Tag Archives: demography

Poverty Poses a Bigger Risk to Pregnancy Than Age

Cross-posted at Family Inequality and The Atlantic.

The problem of income inequality often gets forgotten in conversations about biological clocks.

The dilemma that couples face as they consider having children at older ages is worth dwelling on, and I wouldn’t take that away from Judith Shulevitz’s essay in the New Republic, “How Older Parenthood Will Upend American Society,” which has sparked commentary from Katie RoipheHanna RosinRoss Douthat, and Parade, among many others.

The story is an old one — about the health risks of older parenting and the implications of falling fertility rates for an aging population — even though some of the facts are new. But two points need more attention. First, the overall consequences of the trend toward older parenting are on balance positive, both for women’s equality and for children’s health. And second, social-class inequality is a pressing — and growing — problem in children’s health, and one that is too easily lost in the biological-clock debate.

Older mothers

First, we need to distinguish between the average age of birth parents on the one hand versus the number born at advanced parental ages on the other. As Shulevitz notes, the average age of a first-time mother in the U.S. is now 25. Health-wise, assuming she births the rest of her (small) brood before about age 35, that’s perfect.

Consider two measures of child well-being according to their mothers’ age at birth. First, infant mortality:

(Source: Centers for Disease Control)

Health prospects for children improve as women (and their partners) increase their education and incomes, and improve their health behaviors, into their 30s. Beyond that, the health risks start accumulating, weighing against the socioeconomic factors, and the danger increases.

Second, here is the rate of cognitive disability among children according to the age of their mothers at birth, showing a very similar pattern:

(Source: Calculations made for my working paper)

Again, the lowest risks are to those born when their parents are in their early 30s, a pattern that holds when I control for education, income, race/ethnicity, gender, and child’s age.

When mothers older than age 40 give birth, which accounted for 3 percent of births in 2011, the risks clearly are increased, and Shulevitz’s story is highly relevant. But, at least in terms of mortality and cognitive disability, an average parental age in the late 20s and early 30s is not only not a problem, it’s ideal.

Unequal health

But the second figure above hints at another problem — inequality in the health of parents and children. On that purple chart, a college graduate in her early 40s has the same risk as a non-graduate in her late 20s. And the social-class gap increases with age. Why is the rate of cognitive disabilities so much higher for the children of older mothers who did not finish college? It’s not because of their biological clocks or genetic mutations, but because of the health of the women giving birth.

For healthy, wealthy older women, the issue of aging eggs and genetic mutations from fathers’ run-down sperm factories are more pressing than it is for the majority of parents, who have not graduated college.

If you look at the distribution of women having babies by age and education, it’s clear that the older-parent phenomenon is disproportionately about more-educated women. (I calculated these from the American Community Survey, because age-by-education is not available in the CDC numbers, so they are a little different.)

Most of the less-educated mothers are giving birth in their 20s, and a bigger share of the high-age births are to women who’ve graduated college — most of them married and financially better off. But women without college degrees still make up more than half of those having babies after age 35, and the risks their children face have more to do with high blood pressure, obesity, diabetes, and other health conditions than with genetic or epigenetic mutations. Preterm births, low birth-weight, and birth complications are major causes of developmental disabilities, and they occur most often among mothers with their own health problems.

Most distressing, the effects of educational (and income) inequality on children’s health have been increasing. Here are the relative odds of infant mortality by maternal education, from 1986 to 2001, from a study in Pediatrics. (This compares the odds to college graduates within each year, so anything over 1.0 means the group has a higher risk than college graduates.)

This inequality is absent from Shulevitz’s essay and most of the commentary about it. She writes, of the social pressure mothers like her feel as they age, “Once again, technology has given us the chance to lead our lives in the proper sequence: education, then work, then financial stability, then children” — with no consideration of the 66 percent of people who have reached their early 30s with less than a four-year college degree. For the vast majority of that group, the sequence Shulevitz describes is not relevant.

In fact, if Shulevitz had considered economic inequality, she might not have been quite as worried about advancing parental age. When she worries that a 35-year-old mother has a life expectancy of just 46 more years — years to be a mother to her child — the table she consulted applies to the whole population. She should breathe a little bit easier: Among 40-year-old white college graduates women are expected to live an average extra five years compared with those who have a high school education only.

When it comes to parents’ age versus social class, the challenges are not either/or. We should be concerned about both. But addressing the health problems of parents — especially mothers — with less than a college degree and below-average incomes is the more pressing issue — both for potential lives saved or improved and for social equality.

Philip N. Cohen is a professor of sociology at the University of Maryland, College Park, and writes the blog Family Inequality. You can follow him on Twitter or Facebook.

U.S. Birth Rate Drops to Lowest on Record

In 2011 the U.S. birth rate dropped to the lowest ever recorded, according to preliminary data released by the National Center for Health Statistics and reported by Pew Social Trends:

The decline was led by foreign-born women, who’s birthrate dropped 14% between 2007 and 2010, compared to a 6% drop for U.S.-born women.

