Skip to main content

Family Socioeconomic Status and Early Life Mortality Risk in the United States

Abstract

Objectives

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.

Methods

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).

Results

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.

Conclusions

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.

This is a preview of subscription content, access via your institution.

References

  1. Augustine, J. M., Cavanagh, S. E., & Crosnoe, R. (2009). Maternal education, early child care and the reproduction of advantage. Social Forces, 88(1), 1–29.

    Article  Google Scholar 

  2. Currie, J., & Schwandt, H. (2016). Inequality in mortality decreased among the young while increasing for older adults, 1990–2010. Science, 352(6286), 708–712. https://doi.org/10.1126/science.aaf1437.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. DeNavas-Walt, C., Proctor, B. D., Smith, J. C., & U.S. Census Bureau, & Current Population Reports, P60-239. (2011). Income, poverty, and health insurance coverage in the United States: 2010. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  4. Edelblute, H. B., & Altman, C. E. (2018). Father absence, social networks, and maternal ratings of child health: Evidence from the 2013 social networks and health information survey in Mexico. Maternal and Child Health Journal, 22(4), 626–634. https://doi.org/10.1007/s10995-018-2432-2.

    Article  PubMed  Google Scholar 

  5. Frisbie, W. P., Hummer, R. A., Powers, D. A., Song, S.-E., & Pullum, S. G. (2010). Race/ethnicity/nativity differentials and changes in cause-specific infant deaths in the context of declining infant mortality in the U.S.: 1989–2001. Population Research and Policy Review, 29(3), 395–422. https://doi.org/10.1007/s11113-009-9150-9.

    Article  Google Scholar 

  6. Gage, T. B., Fang, F., O’Neill, E., & DiRienzo, G. (2013). Maternal education, birth weight, and infant mortality in the United States. Demography, 50(2), 615–635. https://doi.org/10.1007/s13524-012-0148-2.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hauser, R. M. (1994). Measuring socioeconomic status in studies of child development. Child Development, 65(6), 1541–1545. https://doi.org/10.1111/j.1467-8624.1994.tb00834.x.

    Article  CAS  PubMed  Google Scholar 

  8. Howell, E., Decker, S., Hogan, S., Yemane, A., & Foster, J. (2010). Declining child mortality and continuing racial disparities in the era of the medicaid and SCHIP insurance coverage expansions. American Journal of Public Health, 100(12), 2500–2506.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hussey, J. M. (1997). The effects of race, socioeconomic status, and household structure on injury mortality in children and young adults. Maternal and Child Health Journal, 1(4), 217–227.

    Article  CAS  PubMed  Google Scholar 

  10. Kalil, A., Ryan, R., & Corey, M. (2012). Diverging destinies: Maternal education and the developmental gradient in time with children. Demography, 49(4), 1361–1383. https://doi.org/10.1007/s13524-012-0129-5.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Krueger, P. M., Tran, M. K., Hummer, R. A., & Chang, V. W. (2015). Mortality attributable to low levels of education in the United States. PLoS ONE, 10(7), e0131809. https://doi.org/10.1371/journal.pone.0131809.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Light, M. T., & Ulmer, J. T. (2016). Explaining the gaps in white, black, and hispanic violence since 1990: Accounting for immigration, incarceration, and inequality. American Sociological Review, 81(2), 290–315. https://doi.org/10.1177/0003122416635667.

    Article  Google Scholar 

  13. Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, 35, 80. https://doi.org/10.2307/2626958.

    Article  Google Scholar 

  14. Mare, R. D. (1982). Socioeconomic effects on child mortality in the United States. American Journal of Public Health, 72(6), 539–547.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Masters, R. K., Hummer, R. A., & Powers, D. A. (2012). Educational differences in U.S. adult mortality: A cohort perspective. American Sociological Review, 77(4), 548–572. https://doi.org/10.1177/0003122412451019.

    Article  PubMed  PubMed Central  Google Scholar 

  16. McLanahan, S. (2004). Diverging destinies: How children are faring under the second demographic transition. Demography, 41(4), 607–627.

    Article  PubMed  Google Scholar 

  17. Mollborn, S. (2016). Young children’s developmental ecologies and kindergarten readiness. Demography, 53(6), 1853–1882. https://doi.org/10.1007/s13524-016-0528-0.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Montez, J. K., Hummer, R. A., & Hayward, M. D. (2012). Educational attainment and adult mortality in the United States: A systematic analysis of functional form. Demography, 49(1), 315–336. https://doi.org/10.1007/s13524-011-0082-8.

