Profiles of Risk: Maternal Health, Socioeconomic Status, and Child Health

Child health is fundamental to well-being and achievement throughout the life course. Prior research has demonstrated strong associations between familial socioeconomic resources and children 's health outcomes, with especially poor health outcomes among disadvantaged youth who experience a concentration of risks, yet little is known about the influence of maternal health as a dimension of risk for children. This research used nationally representative U.S. data from the National Health Interview Surveys in 2007 and 2008 (N = 7,361) to evaluate the joint implications of maternal health and socioeconomic disadvantage for youth. Analyses revealed that maternal health problems were present in a substantial minority of families, clustered meaningfully with other risk factors, and had serious implications for children 's health. These findings support the development of health policies and interventions aimed at families.Key Words: child well-being, family health, inequality, intergenerational, parenting.Understanding the social factors that underlie disparities in children's health is of major concern to scholars of inequality. Poor health in childhood can contribute to a trajectory of relatively low attainment and well-being later in life. Children with serious health problems are more likely to drop out of school, have health problems in adulthood, and earn lower incomes than their healthy counterparts (Case & Paxson, 2006). Identifying the sources of child health disparities is essential to the development of effective policies and programs to reduce inequalities in children's development and achievement over the life course.Prior research has demonstrated unequivocally that the social and economic resources of children's families are critical to their health. Family members share economic resources, home and community environments, and social networks, all of which have an impact on health. Family income is related linearly to children's overall health (Case, Lubotsky, & Paxson, 2002) , and low parental education and growing up in a single-parent family increase the likelihood that children will experience poor health outcomes (Bauman, Silver, & Stein, 2006; Montgomery, Kiely, & Pappas, 1996). These factors operate on children's physical and mental health in an additive fashion (Bauman et ah; Evans, 2003) and influence various health outcomes in a similar manner (Braveman, Cubbin, Egerter, Williams, & Pamuk, 2010; Currie & Lin, 2007).Apart from identifying inheritable genetic traits, less attention has been paid to linkages between parental health and children's well-being. We propose that parents' health is an additional dimension of family inequality that contributes to disparities in children's health, and we tested this proposition using data from the 2007 and 2008 National Health Interview Surveys (NHIS; see http://www.cdc.gov/nchs/nhis.htm). We first show how socioeconomic and health disparities cluster within families. We then employ multivariate models to examine disparities in children's health, showing how socioeconomic and health risk profiles are correlated with children's health outcomes. Our analysis makes several contributions to the literatures on multiple risks, family health, and social inequality. First, our use of latent class analysis (LCA) to show how socioeconomic and health disadvantages cluster within families provides unique insight into the distribution of risk in American families. As expected, we found groups of mothers who face socioeconomic disadvantages only, health disadvantages only, both disadvantages, and neither. We also found a significant proportion of mothers who had limited access to socioeconomic resources and health care but did not report health problems, and a smaller group, composed mostly of disadvantaged single mothers who smoked, had limited access to health care, and a slight elevation in the risk of depression but few other health disadvantages. …