The intergenerational transmission of inequality: Maternal disadvantage and health at birth

Abstract

Health at birth is an important predictor of long-term outcomes, including education, income, and disability. Recent evidence suggests that maternal disadvantage leads to worse health at birth through poor health behaviors; exposure to harmful environmental factors; worse access to medical care, including family planning; and worse underlying maternal health. With increasing inequality, those at the bottom of the distribution now face relatively worse economic conditions, but newborn health among the most disadvantaged has actually improved. The most likely explanation is increasing knowledge about determinants of infant health and how to protect it along with public policies that put this knowledge into practice.

Adolescence and the next generation

“…Similarly, high rates of mental disorders are likely to require not only early clinical intervention, but also the targeting of risk factors and the acquisition of protective social and emotional skills. For poor and socially marginalized adolescents in higher-income countries, who often have high and early fertility, responses may need to be similar to those for adolescents growing up in low-income countries 19 . Creating health-promoting environments for adolescents will ultimately require engagement well beyond the health sector, with education, local government, industry, religious leaders, civil society and young people themselves all essential actors.…”

“…This is surprising, given that adolescents are the next generation to become a parent and we have known for decades that preconception maternal nutrition (for example, folate deficiency) 16 and infectious diseases 17,18 affect the early life health and development of offspring. Indeed, a failure to consider influences on growth during early life that emerge in adolescence before conception may explain why antenatal interventions have too often only led to small gains 10,19 .…”

“…Here we explore the range of adolescent processes-molecular, physio logical, behavioural and sociocultural-that may affect the early growth, health and development of the next generation [19][20][21] (Fig. 1).…”

Perinatal Complications and Aging Indicators by Midlife

“…46,47 Advances in obstetric medicine in developing regions, home to .80% of the world's population, will soon also increase the number of survivors with perinatal complications. [48][49][50] Birth outcomes are important determinants of a range of adult attainments, 47 and previous research indicates that many newborns who survive perinatal complications carry a lifelong vulnerability to poor health. [2][3][4][5] Here we present evidence of such sustained vulnerability emerging already in midlife, before agingrelated diseases begin to develop.…”

Perinatal Complications and Aging Indicators by Midlife

“…Since our cohort was born in the 1970s, advances in obstetric medicine, particularly in developed countries, have reduced infant mortality and saved lives. 46,47 Advances in obstetric medicine in developing regions, home to .80% of the world's population, will soon also increase the number of survivors with perinatal complications. [48][49][50] Birth outcomes are important determinants of a range of adult attainments, 47 and previous research indicates that many newborns who survive perinatal complications carry a lifelong vulnerability to poor health.…”