ECONOMIC REPORT OF THE PRESIDENT

Disparities in Early Health
Prenatal, neonatal, and post-neonatal health (through the first year
of life) are crucial early determinants of later-in-life health and academic
success. Good health and nutritional baselines are directly linked to better
health in childhood. Early health outcomes carry over into adult health outcomes
and even connect to non-health outcomes such as cognition, which
can continue into adulthood. Even before birth, children born into lower
socioeconomic status households face disadvantages in the area of health.
Individuals of lower socioeconomic status experience higher levels of
stress than more advantaged individuals. As such, the link between maternal
stress and child physical and mental health outcomes puts children born
into poorer households at higher risk of adverse health outcomes (Persson
and Rossin-Slater 2015; Thompson 2014; Kunz-Ebrecht et al. 2004; Cohen
et al. 2006; Aizer, Stroud, and Buka 2012). Health disadvantages continue
throughout children’s earliest years in the form of food insecurity, stress,
and cognitive overload (an accumulation of concerns to the point that
the stress becomes overwhelming and impairs cognitive functioning). The
stress and concerns associated with living in poverty can affect cognition
and health into adulthood. Children born to lower-income mothers are also
less likely to receive early and adequate prenatal care. Rates of first trimester
prenatal care increase with educational attainment, from only 58 percent of
mothers with less than a high school diploma to 86 percent of mothers with a
bachelor’s degree or higher (Health Resources and Services Administration
2013).
As a result of exposure to these adverse early childhood health conditions,
children growing up in poverty may experience more physical and
mental health problems throughout their lives. Researchers have shown
that maternal stress during pregnancy depresses birth weight (Persson and
Rossin-Slater 2015; Black, Devereux, and Salvanes 2016) and can increase
the risk of hospitalizations in the first five years of life (Persson and Rossin-
Slater 2015). The impacts of maternal stress during pregnancy can even be
traced to educational attainment (Aizer, Stroud, and Buka 2012) and adult
mental health (Persson and Rossin-Slater 2015).
Children growing up in poverty tend to do worse across a spectrum
of important early health outcomes. They are nearly twice as likely to be
born at a low or very low birth weight and are four times more likely to
have poor overall physical health (Figure 4-3). Birth weight is one early
indicator of health that can be highly predictive of later-life success. Studies
of birth weight find that it is not only a good predictor of short-term health
and mortality, but also of longer-term health and human capital variables,
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