Family Income Impacts Children's Health

Another factor influencing children's health: a mother's education. Across the country, babies born to mothers who have at least 16 years (i.e., a college degree) of education are less likely to die before reaching their first birthday than babies born to mothers who have not finished high school.

For example, in South Carolina, infant mortality among mothers who have not graduated high school reaches 11.6 deaths per 1,000, compared with 5.3 deaths per thousand among mothers who have had at least 16 years of education. This is one of the largest gaps in infant mortality based on years of school, according to the report.

Despite this, infant mortality rates in almost every state exceed what ideally could be achieved -- a national benchmark rate of only 3.2 deaths per 1,000, Egerter said.

Other report highlights:

• Children in poor families in most states are six times more likely to be in less than optimal health, compared with higher income families.
• Children in middle-income families are twice as likely, in some states, to be in less than optimal health than children in higher income families.
• Infant mortality is 40 percent higher among mothers with 13 to 15 years of schooling, compared with mothers with at least 16 years of school.
• Children in homes without a high school graduate are more than four as times likely to be in less than optimal health as children in a home with a high school graduate, and four times as likely to be in suboptimal health as a child in a home where someone has been to college.

Improving children's health across the United States means not only improving access to the health care, but improving the conditions in which many children are raised, Egerter said.

"We need to change the conversation about health in this country," Egerter said. "We need solutions beyond the medical care system to improve the health of children in this country. Children need the right physical and social conditions to help them be healthy kids who develop into healthy adults. Focusing on health care and coverage is important, but we need to recognize that there is more to health than health care," she said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, agreed that household income is key.

"A lot of detailed information in this compelling report distills down to a simple and rather common sense message: the fewer social and economic advantages enjoyed by a household, the worse the health of the children being raised there," Katz said. "Babies born to households deficient in education and income are more likely to die in infancy and less likely to experience optimal health," he added.

This report is a tale of trickle-down disparities, Katz said. "Disadvantaged parents raise children disadvantaged from the start with regard to both health and survival," he said.

The problem of disparities is clear, but the solution is much less so, Katz said.

"Can we get all children born in the U.S. to experience a uniform opportunity for survival and optimal health? Perhaps, but only with real dedication to a mission that will be neither quickly nor easily accomplished," he said.

More information

To see the full report, visit theRobert Wood Johnson Foundation.