Mothers' Social Status and Children's Health: Evidence From Joint Households in Rural India

Diverging destinies: How children are faring under demographic transition

India reached the replacement level of fertility in 2020. However, the journey of fertility transition is unconventional and heterogeneous within the country and across the different socio-economic groups. The fertility transition is considered to be faster than its socio-economic and health transition in several states. Thus, it has been presumed that the returns to fertility decline are heterogeneous across the states and population sub-groups. Our specific hypothesis is that although rich and poor, and educated and un-educated, everyone had significantly contributed to the fertility decline in response to family planning policies, only those socio-economically better-off have been investing relatively more in their children compared to the poor, and this has led to diverging destinies for children. We tested this supposition using a macro-level panel dataset (1992-2021), fixed and random effects, and IV regression models. The results confirm that child health care and outcomes have diverged while fertility declined from 1992 to 2021. These results are sustained in multiple robustness checks. While fertility is declining with highly state-sponsored family planning programmes, the persistent socio-economic inequalities are leading to unequal progress in health outcomes for children in India.

Poor housing quality and the health of newborns and young children

This study uses linked administrative data on live births, hospital stays, and census records for children born in Hungary between 2006 and 2011 to examine the relationship between poor housing quality and the health of newborns and children aged 1-2 years. We show that poor housing quality, defined as lack of access to basic sanitation and exposure to polluting heating, is not a negligible problem even in a high-income EU country like Hungary. This is particularly the case for disadvantaged children, 20-25% of whom live in extremely poor-quality homes. Next, we provide evidence that poor housing quality is strongly associated with lower health at birth and a higher number of days spent in inpatient care at the age of 1-2 years. These results indicate that lack of access to basic sanitation, hygiene, and non-polluting heating and their health impacts cannot be considered as the exclusive problem for low- and middle-income countries. In high-income countries, there is also a need for public policy programs that identify those affected by poor housing quality and offer them potential solutions to reduce the adverse effects on their health.

Intergenerational transmission of height in a historical population: From taller mothers to larger offspring at birth (and as adults)

Changes in growth and height reflect changes in nutritional status and health. The systematic surveillance of growth can suggest areas for interventions. Moreover, phenotypic variation has a strong intergenerational component. There is a lack of historical family data that can be used to track the transmission of height over subsequent generations. Maternal height is a proxy for conditions experienced by one generation that relates to the health/growth of future generations. Cross-sectional/cohort studies have shown that shorter maternal height is closely associated with lower birth weight of offspring. We analyzed the maternal height and offspring weight at birth in the maternity hospital in Basel, Switzerland, from 1896 to 1939 (N = ∼12,000) using generalized additive models (GAMs). We observed that average height of the mothers increased by ∼4 cm across 60 birth years and that average birth weight of their children shows a similarly shaped and upward trend 28 years later. Our final model (adjusted for year, parity, sex of the child, gestational age, and maternal birth year) revealed a significant and almost linear association between maternal height and birth weight. Maternal height was the second most important variable modeling birth weight, after gestational age. In addition, we found a significant association between maternal height and aggregated average height of males from the same birth years at time of conscription, 19 years later. Our results have implications for public health: When (female/maternal) height increases due to improved nutritional status, size at birth-and subsequently also the height in adulthood of the next generation-increases as well. However, the directions of development in this regard may currently differ depending on the world region.