HOW THE MARRIAGE ADVANTAGE IN INFANT HEALTH OUTCOMES INTERSECTS WITH FAMILY-OF-ORIGIN, PRENATAL, AND NEIGHBORHOOD ENVIRONMENTS
Open Access
- Author:
- Buher-Kane, Jennifer
- Graduate Program:
- Sociology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- June 27, 2011
- Committee Members:
- Paul Amato, Committee Chair/Co-Chair
Alan Booth, Committee Chair/Co-Chair
Nancy Landale, Committee Member
Marianne Hillemeier, Committee Member
John David Iceland, Committee Member - Keywords:
- multilevel modeling
health disparities
fertility
demography
family
infant health outcomes
neighborhood crime
intergenerational linkages - Abstract:
- In recent decades, health disparities have gained increased attention among sociological audiences. Implicit in much of this literature is an emphasis on social stratification processes that are produced and reproduced through interactions between individuals and social structures such as families and neighborhoods. Families play a potentially large role in both the development and reproduction of health disparities across generations. However, sociological exploration into the impact of families on one particular health disparity—infant health outcomes (such as low birth weight and preterm birth)—has been relatively minimal. Using multiple data sources, this dissertation provides an in-depth exploration of when and why family structure affects infant health outcomes. This monograph begins by exploring a benefits-of-marriage hypothesis which contrasts two explanations of the marriage advantage: a life course or selection model (positing that the observed advantages are grounded in women’s experiences in prior life stages such as childhood and adolescence) and a mediation model (positing that marriage leads to positive prenatal health characteristics, which in turn lead to better infant health outcomes). Findings indicate that the marriage advantage is diminished but not eradicated with the inclusion of a rich set of childhood environment characteristics. Subsequent exploration using fixed-effects models demonstrates the salience of the marriage advantage between married and single women within a recent, nationally-representative sample of households, but finds no difference between married and cohabiting women. The married-single disparity is partially explained by increased rates of prenatal smoking among single women. Results for two other measures of infant health—low birth weight and preterm birth—indicate no evidence of a marriage advantage within a fixed-effects framework. In sum, the results demonstrate greater support for a life course or selection approach although it is clear that these processes do not account for the entire advantage. Second, this monograph explores a different dimension of the marriage advantage: Are risky neighborhood environments more weakly related to infant health outcomes among married women compared with cohabiting or single women? Drawing upon fundamental cause theory and the buffering hypothesis, multilevel regression results indicate that mother-father relationship status is one type of interpersonal resource that differentially buffers women from the effects of living within stressful social environments. In neighborhoods characterized by high levels of violent and serious property crimes, cohabitation (and perhaps singlehood) are more risky (compared with marriage) than in neighborhoods with relatively low levels of crime—and this disadvantage exists above and beyond measures of a host of human capital, sociodemographic, family background, and pregnancy characteristics. Third, this monograph addresses why single mothers have historically exhibited poorer infant health outcomes by examining intergenerational (mother-daughter) transmissions of infant health risk. Structural equation models indicate that previously-documented mother-daughter similarities in birth weight may be at least partly spurious in that intergenerational transmissions of educational attainment and sociobehavioral modeling accounted for half of the mother-daughter similarity in the risk of low birth weight when subgroups of non-poor and poor women were compared, and partially accounted for the mother-daughter similarity in birth weight (adjusted for preterm birth status). Furthermore, the effect of education on birth weight and the risk of low birth weight operated indirectly through nonmarital birth status. Findings demonstrate the importance of including this broader intergenerational context in future investigations of infant health outcomes—especially with respect to research that intends to inform policies related to preventing infant health risk and reducing infant health disparities. In sum, this dissertation contributes to both health disparities and family sociology literatures by producing theoretical, methodological, and policy-oriented insights related to the formation of infant health disparities that affect long-term human development and social investment.