Considering the last two decades, birthrates for all racial/ethnic groups and both U.S.- and foreign-born women have been dropping, but the percent change is much larger among the foreign-born and all non-white groups.  The drop in the birthrate of foreign-born women is double that of U.S.-born and the drop in the birthrate of white women is often a fraction that of women of color.

It’s easy to forget that effective, reversible birth control was invented only about 50 years ago.  Birth control for married couples was illegal until 1965; legalization for single people would follow a few years later.  In the meantime, the second wave of feminism would give women the opportunity to enter well-paying, highly-regarded jobs, essentially giving women something rewarding to do other than/in addition to raise children.  The massive drop in the birthrate during the ’60s likely reflects these changes.

In addition to a drop in the number of children women are having, this data reflects a steady rise in the number of women deciding not to have children at all.  The decision to eschew parenting altogether is disproportionately high among highly educated women, suggesting that the there-are-now-other-things-in-life-to-do phenomenon might be at play.

Many European countries are facing less than replacement levels of fertility and scrambling to figure out what to do about it (the health of most economies in the developed world is predicated on population growth), the U.S. is likely not far behind.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

U.S. Racial/Ethnic Demographics: 1960, Today, and 2050

Barack Obama won just over 50% of the popular vote last week, but he earned 80% of non-white votes.  According to USA Today exit poll data, he secured 93% of the Black vote, 73% of the Asian vote, 71% of the Hispanic vote, and 58% of the non-white Other vote.

This data suggests are real and palpable difference between how (some) Whites and (most) non-Whites see the world, a difference that will become increasingly influential.

Earlier this month the Pew Research Center released an updated prediction for the racial/ethnic composition of the U.S. in 2050.  They expect that, by 2050, Whites will be a minority, adding up to only 47% of the population.  By that time, they expect Hispanics to account for 29% of the population, and Blacks and Asians to account for 13% and 9% respectively.

Paul Taylor and D’Vera Cohn, at Pew, observe that the demographics of the voting population will change a bit slower since the majority of the demographic change is from births and deaths, not immigration.  In 2011, for example, whites were 66% of those ages 18 and older, but only 56% of 18-year-olds.  In other words, it takes 18 years to grow a voter.

Whatever the pace of change, the era of winning U.S. elections by pandering to the worldview of a single group is ending.  Future politicians will likely have to put effort into attracting a wide range of voters, as Obama did on Tuesday.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Interactive Graphics of Health Habits

Mark Fischetti has posted an interactive graphic at Scientific American that lets you look at the prevalence of several behaviors or characteristics measured on the Centers for Disease Control and Prevention’s survey on risk factors. The graphic includes data on exercise, tobacco use, heavy drinking, binge drinking, and obesity. Commenters on the post suggested it’s unnecessarily snarky about obesity; that said, it provides a quick snapshot of several behaviors demographers often use to judge general trends in health. For each topic, a graph shows the state where it is highest and lowest; you can also select up to 3 additional states to compare.

For instance, the percent of people who took part in a physical activity in the last month is highest in Oregon and lowest in Mississippi; I added my home state of Oklahoma (dark blue) and current residence of Nevada (light blue) too:

You also get a map for each topic that shows where it’s most or least common. Here’s the map for smoking:

Sconnies, you may not be surprised to know that Wisconsin leads the nation in binge drinking:

I can’t embed the graphic, so you’ll have to go to Scientific American’s post to play around and compare your own state.

Steep Drop in Life Expectancy for White High School Drop Outs

The New York Times‘ Sabrina Tavernise reports that the long term trend of increasing life expectancy has reversed it self among one specific group of people.  Between 1990 and 2008, the life expectancy of White men and women without high school degrees has dropped.  Women have lost five years, men three.

The difference in the life expectancy between men and women without high school degrees and those who complete college are even more striking.  Women with a college degree can expect to live, on average, more than 10 years longer than high school drop outs.  Among men, the gap is even larger, a whopping 13 years.

The words “alarming” and “vexing” were used to describe this drop in life expectancy.  Scholars are still unsure of its causes, but note the stress of balancing work and family, “a spike in prescription drug overdoses among young whites, higher rates of smoking among less educated white women, rising obesity, and a steady increase in the number of the least educated Americans who lack health insurance.”

Ultimately, they argue, as fewer and fewer people fail to graduate from high school, the concentration of disadvantages in those that do are making this population especially vulnerable to all kinds of ills, some of which kill them.

Hat tip to The Global Sociology Blog.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Women, Education, and Trends in Childlessness

In doing research for a book I may write about voluntary childnessness, I came across a telling graphic from the Pew Research Center.  First, note that the percent of women age 40-44 without a biological child has almost doubled since the late ’70s.  Today about one-in-five such women (18%) have never given birth:

The percent of women is even higher among women with professional degrees (a master’s or equivalent and higher).  One-in-four women with a master’s degree, and nearly that many women with PhDs, have no biological children by ages 40-44.

