• 05.22.14

Born Behind: The Effects Of Income Inequality Start While You’re In The Womb

Bad health care and bad environment can disadvantage babies before they’re even born.

Born Behind: The Effects Of Income Inequality Start While You’re In The Womb
[Image: Pregnant woman via Shutterstock]

Some people are born at a disadvantage, literally.


There’s mounting evidence that a baby’s health at birth can have lifetime repercussions. A new analysis extends this idea, spelling out how babies born to low-income minority mothers are at a health and developmental disadvantage from the moment they leave the womb.

This isn’t an easy topic to study. It’s difficult to tease apart conditions of a mothers’ prenatal health conditions, genetic inheritance, and a baby’s post-birth environment when looking at what affects the health of a newborn in the long term. The study, in the current Science, is a review of work in this area, as part of the journal’s special issue about the “Science of Inequality.”

In the study, the authors look at low birth weight (less than 5.5 pounds) as a measure of health at birth, since low-birth weight has been shown to correlate with continued health problems, developmental delays and even lower IQs later into life. They found that the most disadvantaged mothers, who were black, unmarried, and had less than a high school education, were more than three times more likely to have a low-birth weight child than the most advantaged mothers (who were white, married, and college educated).

Several factors in the lives of disadvantaged mothers contribute to this disparity, the authors, Brown University economist Anna Aizer and Princeton University economist Janet Currie, write. Environmental conditions, like exposure to toxins, violence, and stress, can affect a baby in the womb–all more likely in poorer communities. Disadvantaged mothers, who may not have health insurance, are also more likely to receive poorer prenatal health case, as well as have their own underlying medical conditions, like diabetes or poor nutrition, that could affect their fetus. Lastly, disadvantaged mothers are more likely to engage in unhealthy behaviors like smoking or drinking that impact a fetus’s health.

There is some good news: The gap in health disparities for prenatal conditions is slowly closing, even as the gap between the rich and the poor gets wider. “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 authors write.

They attribute this to improved knowledge about what matters for fetal health, as well as several policies and programs that are making interventions to improve it. Examples include more expectant mothers getting the flu vaccine; more mothers getting nutrition and food stamp aid; and advances in pollution control that have taken toxins from the air.

Health programs like these can break the cycle of transmitting inequality from generation to generation. When prenatal exposure to pollution correlates with fewer IQ points and behavioral problems in children, the connection couldn’t be any more important.

About the author

Jessica Leber is a staff editor and writer for Fast Company's Co.Exist. Previously, she was a business reporter for MIT’s Technology Review and an environmental reporter at ClimateWire.