Expert Commentary

Maternal education: A matter of life and death for infants?

Infants whose mothers lack a high school education are, in some states, more than twice as likely to die as those born to mothers with four years of college or more.

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Infants whose mothers received less than 12 years of education are, in some states, more than twice as likely to die as those born to college educated mothers, a new study finds.

The issue: Education provides tangible benefits, including employment opportunities and knowledge that can improve both the quality and duration of one’s life. But these effects extend beyond just the direct recipients of an education — children also benefit from their parents’ schooling.

Prior research on maternal education has shown that increased education offers mothers more connections with resources for infant health and an awareness of healthy behaviors (including exercise and not smoking). Education might also hone the skills needed to access and effectively use the health care system.

In general, infants born to more educated mothers have lower mortality rates. A new study delves into the specifics, determining on a state-by-state basis the extent to which mothers’ education levels affect their babies’ chances of survival.

An academic study worth reading: “Inequality in Infant Mortality: Cross-State Variation and Medical System Institutions,” published in Social Problems, October 2017.

About the study: Benjamin Sosnaud, a sociologist at Trinity University, looked at almost 23 million infant birth and death records from 1997 to 2002. The records, provided by the National Vital Statistics System, include data on the mother’s schooling. Sosnaud compared two groups of mothers — those who had less than 12 years of education and those who had 4 years of college or more. Controlling for other variables, including race and maternal age, he analyzed the association between maternal education and infant mortality across the 50 states.

Sosnaud also collected state-specific data from the American Hospital Association on the number of neonatal intensive care units (NICUs) per 10,000 residents and from the American Medical Association on the number of primary care providers per 10,000 residents. This data allowed him to analyze whether linkages exist between these components of state medical systems and trends in infant mortality rates.

Key findings:

  • Taking into account other factors, including race and maternal age, maternal educational level is significantly linked to infant mortality risk.
  • Alaska, North Dakota, Tennessee, West Virginia and Kentucky had the largest differences in infant mortality rates across maternal education levels. In these states, infants born to less-educated mothers were more than twice as likely to die as infants born to more-educated mothers.
  • The state with the smallest difference in infant mortality rates across maternal education levels was Hawaii. New Mexico and Nevada also exhibited less inequality.
  • In states with more NICUs, infant mortality risk decreased only for those born to less-educated mothers.
  • In states with more primary care physicians per 10,000 residents, infant mortality risk decreased for both groups of mothers, but more so for the college-educated group. Sosnaud suggests this might be because not all mothers could access primary care providers, regardless of availability.

Other resources:

  • The U.S. Centers for Disease Control and Prevention’s Division of Reproductive Health describes initiatives aimed at reducing infant mortality rates. They also have statistics available on infant mortality by state.
  • The U.S. Health Resources and Services Administration’s Maternal and Child Health Bureau collects relevant data and research.
  • The U.S. Department of Health and Human Services has an advisory committee on infant mortality.

Related research:

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