Education, birth weight, and infant mortality

Timothy B. Gage, University at Albany, State University of New York (SUNY)
Furrina F. Lee, University at Albany, State University of New York (SUNY)
Erin O'Neill, University at Albany, State University of New York (SUNY)
Howard Stratton, University at Albany, State University of New York (SUNY)

This research determines if the declines in infant mortality with increased education are due to “indirect” effects that operate through improved birth weight and potentially causal or to “direct” effects, independent of birth weight. The data used are the 2001 US national linked birth-death files, African Mexican, and European American cohorts by sex. Education is dichotomized as low (i.e. high school and less) versus high (i.e. college and above) education. The analysis is conducted using Covariate Density Defined mixture of logistic regression, which explores “normal” and “compromised” births separately. Among “normal” births, mean birth weight increases significantly with high education, 27 to 108 grams. Mortality declines significantly due to “direct” effects of high education (by a factor of 0.4-to 0.96). Only 3 (of six possible) “normal” “indirect” effects are significant, and all increase infant mortality with higher education despite improvements in birth weight! European American births display the largest and Mexican American the smallest effects of education on birth outcomes. Among “compromised” births education has small and inconsistent effects. These results are consistent with the view that interventions targeting birth weight may not result in lower infant mortality rates.