Born to Lose: Health Inequality at Birth

http://economix.blogs.nytimes.com/2011/06/27/born-to-lose-health-inequality-at-birth/

June 27, 2011, 6:00 AM
By NANCY FOLBRE

In an imaginary world of equal opportunity we would all be free to choose our own economic future. In reality, many children in the United States are born to lose, suffering health disadvantages at birth that reduce their likelihood of economic success.

Epidemiologists and economists have long agreed that low birth weight is an important, albeit approximate, predictor of future health problems. A wealth of new economic research tracing individuals over time shows that it is also an approximate predictor of future earnings problems, with statistical effects almost as strong as children’s test scores.

Among other things, low birth weight increases the probability of suffering from attention deficit hyperactivity disorder and lowers the probability of graduating from high school.

In the current American Economic Review, Janet Currie of Princeton, a pioneer in this new area of research, summarizes recent findings and points out that children of black mothers who dropped out of high school are three times as likely as children of white college-educated mothers to suffer low birth weight.

Many of the mechanisms that underlie this inequality are linked to characteristics of the physical environment, such as exposure to environmental toxins.

For instance, carbon monoxide related to automobile emissions harms fetal health. Detailed statistical analysis of families in New Jersey shows that moving from an area with high levels of carbon monoxide to one with lower levels has an effect on birth weight larger than persuading a woman who was smoking 10 cigarettes a day during pregnancy to quit.

Another memorable illustration of carbon monoxide effects comes from a study of the impact of E-ZPass electronic technologies, which improve infant health by reducing auto emissions in neighborhoods close to highway toll booths.

Exposure to toxic air pollutants and waste dumps (like Superfund cleanup sites) both lowers birth weight and increases the risks of premature and infant death.

Professor Currie’s research shows that black and Latino children are significantly more likely than white children to be born to mothers living in proximity to such hazards, supporting arguments long made by environmental justice advocates.

Less-educated mothers are less aware of such health risks and less able to mobilize the economic resources necessary to move to better neighborhoods. This helps explain results showing that improved educational opportunities for mothers improve infant health.

Another important policy implication is that stricter environmental regulation would benefit low-income children in particular. Professor Currie has taken part in research showing that reductions in the release of three toxicants (cadmium, toluene, and epichlorohydrin) from 1988 to 1999 account for a 3.9 percent reduction in infant mortality over that time.

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Professor Currie herself tends to emphasize the pricing problem. As she put it: “Factories dump toxic releases into the atmosphere but don’t pay the cost of pollution. There would be less harm to the children who ingest the toxins if the factories had to bear the cost.”

Changes would happen even more quickly if the chief executives of these companies — and their children — had to bear the cost. But these adults are free to choose where to live and what to breathe. And their children are, for the most part, born to win.

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