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Socioeconomic disparities in maternal and child health are well-known, widespread problems in the US. A high proportion of women with young children participate in the labor force making maternal employment attributes, such as income, leave benefits, workplace flexibility, and stress potential determinants of maternal and child health inequalities. This dissertation research examined the contribution of maternal employment attributes to family health outcomes and disparities, including adolescent health, maternal depressive symptoms, and pediatric preventive service utilization. To examine the effect of maternal paid leave (sick and vacation) and work intensity on pediatric preventive care among children aged 0-17, we used data from the Medical Expenditures Panel Survey and the National Health Interview Survey (years 2007-2010) and applied instrumental variable techniques. Our results demonstrate that paid sick leave may influence compliance with several preventive care services for children, including well-child visits, dental care and receipt of the influenza vaccine. Paid sick leave predicted an increase in the marginal probability of complying with recommended well-child visits (0.13; 95% CI: 0.032, 0.23), dental exams (0.31; 95% CI: 0.15, 0.47), preventive dental care (0.30; 95% CI: 0.11, 0.50), and influenza vaccines (0.17; 95% CI: 0.07, 0.27). To study the relationship between maternal employment attributes and maternal depressive symptoms among women with very young children, we examined data from the NICHD (National Institute of Child Health and Development) Early Child Care and Youth Development Study (SECCYD) (years 1991-2005). Results from individual fixed effects analyses suggest that some employment attributes may predict depressive symptoms. Women who worked from home reported a statistically significant decrease in depression scores over time (â=-1.60, SE=0.53, p=0.002). Women who reported a one-unit increase in job concerns experienced, on average, a 2-point increase in depression scores over time (â=1.91, SE=0.43, p0.01). Finally, we used data from the NICHD SECCYD and endogenous treatment effect models to assess the influence of cumulative maternal income (between birth and 3rd grade) on adolescent health and development. We found no evidence that cumulative maternal income predicted adolescent outcomes. However, other components of the early family environment were related to specific outcomes. A one-unit increase in family socioeconomic status was associated with a 0.05 point decrease in the probability of being overweight or obese at age 15. High work intensity (more periods of employment over time and more hours worked per week) and high birth weight (4,000 grams) were also associated with a 0.09 and 0.10 point increase in the probability of being overweight or obese at age 15, respectively. Higher levels of health endowment were predictive of improved adolescent outcomes at age 15, including better health status, fewer behavioral problems, and no tobacco use. Parental marital status (being married) and White race/ethnicity were also protective against risk-taking. Results from this dissertation research suggest that maternal employment attributes exert real and important influences on family health. Our research highlights the effects of specific attributes, including paid sick leave, schedule control and flexibility, supportive work environments, and work intensity on various maternal and child health outcomes. These findings suggest that policies to assure adequate access to leave and flexible working hours and locations might ease the challenges faced by working families.
As women's labor force participation has risen around the globe, scholarly and policy discourse on the ramifications of this employment growth has intensified. This book explores the links between maternal employment and child health using an international perspective that is grounded in economic theory and rigorous empirical methods. Women's labor-market activity affects child health largely because their paid work raises household income, which strengthens families' abilities to finance healthcare needs and nutritious food; however, time away from children could counteract some of the benefits of higher socioeconomic status that spring from maternal employment. New evidence based on data from nine South and Southeast Asian countries illuminates the potential tradeoff between the benefits and challenges families contend with in the face of women's labor-market activity. This book provides new, original evidence on links between maternal employment and children's health using data associated with three indicators of children's nutritional status: birth size, stunting, and wasting. Results support the implementation and enforcement of policy interventions that bolster women's advancement in the labor market and reduce undernutrition among children. Scholars, students, policymakers and all those with an interest in nutritional science, gender, economics of the family, or development economies will find the methodology and original results expounded here both useful and informative.
In a review written in 1979, I noted that there was a paucity of research examining the effects of maternal employment on the infant and young child and also that longitudinal studies of the effects of maternal em ployment were needed (Hoffman, 1979). In the last 10 years, there has been a flurry of research activity focused on the mother's employment during the child's early years, and much of this work has been longi tudinal. All of the studies reported in this volume are at least short-term longitudinal studies, and most of them examine the effects of maternal employment during the early years. The increased focus on maternal employment during infancy is not a response to the mandate of that review but rather reflects the new employment patterns in the United States. In March 1985, the Bureau of Labor Statistics reported that 49.4% of married women with children less than a year old were employed outside the home (Hayghe, 1986). This figure is up from 39% in 1980 and more than double the rate in 1970. By now, most mothers of children under 3 are in the labor force.
Work, Family, Health, and Well-Being grew out of a conference held in Washington, D.C. in June 2003 on "Workforce/Workplace Mismatch: Work, Family, Health, and Well-Being" sponsored by the National Institutes of Health (NIH). The text considers multiple dimensions of health and well-being for workers and their families, children, and communities. Investigations into the socioeconomic gradient in health within broad occupational categories have raised important questions about the role of specific working conditions versus the role of conditions of employment such as wages and level of job security afforded a worker and his/her family in affecting health outcomes. Organized into seven parts, this text: *provides an overview of changes in work and family time and time use; *dedicates a section focusing specifically on employers and workplaces; *explores disciplinary perspectives on work, family, health, and well-being; *focuses on the most studied work and family nexus, the interrelationship between parental employment, especially maternal employment and the child's well-being; *examines gender differences in the division of labor, the effect of marriage on health, the shifting nature of care-giving throughout life, and the role of work on various health and well-being outcomes; *explores occupational health literature; and *focuses on the unique work-family issues faced by low-income families and workers in low-wage jobs. This book appeals to anyone in the fields of psychology, sociology, family studies, demographics, economics, anthropology, and social work.
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This study uses longitudinal data from the NICHD Study on Early Child Care (SECC) to examine the effects of maternal employment on family well-being, measured by maternal mental and overall health, parenting stress, and parenting quality. First, we estimate the effects of maternal employment on these outcomes measured when children are 6 months old. Next, we use dynamic panel data models to examine the effects of maternal employment on family outcomes during the first 4.5 years of children's lives. Among mothers of six month old infants, maternal work hours are positively associated with depressive symptoms and self-reported parenting stress, and negatively associated with self-rated overall health among mothers. Compared to mothers who are on leave 3 months after childbirth, mothers who are working full-time score 22 percent higher on the CES-D scale of depressive symptoms. However, maternal employment is not associated with the quality of parenting at 6 months, based on trained assessors' observations of maternal sensitivity. Moreover, during the first 4.5 years of life as a whole, we find only weak evidence that maternal work hours are associated with maternal health, and no evidence that maternal employment is associated with parenting stress and quality. We find that unobserved heterogeneity is an important factor in modeling family outcomes.
Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.