Social Spending and Educational Gaps in Infant Health in the United States, 1998-2017.

Recent expansions of child tax, food assistance, and health insurance programs have made American families' need for a robust social safety net highly evident, while researchers and policymakers continue to debate the best way to support families via the welfare state. How much do children-and which children-benefit from social spending? Using the State-by-State Spending on Kids Dataset, linked to National Vital Statistics System birth data from 1998 to 2017, we examine how state-level child spending affects infant health across maternal education groups. We find that social spending has benefits for both low birth weight and preterm birth rates, especially among babies born to mothers with less than a high school education. The stronger benefits of social spending among lower educated families lead to meaningful declines in educational gaps in infant health as social spending increases. Our findings are consistent with the idea that a strong local welfare state benefits infant health and increases equality of opportunity, and that spending on nonhealth programs is equally beneficial for infant health as investments in health programs.

Public Investments and Class Gaps in Parents' Developmental Expenditures.

Families and governments are the primary sources of investment in children, providing access to basic resources and other developmental opportunities. Recent research identifies significant class gaps in parental investments that contribute to high levels of inequality by family income and education. State-level public investments in children and families have the potential to reduce class inequality in children's developmental environments by affecting parents' behavior. Using newly assembled administrative data from 1998-2014, linked to household-level data from the Consumer Expenditure Survey, we examine how public sector investment in income support, health and education is associated with the private expenditures of low and high-SES parents on developmental items for children. Are class gaps in parental investments in children narrower in contexts of higher public investment for children and families? We find that more generous public spending for children and families is associated with significantly narrower class gaps in private parental investments. Moreover, we find that equalization is driven by bottom up increases in low-SES households' developmental spending in response to the progressive state investments of income support and health, and by top down decreases in high-SES households' developmental spending in response to the universal state investment of public education.

Immigrant-native differences in child health: does maternal education narrow or widen the gap?

Abundant U.S. research documents an "immigrant advantage" in children's physical health. This article extends consideration to the United Kingdom, permitting examination of a broader group of immigrants from disparate regions of the world and different socioeconomic backgrounds. Drawing on birth cohort data (ages 0-5) from both countries (n=4,139 and n=13,381), the analysis considers whether the children of immigrants have a physical and mental health advantage around the beginning of elementary school, and whether advantage is more pronounced among low-educated populations. Findings indicate that the children of immigrants are not uniformly healthier than those in native-born families. Rather, there is heterogeneity in the immigrant advantage across outcomes, and evidence of both greater advantage and disadvantage among children in low-educated immigrant families.

Nativity Differences in Youths' Weight Trajectories: Foreign-Born Health Integration during the Transition to Adulthood.

Nativity differences in youths' health in the United States are striking, with the children of foreign-born parents showing more favorable outcomes than those of native-born parents. Very little is known about how inequalities evolve within the same individuals over time, or more generally about life cycle aspects of the health integration of youth with migration backgrounds. Using data from the National Longitudinal Study of Adolescent Health, I examine nativity differences in trajectories of weight gain during adolescence and early adulthood, as well as the degree to which trajectories are stratified by race/ethnicity and socioeconomic status. Do nativity differences converge, diverge or remain stable over time, and how are patterns socially stratified within and across nativity groups? I find that first-generation adolescents begin at a lower weight than their third generation peers and gain weight at a significantly slower pace, producing meaningful differences by early adulthood. More complex examination of the relationship between nativity and weight gain reveals additional differences by ethnicity: the foreign-born advantage over time does not extend as strongly to Hispanic adolescents. The findings demonstrate how the health-related integration of foreign-born youth is tied to race/ethnicity and socioeconomic circumstances, and suggest the need to examine the ways in which social circumstances and health change together.

Schooling Location and Economic, Occupational and Cognitive Success among Immigrants and Their Children: The Case of Los Angeles.

