Parents’ Income and Education Influence Children’s Health

Every parent wants their children to live long, healthy lives. But a new report from the Robert Wood Johnson Foundation Commission to Build a Healthier America says that health, as a child and then as an adult, may largely depend on where the children live, their family income and the amount of education their parents have. In fact, parents’ income and education are so linked to their children’s health that there’s even a significant difference between the health of middle-class children and that of children with the greatest advantages. “This report shows us just how much a child’s health is shaped by the environment in which he or she lives,” commission Co-Chairwoman Alice M. Rivlin said in a statement.
According to the report, 15.9 percent of American children ages 17 years or younger had less than optimal health during 2003. This rate varied widely across states from a high of 22.8 percent in Texas to a low of 6.9 percent in Vermont. However, both nationally and within states, these rates also varied dramatically by income. Children in poor families are more likely—over six times as likely, in some states—to be in less than optimal health, compared with higher-income children. For example, in Texas, 44 percent of children in poor families are in less than optimal health compared with 6.7 percent of children in higher-income families. Other states with wide gaps in health between children from high- or low-income families are Nevada, Arizona, Louisiana, Washington, D.C., and Mississippi.
In contrast, only 13 percent of low-income children in New Hampshire have less than optimal health, compared with 6.4 percent of children in higher-income families. After New Hampshire, the states with the smallest gaps in health between children from high- or low-income families are Virginia, Minnesota, North Dakota and Wyoming.
However, these differences were not confined to comparisons between the top and bottom groups. Aside from a few exceptions, children in middle-income families are also more likely—over twice as likely in some states—than children in higher-income families to be in less than optimal health. “Children in poor and less-educated families generally have the worst health, but even children in middle-class families fare worse than those at the top,” noted Dr. Paula Braveman, one of the authors of the report.
A mother’s education is also an influencing factor in children’s health. After correlating mortality rates to how many years of schooling the mother completed, the report found that babies born to mothers who have at least 16 years of education are less likely to die before reaching their first birthday than babies born to mothers who did not finish high school. One of the largest gaps in infant mortality based on years of schooling was in Tennessee where the infant mortality rate for mothers with less than a high school education was 11.7 deaths per 1,000 infants; a rate that fell to 4.9 deaths for mothers who had at least a bachelor’s degree. Despite this, infant mortality rates in almost every state exceed what ideally could be achieved—a national benchmark rate of only 3.2 deaths per 1,000, said Sue Egerter, co-director of the University of California, San Francisco, Center on Social Disparities in Health, and another of the report’s authors.
A parents’ education also influences a child’s health in later years. Children who grow up in homes without a high school graduate are more than four times as likely to be in less than optimal health as children in a home with a high school graduate, and four times as likely to be in suboptimal health as a child in a home with someone who has been to college.
Egerter says that improving children’s health across the U.S. means not only improving access to health care, but improving the conditions in which many children are raised. “We need to change the conversation about health in this country,” she said. “We need solutions beyond the medical care system to improve the health of children in this country. Children need the right physical and social conditions to help them be healthy kids who develop into healthy adults. Focusing on health care and coverage is important, but we need to recognize that there is more to health than health care.”
“This report shows how much healthier kids in each state could be if we narrow the gap between the children of the wealthiest, most educated families and everyone else,” said Dr. Braveman. “Child health is a foundation for his or hers health throughout life. So, the health of our children is not only an important concern in itself, it’s a very important indicator of the health of the nation.”
To view the report America’s Health Starts With Healthy Children: How Do States Compare? in its entirety or to see how your state faired, visit http://www.commissiononhealth.org/StateByStateData.aspx.