Family Socioeconomic Status and Early Life Mortality Risk in the United States
We examine the association between several dimensions of parental socioeconomic status (SES) and all-cause and cause-specific mortality among children and youth (ages 1–24) in the United States.
We use Cox proportional hazard models to estimate all-cause and cause-specific mortality risk based on data from the 1998 to 2015 National Health Interview Survey-Linked Mortality Files (NHIS-LMFs), restricted to children and youth ages 1–17 at the time of survey followed through age 24, or the end of the follow-up period in 2015 (N = 377,252).
Children and youth in families with lower levels of mother’s education, father’s education, and/or family income-to-needs ratio exhibit significantly higher all-cause mortality risk compared with children and youth living in higher SES families. For example, compared to children and youth living with mothers who earned college degrees, those living with mothers who have not graduated high school experience 40% higher risk of early life mortality over the follow-up period, due in part to higher mortality risks of unintentional injuries and homicides. Similarly, children/youth whose fathers did not graduate high school experience a 41% higher risk of dying before age 25 compared to those with fathers who completed college.
Today’s children and youth experience clear disparities in mortality risk across several dimensions of parental SES. As the U.S. continues to lag behind other high-income countries in health and mortality, more attention and resources should be devoted to improving children’s health and well-being, including the family and household contexts in which American children live.
KeywordsMortality Early life Socioeconomic status Disparities National Health Interview Survey
We are grateful for research support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD grant R01HD082106); the Carolina Population Center and its NICHD center grant (P2C HD050924); the University of Colorado Population Center and its NICHD center grant (P2C HD066613); the Carolina Population Center Training grant (T32 HD007168); and the NICHD National Research Service Award (F32 HD 085599). We also thank the National Center for Health Statistics (NCHS) for collecting the data and making the restricted-use linked files available to researchers through the Federal Statistical Research Data Centers (RDC); Pat Barnes for creating the restricted use linked files and assisting us in navigating the NCHS and RDC protocols; and Bert Grinder and Gale Boyd for supporting our use of the Research Triangle Institute RDC facilities. The content and views expressed in this manuscript are solely those of the authors and do not necessarily represent the official views of NIH, NICHD, or NCHS.
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