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Research Studies in Pension

Factor Affecting Retirement Mortality (FARM)

This FARM site consists of

• an Introduction
• an Abstract
• a Bibliography of research papers
• a collection of Summaries of the research papers.

Use the Table of Summaries to link to the summaries either by author or by risk factor.

Abstract | Bibliography | Introduction | Table of Summaries

The Effects of Poverty, Race, and Family Structure on US Children's Health: Data from the NHIS, 1978 through 1980 and 1989 through 1991

Montgomery, L., J. Kiely, and G. Pappas, 1996. American Journal of Public Health, 86(10): 1401–1405.

There has been a steady increase in childhood poverty and also a growing number of children in single–mother households. Through health interview surveys, this study aimed to investigate the complex relationship between children's health, family structure, social class and race for US children and youth under 20 years of age. It was conducted for two time periods, 1978 through 1980 and 1989 through 1991.

Independent relationships of family structure, poverty and race with child health were identified in both time periods. It was found that children in families headed by single mothers, black children and those living below 150% of the poverty index were much more likely to be in poor or fair health compared with children in two–parent families, white children, or those in more affluent families. Poverty had the strongest effect on child health in both time periods and this was consistent over the 14–year period. The association between children's health and poverty is not explained by race or family structure. That is, when considering the effects of poverty, adjustments for race or family structure has a relatively small effect.

In both races, poor children were twice as likely to have fair or poor health as children in more affluent families, although a smaller proportion of poor white children were in fair or poor health compared with poor black children. The same pattern existed in both time periods; however, the rates of fair/poor health had decreased in the later period. This may have been a result of a change in the questionnaire. The highest rates of poor or fair health are for children in low–income, single– mother families.

Children in single–mother families were 2.6 times as likely to have fair/poor health as children in two–parent families. Adjusting for race and poverty individually, reduces the risk, however, even after adjustment for both factors, there remains about a 50% greater likelihood of having poor/fair health status for children in single–parent families. The poverty rate for children in single–mother families is more than five time the rate for children in two–parent families. Over 55% of children in single female–headed families live below the official poverty index. It is noteworthy that the health status of black children living above 150% of the poverty index from 1978 through 1980 does not differ by family structure.

Family structure was defined in terms of the child's living arrangements. Children in single–mother families were compared with those in two–parent families. All other types of family structure, such as those households that included other adults were excluded. Single mothers included those who were separated, divorced, widowed and never married. Only black and white categories of race were used, the numbers of other minority children in the surveys were too small to make reliable estimates. Poverty was defined as 1.5 times the poverty index. The summary health measure was perceived health status. The question and categories for health status were different for the different time periods; therefore health states were analyzed in two categories, fair/poor or excellent/very good/good. The child's age was a control variable.

The study was limited by the lack of detail in the measures for poverty and family structure. Further information about short–and long–term poverty effects, kinds of instability and hardship, housing characteristics and childcare arrangements would provide better measure of long– term economic well–being. This would assist in clarifying the relationship with health status. In addition, greater sub–divisions of social class would facilitate observation of the gradient relationship between social class and health. In the study, race and perceived health status were self– reported and this was usually by the mother. This is generally considered to be highly correlated with clinically evaluated health status, mortality and the use of health care services.

It is possible that there are some variations in children's health between the different categories of single mothers. It has been shown that the problem of child poverty is not primarily the number of minority teenage mothers. The majority of single mothers are divorced or separated. The sharp rise in childhood poverty is thought to be primarily the result of declining family income, especially the relative and absolute decline of fathers' incomes. Women's economic status is affected more by marital disruption than men's, they usually have the care of dependent children and they earn much less than men.