Abstract
The purpose of this study was to explore relationships between the Great Recession in the United States and maternal and child health (MCH) disparities in prenatal care, birth weight, gestational age, and infant mortality. Using annual, 2005–2011 individual-level Washington (WA) and Florida (FL) birth certificate data, we analyzed MCH outcome rates and disparities among subpopulation component groups (e.g., subpopulation ‘maternal ethnicity’ divided into component groups such as non-Hispanic white, non-Hispanic black). We focused on whether disparities widened during two recession periods: Period 1 (December 2007–June 2009—official dates of Great Recession) and Period 2 (January 2010–December 2011) and compared these to a Baseline Period 0 (January 2005–March 2007). Subpopulations (n = 14) and component groups (n = 47) were identified a priori. Results indicate that disparities widened on at least one MCH outcome for 22 component groups in WA during Period 1 and 37 component groups during Period 2, compared to baseline. In FL, disparities widened for 25 component groups during Period 1 and 31 during Period 2. Disparities increased in both periods on the same outcomes for 11 WA component groups and 7 component groups in FL. Disparity increases tended to cluster among those with young age, low education, and among members of minority race/ethnicity groups—particularly black mothers. Findings support hypothesized relationships between expected increases in need during the Great Recession, and worsening MCH outcomes and disparities. Compared to baseline, there were more disparity increases in Period 2 than 1. Additional research regarding specific factors influencing changes in disparities are needed.
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Acknowledgements
The authors would like to acknowledge valuable feedback provided by Jerry Herting, Andrew Dannenberg, and Chris Adolph on this manuscript as it was being developed. Also acknowledged is financial support the first author received from the University of Washington’s ITHS TL1 Predoctoral Training Grant (TL1 TR000422) during the 2011–2012 and 2012–2013 years as well as a University of Washington School of Nursing Hahn Endowed Fellowship during Spring Quarter 2014. Funding was also provided by National Heart Lung and Blood Institute for the first author during manuscript finalization and revision in 2018–2019 (Grant No. 5K12HL137940-02).
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Abu-Rish Blakeney, E., Bekemeier, B. & Zierler, B.K. Relationships Between the Great Recession and Widening Maternal and Child Health Disparities: Findings from Washington and Florida. Race Soc Probl 12, 87–102 (2020). https://doi.org/10.1007/s12552-019-09272-1
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DOI: https://doi.org/10.1007/s12552-019-09272-1