    Article  PubMed  PubMed Central  Google Scholar 

  19. National Center for Health Statistics. (2018). The linkage of national center for health statistics survey data to the national death index2015 Linked Mortality File (LMF): Methodology overview and analytic considerations. Retrieved May, 2019 from https://www.cdc.gov/nchs/data/datalinkage/LMF2015_Methodology_Analytic_Considerations.pdf.

  20. National Research Council and Institute of Medicine. (2013). U.S. Health in International Perspective: Shorter Lives, Poorer Health. Washington, D.C.: National Academies Press.

  21. Price, J., Jordan, J., Prior, L., & Parkes, J. (2011). Living through the death of a child: A qualitative study of bereaved parents’ experiences. International Journal of Nursing Studies, 48(11), 1384–1392. https://doi.org/10.1016/j.ijnurstu.2011.05.006.

    Article  PubMed  Google Scholar 

  22. Rogers, R. G., Lawrence, E. M., Hummer, R. A., & Tilstra, A. M. (2017). Racial/ethnic differences in early-life mortality in the United States. Biodemography and Social Biology, 63(3), 189–205. https://doi.org/10.1080/19485565.2017.1281100.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rubin, D. B. (1987). Multiple imputation for nonresponse in surveys. Hoboken: Wiley-Interscience.

    Book  Google Scholar 

  24. Singh, G. K., Azuine, R. E., Siahpush, M., & Kogan, M. D. (2012). all-cause and cause-specific mortality among US youth: Socioeconomic and rural-urban disparities and international patterns. Journal of Urban Health, 90(3), 388–405. https://doi.org/10.1007/s11524-012-9744-0.

    Article  PubMed Central  Google Scholar 

  25. Singh, G. K., & Kogan, M. D. (2007). Widening socioeconomic disparities in US childhood mortality, 1969–2000. American Journal of Public Health, 97(9), 1658.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Song, J., Floyd, F. J., Seltzer, M. M., Greenberg, J. S., & Hong, J. (2010). Long-term effects of child death on parents’ health-related quality of life: A dyadic analysis. Family Relations, 59(3), 269–282.

    Article  PubMed  PubMed Central  Google Scholar 

  27. StataCorp. (2017). Stata statistical software: Release 15. College Station: StataCorp LLC.

    Google Scholar 

  28. Thakrar, A. P., Forrest, A. D., Maltenfort, M. G., & Forrest, C. B. (2018). Child mortality in the US And 19 OECD comparator nations: A 50-year time-trend analysis. Health Affairs (Project Hope), 37(1), 140–149. https://doi.org/10.1377/hlthaff.2017.0767.

    Article  Google Scholar 

  29. Thiébaut, A. C. M., & Bénichou, J. (2004). Choice of time-scale in Cox’s model analysis of epidemiologic cohort data: A simulation study. Statistics in Medicine, 23(24), 3803–3820. https://doi.org/10.1002/sim.2098.

    Article  PubMed  Google Scholar 

  30. Wasserstein, R. L., Schirm, A. L., & Lazar, N. A. (2019). Moving to a world beyond p < 0.l05. The American Statistician, 73(sup1), 1–19. https://doi.org/10.1080/00031305.2019.1583913.

    Article  Google Scholar 

  31. Westreich, D., & Greenland, S. (2013). The table 2 fallacy: Presenting and interpreting confounder and modifier coefficients. American Journal of Epidemiology, 177(4), 292–298. https://doi.org/10.1093/aje/kws412.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wooldridge, J. M. (2008). Introductory econometrics: A modern approach (4th ed.). Boston: Cengage Learning.

    Google Scholar 

  33. World Health Organization. (2011). ICD-10: International statistical classification of diseases and related health problems. Geneva: World Health Organization.

    Google Scholar 

  34. Xu, J., Murphy, S. L., Kochanek, K. D., Bastian, B., & Arias, E. (2018). Deaths: Final data for 2016. National Vital Statistics Reports July 26, 2018, 67(5), 1–128.

Download references

Acknowledgements

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.

Author information

Affiliations

Authors

Corresponding author

Correspondence to David B. Braudt.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Braudt, D.B., Lawrence, E.M., Tilstra, A.M. et al. Family Socioeconomic Status and Early Life Mortality Risk in the United States. Matern Child Health J 23, 1382–1391 (2019). https://doi.org/10.1007/s10995-019-02799-0

Download citation

Keywords

  • Mortality
  • Early life
  • Socioeconomic status
  • Disparities
  • National Health Interview Survey