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Open Access Publications from the University of California

Accounting for the Change in the Gradient: Health Inequality among Infants

  • Author(s): Lin, Wanchuan
  • et al.

This study investigates changes in the relationship between maternal education and infant health using American Vital Statistics data from 1983 to 2000. I find that the disparity, as measured by infant deaths, between infants whose mothers have different levels of education, has remained constant over time while these differences, measured by Apgar scores, have been narrowing over the past two decades. This is in sharp contrast to the increasing disparities in health among adults of different educational backgrounds. A simple decomposition reveals that an increase in access to medical care is the dominant factor explaining the closing gap. Given that Hispanic women tend to have favorable birth outcomes while African-Americans tend to have worse-than-average infant outcomes, the gap has also declined because an increasing share of births to less-educated women was accounted for by Hispanics rather than by African-Americans. There are also several behavioral factors which have had an important impact. Namely, the gap has decreased because less-educated women smoke less, but this improvement is partially offset by an increase in the number of less educated women who gain excessive gestational weight. Finally, the gap has decreased because an increasing number of college-educated women are seeking fertility treatments.

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