Large numbers of foreign-born residents in the United States mean that many people receive at least part of their education abroad. Despite this fact, our understanding of nativity differences in the success of adults and their children is based on research that does not empirically consider variation in the benefits to schooling depending on where it is received. We use data from the Los Angeles Family and Neighborhood Survey (L.A. FANS) to examine: a) whether the socioeconomic and cognitive returns to education depend on whether it is received in the U.S. or abroad; and b) whether schooling location partially accounts for nativity differences in these returns. We find that the returns to schooling are generally largest for adults who receive at least some of their highest level of education in the U.S. The beneficial effects of U.S. schooling are more pronounced at higher levels of educational attainment. Schooling location accounts for a sizeable fraction of the lower socioeconomic and cognitive returns of the foreign-born, relative to natives; some meaningful differences remain, however. In addition, the higher cognitive skills of the children of foreign-born adults remain unexplained. Although we cannot distinguish among the possible pathways underlying these associations (e.g., school quality, transferability of credentials, the timing of immigration) our findings suggest the importance of considering factors related to schooling location as predictors of socioeconomic and cognitive success in the United States.

The Educational Gradient in Health among Children in Immigrant Families.

Educational inequality in the health of U.S. children-what social scientists refer to as the "educational gradient" in health-is present at birth for virtually every marker of health, and increases throughout childhood. However, a puzzling contradiction to this pattern has been observed among the growing population of youth in immigrant families. Some evidence suggests an ambiguous relationship between education and health among immigrant families, with a flat relationship between maternal education and maternal health behaviors and children's birth outcomes, and a stronger relationship as children become adolescents. Does an educational gradient in health emerge among children in immigrant families during childhood and adolescence? To date, we lack a prospective examination of how the gradient changes from birth throughout childhood and adolescence among this population. Moreover, while the dominant explanation for a weaker gradient among children with immigrant parents centers on the family setting, we know little about family-level dynamics among the same immigrant families as children age. Using national, longitudinal data from the Fragile Families and Child Well-Being Study, we examine the association between maternal education and children's health (measured by mothers' ratings) over the early life course (birth through age 15) among children of immigrants and children of native-born parents, and consider whether changes in children's economic status and family composition contribute to the educational gradient, or lack thereof, in child health. Analyses reveal that: (1) maternal education is strongly predictive of health, even among children of immigrants; (2) immigrant status does not appear to be protective for health within educational groups, as evidenced by poorer health among children of immigrants whose mothers have the lowest level of education, as compared to children of natives; (3) children in the least-educated immigrant families are experiencing better health trajectories as they age than children in similar native-born families; and (4) accounting for economic conditions and family composition does not reduce the size of the gradient over time.

CROSS-SECTIONAL AND LONGITUDINAL MEASUREMENTS OF NEIGHBORHOOD EXPERIENCE AND THEIR EFFECTS ON CHILDREN.

Despite the abundance of research on neighborhoods' effects on children, most studies of neighborhood effects are cross-sectional, rendering them unable to depict the dynamic nature of social life, and obscuring important aspects of community processes and outcomes. This study uses residential histories from the Los Angeles Family and Neighborhood Survey and the Child Development Supplement of the Panel Study of Income Dynamics to explore two questions: 1) How much do residential mobility and neighborhood change contribute to the overall socioeconomic variation in children's neighborhoods? 2) Does measuring community factors at more than one point in time matter for the conclusions that we draw from research on "neighborhood effects" on children's behavioral, cognitive and health-related well-being? Residential mobility plays a non-trivial role over the period of childhood in determining children's exposure to neighborhoods of different economic types. However, quantitative estimates of neighborhood effects that allow neighborhood characteristics to vary through residential mobility and neighborhood change do not depict a strikingly different picture from cross-sectional estimates. Children do not experience enough variation in their local surroundings to produce meaningful differences between static and dynamic measurements of neighborhoods. We also uncover interesting regional and race/ethnic differences in neighborhood dynamics and neighborhood effects.

Child access to the nutritional safety net during and after the Great Recession: The case of WIC.

Because children disproportionately live in poverty, they are especially vulnerable during economic crises, making the social safety net a key buffer against the effects of economic disadvantage on their development. The Great Recession of 2007-2009 had strong and lasting effects on American children and families, including striking negative effects on their health environments. Understanding access to the health safety net during this time of increased economic need, as well as the extent to which all children-regardless of age, income or race/ethnicity-share in the increased use of transfer programs, is therefore important in identifying the availability and accessibility of government assistance for those in need. Focusing on the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program because of its strong effects on child development, we use longitudinal data from the Survey of Income and Program Participation (SIPP) to examine change and stability in children's WIC enrollment before, during and after the recession. Specifically, we examine: 1) whether children's WIC enrollment increased alongside changing family income, and 2) the extent to which changes in participation were shared by all subpopulations, regardless of age, income, and race/ethnicity. Analyses reveal that WIC participation among eligible children increased leading up to, during, and after the Great Recession, suggesting that the program was responsive to increasing economic need. Examining the distribution of WIC enrollment across demographic groups largely reveals a pattern of stable inequality in access and "take up." Children born to poorer and less-educated mothers were more likely to be enrolled prior to the recession, and these differences remain mostly constant during and after the recession. Eligible Hispanic children had consistently higher enrollment, particularly among those in families with foreign-born mothers. The findings suggest that not all eligible children equally enroll in WIC, but that these differences have not been drastically exacerbated by macroeconomic instability.

