Poor health at birth is one key channel through which economic status and well-being is transmitted from parent to child. Again, compared to the nation's richest countries, the U.S. ranks at or near the very bottom in almost every measure of health: infant mortality, low birth weight, life expectancy, and more. Research has shown that black men in Harlem are more likely to die before 65 than men in Bangladesh. The main causes of death in poor black communities aren't only homicide, drug abuse, and AIDS, but a seemingly more benign litany that includes "unrelenting stress," cardiovascular disease, cancer, and untreated medical conditions.

Studies highlight early childhood as a critical period for brain development and for setting in place the structures that will shape future cognitive, social, emotional, and health outcomes. Limited parental resources, including child poverty and lack of health insurance, and its attendant stressors have the potential to shape the neurobiology of the developing child in powerful ways, which may lead directly to worse health later in life.

Let's take the case of low birth weight. A study I co-authored with Robert Schoeni finds that babies born too soon or small suffer significant detrimental effects. Low birth weight--defined in medical convention as less than 5.5 pounds--increases the probability of dropping out of high school by one-third, reduces later earnings by about 15 percent a year, and burdens people in their 30s and 40s with the health of someone who is 12 years older. Our study, the first to link birth weight with adult health and socioeconomic success using a full, representative sample of the U.S. population, provides a detailed look at how well-being and disadvantage are transmitted across generations within families.

The poor economic status of parents during pregnancy leads to worse birth outcomes. In turn, these negative birth outcomes have harmful effects on children's cognitive development, health, and educational attainment, and also on their health and economic status in adulthood. These effects then get passed down to the subsequent generation when the children, who are now adults, have their own children.

Not only does low income and lack of health insurance for parents increase the likelihood of poor birth outcomes, but the effects are cruelly compounded for their kids: The lack of health insurance intensifies the negative impact of low birth weight.

INTERVENE, BUT HOW?

Evidence like this is a report card that shows how the life chances of poor children are being undermined. Even more importantly, it is a challenge to do better. Being born at-risk does not have to be a life sentence for our children. The policy implication is that better access to health insurance and better prenatal care for low-income women may have significant effects on economic mobility. …

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