Here’s where the really telling graph comes in.  Though women with higher levels of education are less likely to have biological children than other types of women, the trend  of increasing childlessness shown above doesn’t apply to them.  In fact, women with master’s and PhDs in the most recent data are more likely to have children than their counterparts 14 years ago.  In the first half of the 1990s, nearly one-in-three women with professional degrees did not have biological children; today it’s one-in-four. Childbearing among the most educated women, then, bucks the trend. It has gone up.

The data probably reflect greater endorsement of the idea that a woman can, or should be able to, balance both a career and a family, as well as the rise of policies that make that possible.  University of Florida sociologist Tanya Koropeckyj-Cox, who’s studied this stuff, says as much.  It may be hard to imagine now, but there was a time when having children would destroy a woman’s always-already fragile career; as much as we may love or hate the “mommy track,” at least today there is one.  Koropeckyj-Cox also suggests that women with higher incomes may have greater access to infertility treatments, making overcoming health problems or delayed childbearing more possible for them than it is among women with less education.

In any case, the data suggests an interesting story about gender, childbearing, educational achievement, and historical change.  I’d be happy to hear more interpretation in the comments.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Historical Changes in Causes of Death

The Washington Post has provided an image from the New England Journal of Medicine that illustrates changing causes of death. Comparing the top 10 causes of death in 1900 and 2010 (using data from the Centers for Disease Control and Prevention), we see first that mortality rates have dropped significantly, with deaths from the top 10 causes combined dropping from about 1100/100,000 to about 600/100,000:

And not surprisingly, what we die from has changed, with infectious diseases decreasing and being replaced by so-called lifestyle diseases. Tuberculosis, a scourge in 1900, is no longer a major concern for most people in the U.S. Pneumonia and the flu are still around, but much less deadly than they used to be. On the other hand, heart disease has increased quite a bit, though not nearly as much as cancer.

The NEJM has an interactive graph that lets you look at overall death rates for every decade since 1900, as well as isolate one or more causes. For instance, here’s a graph of mortality rates fro pneumonia and influenza, showing the general decline over time but also the major spike in deaths caused by the 1918 influenza epidemic:

The graphs accompany an article looking at the causes of death described in the pages of NEJM since its founding in 1812; the overview highlights the social context of the medical profession. In 1812, doctors had to consider the implications of a near-miss by a cannonball, teething could apparently kill you, and doctors were concerned with a range of fevers, from bilious to putrid. By 1912, the medical community was explaining disease in terms of microbes, the population had gotten healthier, and an editorial looked forward to a glorious future:

Perhaps in 1993, when all the preventable diseases have been eradicated, when the nature and cure of cancer have been discovered, and when eugenics has superseded evolution in the elimination of the unfit, our successors will look back at these pages with an even greater measure of superiority.

As the article explains, the field of medicine is inextricably connected to larger social processes, which both influence medical practice and can be reinforced by definitions of health and disease:

Disease definitions structure the practice of health care, its reimbursement systems, and our debates about health policies and priorities. These political and economic stakes explain the fierce debates that erupt over the definition of such conditions as chronic fatigue syndrome and Gulf War syndrome. Disease is a deeply social process. Its distribution lays bare society’s structures of wealth and power, and the responses it elicits illuminate strongly held values.

The Effect of Title IX on Sports Participation

Cross-posted at Global Policy TV.

Title IX, an amendment to the Civil Rights Act of 1964, stated that “No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance…”  Passed on this day in 1972, this policy meant that schools and colleges receiving federal funding could not legally give preference to men.  Instead, they had to allocate their resources to men and women in proportion to their interest and enrollment.

The intention of the policy was to change the norms that gave preference to men in all sorts of fields, from medical schools to sports teams.  Because most schools and colleges have extensive athletics departments, sports was included among the resources that the schools were required to dole out fairly.

Accordingly, even grudging and partial compliance with the requirements of Title IX dramatically increased the opportunity for women to play sports.  In the next 35 years, women’s participation in high school and college sports would increase by 904% and 456% respectively (source).  Today, 42% of high school athletes and 45% of college athletes are women (source).

Title IX is often mistakenly accused of forcing schools to cut funding for men’s athletics.  In fact, funding for men’s athletics, as well as the number of men who play sports in school, has increased since Title IX.  The chart above also shows that men’s participation has increased by 15% in high school and 31% in college.  It’s not true, then, that Title IX has led to fewer male athletes (especially because some colleges count men as women).  Still, there is great resistance to the Amendment, with a particular emphasis on sports.  Many schools are only marginally compliant, and then only because (tireless) Title IX Officers keep pressure on institutions to follow the law.

It will be fascinating to see how changing college demographics affect the politics around Title IX.  After all, forty years later, people still argue that it’s not right that women’s sports get (almost) as much funding men’s.  Now there are more women on college campuses than men, so proportional funding may mean spending more money on women’s sports than men’s.  Fire and brimstone upon us.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.