An unconditional prenatal cash benefit is associated with improved birth and early childhood outcomes for Metis families in Manitoba, Canada

Struck, Shannon; Enns, Jennifer; Sanguins, Julianne; Chartier, Mariette; Nickel, Nathan; Château, Dan; Sarkar, Joykrishna; Burland, Elaine; Hinds, Aynslie; Katz, Alan; Santos, Rob; Chartrand, A Frances; Brownell, Marni

doi:10.1016/j.childyouth.2020.105853

Cited by 10 publications

(18 citation statements)

References 48 publications

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“…Viewed in that framework, it is not surprising that community-based parenting programs that promote caregiver self-care, connection to resources, and knowledge of child attachment have proven efficacious in communities affected by violence ( 99 , 100 ). Beyond community-based interventions that focus on providing more supports to parents and caregivers in higher-risk settings, national policies that increase resources for pregnant women and other caregivers—such as expansion of perinatal Medicaid coverage, increased parental leave, and perinatal cash transfer programs—can uplift our capacity to break intergenerational cycles of risk for child psychopathology and poor health ( 101 – 103 ). A growing body of literature highlights the importance and benefits of offering universal access to evidence-based parenting support and training programs—especially early in child development ( 104 ).…”

Section: Discussionmentioning

confidence: 99%

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

et al. 2022

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ObjectiveExperiences of stress and adversity, such as intimate partner violence, confer risk for psychiatric problems across the life span. The effects of these risks are disproportionately borne by women and their offspring—particularly those from communities of color. The prenatal period is an especially vulnerable period of fetal development, during which time women's experiences of stress can have long-lasting implications for offspring mental health. Importantly, there is a lack of focus on women's capacity for resilience and potential postnatal protective factors that might mitigate these intergenerational risks and inform intervention efforts. The present study examined intergenerational associations between women's prenatal stressors and child executive functioning and externalizing problems, testing maternal parenting quality and child sex as moderators, using a large, prospective, sociodemographically diverse cohort.MethodsWe used data from 1,034 mother-child dyads (64% Black, 30% White) from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) pregnancy cohort within the ECHO PATHWAYS consortium. Women's prenatal stressors included stressful life events (pSLE) and intimate partner violence (pIPV). Measures of child psychopathology at age 4–6 included executive functioning and externalizing problems. Parenting behaviors were assessed by trained observers, averaged across two sessions of mother-child interactions. Linear regression models were used to estimate associations between women's prenatal stressors and child psychopathology, adjusting for confounders and assessing moderation effects by maternal parenting quality and child sex.ResultsWomen's exposures to pSLE and pIPV were independently associated with child executive functioning problems and externalizing problems in fully-adjusted models. Maternal parenting quality moderated associations between pSLE and both outcomes, such that higher parenting quality was protective for the associations between women's pSLE and child executive functioning and externalizing problems. No moderation by child sex was found.DiscussionFindings from this large, sociodemographically diverse cohort suggest women's exposures to interpersonal violence and major stressful events—common for women during pregnancy—may prenatally program her child's executive functioning and externalizing problems. Women's capacity to provide high quality parenting can buffer this intergenerational risk. Implications for universal and targeted prevention and early intervention efforts to support women's and children's wellbeing are discussed.

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Section: Discussionmentioning

confidence: 99%

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

et al. 2022

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“…For adolescents, the SSP increased minor delinquency and substance use 2012; Struck et al, 2021;Woolley et al, 1996) or national surveys, such as the National Longitudinal Survey of Children and Youth (Hanratty & Trzcinski, 2009;Lebihan & Mao Takongmo, 2018;Milligan & Stabile, 2011), the Canadian Community Health Survey (Brown & Tarasuk, 2019;Daley, 2017;Ionescu-Ittu et al, 2015;Lebihan & Mao Takongmo, 2019;Tarasuk et al, 2019), or the Survey of Labour and Income Dynamics (Milligan & Stabile, 2007, 2011. These studies frequently used difference-in-differences methods (Ang, 2015;Baker et al, 2021;Brown & Tarasuk, 2019;Daley, 2017;Hanratty & Trzcinski, 2009;Ionescu-Ittu et al, 2015;Kim, 2014;Lebihan & Mao Takongmo, 2018;Lebihan & Mao Takongmo, 2019;Milligan, 2005;Milligan & Stabile, 2007, 2011Parent & Wang, 2007), time-series analyses (McNown & Ridao-cano, 2004), or cross-sectional (Brownell et al, 2016), repeated cross-sectional (Redelmeier et al, 2012;Tarasuk et al, 2019), or retrospective cohort (Brownell et al, 2018;Enns et al, 2019;Struck et al, 2021) designs to compare exposed individuals or populations to those unexposed to the intervention. Two studies simulated the effects of cash transfers using administrative or survey datasets (Milligan & Stabile, 2011;Woolley et al, 1996).…”

Section: Positivementioning

confidence: 99%

“…One study included a randomized controlled trial (Morris & Michalopoulos, 2003). To account for confounding, propensity-score matching (Brownell et al, 2018;Brownell et al, 2016;Enns et al, 2019;Struck et al, 2021) was employed in some cases.…”

Section: Positivementioning

confidence: 99%

“…Four studies measured birth outcomes, including preterm birth, birth weight, and hospital stays in the newborn period, and reported protective effects of an unconditional cash transfer (Brownell et al, 2018;Brownell et al, 2016). Two of these studies were specific to First Nations (Enns et al, 2021) or Métis (Struck et al, 2021) women and their children. One study measured the effects of universal child care benefit (UCCB) on child health, and found beneficial effects only on child aggression scores (Lebihan & Mao Takongmo, 2018).…”

