The public health implications of maternal care trade-offs

Abstract

The socioeconomic and ethnic characteristics of parents are some of the most important correlates of adverse health outcomes in childhood. However, the relationships between ethnic, economic, and behavioral factors and the health outcomes responsible for this pervasive finding have not been specified in child health epidemiology. The general objective of this paper is to propose a theoretical approach to the study of maternal behaviors and child health in diverse ethnic and socioeconomic environments. The specific aims are: (a) to describe a causal pathway between the utility that women obtain through work outside the home and through child care and disease hazard rates in childhood using an optimization model; (b) to specify the influence of ethnic and socioeconomic factors on model constraints; (c) to use the model as a tool to learn about how different combinations of maternal wage labor and child care time might influence child health outcomes in diverse social contexts; (d) to identify parameters that will require measurement in future research; (e) to discuss research strategies that will enable us to obtain these measurements; and (f) to discuss the implications of the model for biostatistical modeling and public health intervention. Optimization models are powerful heuristic tools for understanding how ethnic, environmental, family, and personal characteristics can place important constraints on both the quality and quantity of care that women can provide to their children. They provide a quantitative appreciation for the difficult trade-offs that most women face between working in order to purchase basic goods that children cannot do without (e.g., food, clothing, shelter, health insurance), and increasing offspring well-being through child care (e.g., training in social skills, affection, protection from environmental hazards, help with homework).

Poverty related risk for potentially preventable hospitalisations among children in Taiwan

“…This may explain, at least in part, the economic disparity we observed in hospitalisations due to respiratory diseases. A similar association has been found between economic status and child safety [ 34 , 35 ], which partly explains why poor children suffer from higher incidences of acute injuries and poisonings.…”

Plasticity in Human Life History Strategy

“…There is also evidence that individuals who experience stressful environments during childhood invest less in their own offspring (Ellis et al 2009;Hurtado et al 2006). For instance, parental investment is reduced under conditions of harsh, unavoidable stressors such as pathogen loads, famine, or warfare (Quinlan 2007).…”

Maternal Time Allocation in Two Cooperative Childrearing Societies

“…It is argued that the reduction in work activities or investment in child care illustrates that many activities are not compatible with child care. Women must balance providing high-quality care, with minimal sacrifice in time and efficiency in economic activities (Hurtado et al 2006)-at times an impossible task. For example, among the Humla in Nepal (Levine 1988), the nature of work and the distance mothers must travel from the home require mothers to leave their infants at home while they participate in subsistence activities.…”