October 8, 2008
Parents' Income, Education Affect Kids' Health
By Pauline Vu, Staff Writer
"The public should not be shocked that children in poor families have worse health than children in better-off families…However, it will be startling to most people to learn that children in middle-class families have worse health than children in wealthier families," said Paula Braveman, one of the authors of the report by the Robert Wood Johnson Foundation Commission to Build a Healthier America.
"It vividly illustrates how much parents' income and education levels matter when it comes to children's health," she said. "They matter a lot."
The health of American children is a matter of concern, made worse by the disparities that exist between poor kids and rich kids, the report found.
The authors warned that the sources of health disparities are so entrenched that a major expansion of health care alone would not close the gap. They said in a conference call to discuss the findings that although policymakers, including the presidential candidates, are focused on improving health care, the problem needs to be tackled by changing underlying social conditions.
"Even if we had equal access to health care, we'd still have disparities and shortfalls in health," said David Williams, the commission's staff director. "It's not just access to health care, it's where you live, learn, work, play and worship."
For example, the report authors said, children in unsafe neighborhoods have less access to parks and other recreational centers, and grocery stories in poor neighborhoods probably don't sell healthy foods like fresh fruit. Children born to less-educated parents also are more likely to be pick up unhealthy habits and be exposed to secondhand smoke.
The report looked at infant mortality and children's health. Nationwide, 6.5 out of 1,000 infants die before their first birthdays, a problem that is worst in Mississippi, which has the highest overall infant mortality rates: 9.9 deaths every 1,000 live births. Massachusetts has the lowest level, 4.6 deaths per 1,000 infants.
The report also correlated these rates to how many years of schooling the mother completed. In Tennessee, for example, the infant mortality rate for mothers with less than a high school education was 11.7 deaths per 1,000 infants; that rate fell to 4.9 deaths for mothers who at least had a bachelor's degree.
The report also compared numbers of children with "optimal" health - based on parents' assessment of whether their children's health ranged from "excellent" to "poor" - with family incomes ranging from the federal poverty level to those making more than four times as much. (The report authors said using parents' assessments highly correlates with more objective measures of health.)
Nationwide, 15.9 percent of children aren't at optimal health. Among the states, Texas has the biggest percentage of children with less-than-optimal health - 22.8 percent - followed closely by California (22.5 percent) and Nevada (20.4 percent).
Once income is considered, the three states also have the largest percentages of poor kids with less than good health: 44.1 percent of poor Texan children, 43.5 percent of Nevadans and 41 percent of poor Californian kids have less-than-perfect health.
This results in some of the biggest "health gaps" between the percentage of poor and rich children with imperfect health, according to the report. In Texas, 44.1 percent of poor children have less-than-optimal health, while only 6.7 percent of children in high-income families are at that level.
The states with the biggest health gaps comprise a wide swath of the South and Southwest. States in the upper Midwest, northern Great Plains and Northeast have the smallest gaps between poor and rich kids when it comes to health.
In Vermont, only 6.9 percent of children are considered not healthy, followed by New Hampshire (8.3 percent), Maine (9.1 percent) and North Dakota (9.2 percent).