Section: Child Health Outcomesmentioning

confidence: 99%

“…Multiple studies looked specifically at cash transfers in pregnancy or in the newborn period (Ang, 2015;Brownell et al, 2018;Brownell et al, 2016;Kim, 2014;Milligan, 2005;Parent & Wang, 2007). These have been evaluated in terms of how they may promote maternal and infant health among families with low income, as in the case of Manitoba's Healthy Baby Prenatal Benefit (Brownell et al, 2018;Brownell et al, 2016;Enns et al, 2019;Struck et al, 2021), or how they may promote fertility, as in the case of the Quebec Alliance for Newborn Children (Ang, 2015;Kim, 2014;Milligan, 2005;Parent & Wang, 2007). Multiple studies also evaluated national-level benefits, including the Universal Child Care Benefit (Baker et al, 2021;Daley, 2017;Ionescu-Ittu et al, 2015;Lebihan & Mao Takongmo, 2018;Lebihan & Mao Takongmo, 2019), which was a universal benefit paid per child to all families with children under 6 years of age, and the Canada Child Benefit (Baker et al, 2021;Brown & Tarasuk, 2019;Milligan & Stabile, 2011), National Child Benefit (Milligan & Stabile, 2007), and other national-level income-based child benefits (McNown & Ridao-cano, 2004;Tarasuk et al, 2019;Woolley et al, 1996).…”

Section: Exposure/interventionsmentioning

confidence: 99%

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Cash transfer programs and child health and family economic outcomes: a systematic review

Fuller

Zaffar

Cohen

et al. 2022

Can J Public Health

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Objectives Family income is an important determinant of child and parental health. In Canada, cash transfer programs to families with children have existed since 1945. This systematic review aimed to examine the association between cash transfer programs to families with children and health outcomes in Canadian children (ages 0 to 18) as well as family economic outcomes. Methods We reviewed academic and grey literature published up to November 2021. Additional studies were identified through reference review. We included any study that examined children 0-18 years old and/or their parents, took place in Canada and reported Canada-specific data, and reported child, youth and/or parental health outcomes, as well as family economic outcomes. Risk of bias was assessed by two reviewers using a modified Newcastle-Ottawa Scale. Synthesis Our search yielded 23 studies meeting the inclusion criteria out of 7052 identified. Eight studies in total measured child health outcomes, including birth outcomes, child overall health, and developmental and behavioural outcomes, and four directly addressed parental health, including mental health, injuries, and obesity. Most studies reported generally positive associations, though some findings were specific to certain subgroups. Some studies also examined fertility and labour force participation outcomes, which described varying effects. Conclusion Cash transfer programs to families with children in Canada are associated with better child and parental health outcomes. Additional research is needed to evaluate the mechanisms of effects, and to identify which types and levels of government transfers are most effective, and target populations, to optimize the positive effects of these benefits.

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Association of the 2021 Child Tax Credit Advance Payments With Low Birth Weight in the US

Margerison,

Zamani-Hank,

Catalano

et al. 2023

JAMA Netw Open

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ImportanceInfants and pregnant people in the US fare worse on almost all health measures compared with those in peer nations. Families in the US are more likely to live in poverty and have a less generous social safety net, which has generated debate over the contribution of economic conditions to this disparity.ObjectiveTo assess the association between temporary increases in income during pregnancy through the 2021 expanded Child Tax Credit (CTC) and birth outcomes.Design, Setting, and ParticipantsThis cross-sectional study applied a comparison-population, interrupted time series design to data from US birth certificates (January 1, 2014, through December 31, 2021) to test whether the log odds of low birth weight (LBW) among monthly cohorts of births exposed to the CTC would coincide with a decreased incidence of LBW. All singleton live births to US residents aged 15 to 49 years with available data were included.ExposureMonthly birth cohorts exposed to the CTC were defined as those born to parous people during the CTC advance payment period from July through December 2021.Main Outcomes and MeasuresThe main outcome was the natural logarithm of the odds of LBW (&lt;2500 g) among monthly birth cohorts.ResultsAmong included births (n = 28 866 466), 61.2% were to parous people, the majority were to people aged 20 to 39 years (91.7%), and 6.5% were born LBW. The odds of LBW increased above expected values in 5 of the 6 months of the CTC payments (range of increases, 3.3%-5.4% across the 5 months). The outlier-adjusted odds of LBW increased, on average, by 4.2% (95% CI, 2.7%-5.7%) among the monthly birth cohorts exposed to the CTC.Conclusions and RelevanceThis study found that the odds of LBW among birth cohorts exposed to the CTC increased above expected values in 5 of the 6 months of the CTC advance payments. Additional research is needed to evaluate rival explanations for this increase in LBW among births exposed to the CTC payments.

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An unconditional prenatal cash benefit is associated with improved birth and early childhood outcomes for Metis families in Manitoba, Canada

Cited by 10 publications

References 48 publications

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

Intergenerational Transmission of Effects of Women's Stressors During Pregnancy: Child Psychopathology and the Protective Role of Parenting

Cash transfer programs and child health and family economic outcomes: a systematic review

Association of the 2021 Child Tax Credit Advance Payments With Low Birth Weight in the US

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