Grandparents' Education and Infant Health: Pathways Across Generations

• DOI: http://doi.org/10.1111/jomf.12383
• Author: Michael J. McFarland,Bridget J. Goosby,Sara S. McLanahan,Nancy E. Reichman
• Date: 01 June 2017
• Published date: 01 June 2017

M J. MF Florida State University

S S. ML Princeton University∗

B J. G University of Nebraska at Lincoln∗∗

N E. R Rutgers University∗∗∗

Grandparents’ Education and Infant Health:

Pathways Across Generations

Using data from the Fragile Families and Child

Wellbeing survey linked to respondents’ med-

ical records (N=2,870), this study examines

the association between grandparents’ educa-

tion and birth outcomes and explores potential

pathways underlying this relationship. Results

show that having a grandfather with less than

a high school education was associated with

a 93 gram reduction in birth weight, a 59%

increase in the odds of low birth weight, and a

136% increase in the odds of a neonatal health

condition when compared with having a grand-

father with a high school education or more.

These associations were partially accounted for

Center for Demography and Population Health, Department

of Sociology, Florida State University, 619 Bellamy

Building, Tallahassee, FL 32306–2240

(mmcfarland@fsu.edu).

∗Bendheim-Thoman Center for Research on Child

Wellbeing, Princeton University, 265 WallaceHall,

Princeton, NJ 08544.

∗∗Department of Sociology, University of Nebraska at

Lincoln, 741 Old Father Hall, Lincoln, NE 68588.

∗∗∗Robert Wood Johnson Medical School, Department of

Pediatrics, Rutgers University,Room 3272, 89 French St.,

New Brunswick, NJ 08903.

This article was edited by Linda Waite.

Key Words: education, grandparents, health, infants, multi-

generational.

by mother’s educational attainment and mar-

ital status as well as by prenatal history of

depression, hypertension, and prenatal health

behaviors, depending on the specic outcome.

The ndings from this study call for heightened

attention to the multigenerational inuences of

educational attainment for infant health.

Social disparities in infant health are pervasive

in the United States. Rates of low birth weight,

preterm births, and other infant health condi-

tions are consistently higher among mothers

with lower levelsof educational attainment when

compared with their more advantaged counter-

parts (Reichman & Teitler, 2013). Despite years

of calls to improve perinatal health outcomes,

disparities by socioeconomic status (SES) have

remained relatively constant over time (U.S.

Department of Health and Human Services,

2000), suggesting that researchers lack a full

understanding of the processes producing these

disparities. Multigenerational inuences repre-

sent one area that may help ll this gap in

knowledge. Indeed, the multigenerational ori-

gins of infant health may be particularly impor-

tant because poor infant health impedes SES

attainment and represents a potential pathway

by which inequality is transferred across genera-

tions (Goosby & Cheadle, 2009; Palloni, 2006).

Mare (2011), in his Population Association

of America’s presidential address, sagaciously

784 Journal of Marriage and Family 79 (June 2017): 784–800

DOI:10.1111/jomf.12383

Grandparents’ Education and Infant Health 785

argued that scholars have been unjustied in

ignoring the multigenerational transmission of

inequality and advocated that demographers

direct their research efforts toward this end.

His call has resulted in an upsurge of research

focused on the inuences of grandparents (e.g.,

Fomby, James-Hawkins, & Mollborn, 2015;

Sharkey & Elwert, 2011; Zeng & Xie, 2014)

but has been limited to stratication-related

outcomes. Our study extends Mare’s argument

to infant health. The bulk of research on infant

health has focused on immediate risk factors

to the neglect of long-term multigenerational

processes. Given that infant health is socially

patterned (Blumenshine, Egerter, Barclay,

Cubbin, & Braveman, 2010) and SES has inter-

generational origins (Warren & Hauser, 1997),

infant health may be at least partially rooted in

multigenerational origins.

In this study, we investigate the relationship

between maternal grandparent’s education and

birth outcomes and explore the relative plau-

sibility of intervening social, behavioral, and

biological pathways. Past research has been

handicapped by data limitations because vital

statistics data lack demographic data on grand-

parents, and most survey research lacks detailed

information on birth outcomes and obstetrical

data. Here we are able to surmount this issue

by employing data from the Fragile Families

Project (www.fragilefamilies.princeton.edu),

which links survey data to medical les from

the birth hospitalization.

B

Whether and to what extent grandparents’ edu-

cational attainment is related to the birth out-

comes of their grandchildren is unknown. Two

strands of literature provide clues about this

topic. First, although not focused on infant health

outcomes per se, a modest but growing lit-

erature suggests that grandparents’ SES status

can inuence the well-being of their grand-

children (Cherlin & Furstenberg, 1992; Fomby

et al., 2015; Sharkey & Elwert, 2011; Warren

& Hauser, 1997). Overall, this literature hints

that grandparents’ SES can inuence grandchil-

dren’s outcomes either indirectly through the

status attainment of parents or indirectly through

other mechanisms such as role modeling.

Second, although the small body of literature

that directly examines the relationship between

grandparent’s SES and infant health cannot

provide many denitive answers because of

varying samples, study designs, and measures

of SES, three tentative conclusions can be

reached. Mothers from disadvantaged back-

grounds in childhood tend to have children with

lower birth weight when compared with their

more advantaged counterparts (Astone, Misra,

& Lynch, 2007; Gavin, Hill, Hawkins, & Maas,

2011; Gavin, Thompson, Rue, & Gou, 2012;

Kane, 2015). Mother’s adult SES and marital

status operate as pathways connecting early

life experiences to birth outcomes (Gavin et al.,

2011, 2012; Kane, 2015). Finally, substance use

appears to be a key pathway connecting moth-

ers’ early life experiences with birth outcomes

(Gavin et al., 2011, 2012).

Cumulative Inequality and Under-the-Skin

Processes

The underlying theme behind this research is

that a mother is, at least partially, a product

of her parents’ social environment, and the

consequences of this environment can rever-

berate across generations. We use Ferraro and

Shippee’s (2009) cumulative inequality (CI)

theory to better understand how these processes

may be operating in the case of birth outcomes.

CI theory combines concepts from the cumu-

lative adversity and disadvantage literature and

life course sociology to argue that conditions

established in the past have an enduring impact

and cumulate rather than equilibrate over time

(Mare, 2011; O’Rand, 2003). CI theory builds

on cumulative adversity and disadvantage the-

ory, posited by Dannefer (1987) and O’Rand

(2003), by explicitly integrating the intergen-

erational transmission of inequalities into life

course health processes.

Three elements of CI theory are important

for this study. First, CI theory states that child-

hood conditions and therefore family lineage

are particularly important for the accumulation

of inequality. Moreover, childhood conditions

are thought to be especially detrimental when

disadvantage emerges early in life and persists

across childhood, as is often the case for moth-

ers with low childhood SES. This proposition

suggests that the health of a mother’s infant

at birth should be, at least partially, anchored

in the conditions in which the mother was

reared. Second, social inequalities emerge dur-

ing the life course through developmental and

demographic processes. For instance, early