Early childhood WIC participation, cognitive development and academic achievement.

For the 22% of American children who live below the federal poverty line, and the additional 23% who live below twice that level, nutritional policy is part of the safety net against hunger and its negative effects on children's development. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides steadily available food from the food groups essential for physical and cognitive development. The effects of WIC on dietary quality among participating women and children are strong and positive. Furthermore, there is a strong influence of nutrition on cognitive development and socioeconomic inequality. Yet, research on the non-health effects of U.S. child nutritional policy is scarce, despite the ultimate goal of health policies directed at children-to enable productive functioning across multiple social institutions over the life course. Using two nationally representative, longitudinal surveys of children-the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) and the Child Development Supplement (CDS) of the Panel Study of Income Dynamics-I examine how prenatal and early childhood exposure to WIC is associated in the short-term with cognitive development, and in the longer-term with reading and math learning. Results show that early WIC participation is associated with both cognitive and academic benefits. These findings suggest that WIC meaningfully contributes to children's educational prospects.

Cumulative inequality in child health and academic achievement.

Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered, the duration and stability of poor health, and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N = 9,252) to ask: (1) if child health is a source of cumulative inequality in academic achievement, (2) whether this relationship depends on the timing and duration of poor health, and (3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists and that whether we observe shrinking or widening inequality as children age depends on when we measure their health and whether children have access to compensatory resources.

A Life Course Perspective on Child Health, Academic Experiences and Occupational Skill Qualifications in Adulthood: Evidence from a British Cohort.

Existing research rarely examines the social consequences of poor childhood health from a longitudinal perspective. Using data from the British National Child Development Study, I follow a cohort from before birth through middle age to examine whether children's health limitations before and during the educational process predict occupational skill qualifications in mid-adulthood, and whether any negative consequences are strongest for children in persistently poor health. I also examine whether differences in achievement explain the observed associations, and at what point during the schooling process performance begins to play a large explanatory role. Poor health is strongly negatively related to qualifications in adulthood, particularly for children in persistently poor health. These associations are largely explained by differences in performance early in children's academic careers, before the first important transition point. The relationship between prenatal maternal smoking and mid-adulthood qualifications is more persistent. This paper demonstrates that a static conceptualization of childhood health is inadequate to fully understand the dynamic process through which social status and health over the course of childhood have long-run consequences for the adult life course.

Understanding links between adolescent health and educational attainment.

The educational and economic consequences of poor health during childhood and adolescence have become increasingly clear, with a resurgence of evidence leading researchers to reconsider the potentially significant contribution of early-life health to population welfare both within and across generations. Meaningful relationships between early-life health and educational attainment raise important questions about how health may influence educational success in young adulthood and beyond, as well as for whom its influence is strongest. Using data from the National Longitudinal Survey of Youth 1997, I examine how adolescents'health and social status act together to create educational disparities in young adulthood, focusing on two questions in particular. First, does the link between adolescent health and educational attainment vary across socioeconomic and racial/ethnic groups? Second, what academic factors explain the connection between adolescent health and educational attainment? The findings suggest that poorer health in adolescence is strongly negatively related to educational attainment, net of both observed confounders and unobserved, time-invariant characteristics within households. The reduction in attainment is particularly large for non-Hispanic white adolescents, suggesting that the negative educational consequences of poor health are not limited to only the most socially disadvantaged adolescents. Finally, I find that the link between adolescent health and educational attainment is explained by academic factors related to educational participation and, most importantly, academic performance, rather than by reduced educational expectations. These findings add complexity to our understanding of how the educational consequences of poor health apply across the social hierarchy, as well as why poor health may lead adolescents to complete less schooling.