The role of workplace characteristics in breastfeeding practices

The present analyses were undertaken to understand the role of workplace characteristics in the breastfeeding practices of working women. The effects of the perception of the availability of employer-sponsored child care, the perception of the availability of a flexible schedule, hours worked at home, and worked a fixed schedule on breastfeeding outcomes were estimated using a sample of 1,506 births from the National Longitudinal Survey of Youth 1979 and the Children of the National Longitudinal Survey of Youth 1979. The availability of employer-sponsored child care increased the likelihood of breastfeeding six months after birth by 47 percent. In addition, working an additional eight hours at home per week, at the mean, increased the probability of breastfeeding initiation by 8 percent and breastfeeding six months after birth by 16.8 percent. Workplace characteristics show promise as an effective way to increase breastfeeding rates among working women.     

The incidence of the healthcare costs of obesity

Who pays the healthcare costs associated with obesity? Among workers, this is largely a question of the incidence of the costs of employer-sponsored coverage. Using data from the National Longitudinal Survey of Youth and the Medical Expenditure Panel Survey, we find that the incremental healthcare costs associated with obesity are passed on to obese workers with employer-sponsored health insurance in the form of lower cash wages. Obese workers without employer-sponsored insurance do not have a wage offset relative to their non-obese counterparts. A substantial part of the lower wages among obese women attributed to labor market discrimination can be explained by their higher health insurance premiums.     

Mother’s educational attainment and their young adult daughters’ fast food intake: The role of race/ethnicity

Abstract

The relationship between mothers’ educational attainment and their daughters’ fast food intake and the moderating effect of race/ethnicity on the relationship was examined. The National Longitudinal Survey of Youth 1979 (NLSY79) and the National Longitudinal Survey of Youth 1979 for Children and Young Adults (NLSY79 CY) were used. Young women with mothers who received higher education were less likely to eat fast food. Race/ethnicity moderated the relationship between mothers’ educational attainment and their young adult daughters’ fast food intake. Through this study, we seek to understand the intergenerational relationship between mother and daughter and the effect of mothers’ education on their young adult children’s fast food consumption. Providing more opportunities for mothers to increase their educational attainment should be considered to reduce their children’s fast food intake. Mothers’ educational attainment should be focused on more closely for non-Hispanic Whites as a factor to reduce young women’s fast food intake, and other economic factors should be considered to understand the role of mothers’ educational attainment among African Americans and Hispanic/Latinas.     

Stability of health care coverage among low-income working women

This article examines health insurance stability patterns and the factors associated with stable coverage in a sample of 453 low-income working women. Using data from the National Longitudinal Survey of Youth (NLSY), the authors found that only 51 percent of these women had stable coverage during 1995-1997. Logistic regression results indicate that, controlling for other factors, health insurance stability is significantly higher for those who have higher levels of welfare receipt, have more work hours, have fewer job changes, have higher education levels, are African American or Hispanic, and who live outside central cities. The findings suggest that point-in-time health coverage estimates substantially underestimate the health coverage problems of low-income working women. Health policies need to be more sensitive to transitional problems resulting from job changes, marital disruptions, and other changes in circumstances. Recommendations for revising health care policies and for improving existing health care programs are presented.     

Race, family income, and low birth weight.

The relations among race, family income, and low birth weight were examined using information obtained from the National Longitudinal Survey of Youth, which conducted yearly interviews with a nationally representative sample of young women identified in the late 1970s. Data were available for these women and their offspring from 1979 through 1988. Maternal education, maternal age, age/parity risk, marital status, and smoking during pregnancy served as covariates in cross-sectional and longitudinal analyses. The risk of low birth weight among births to black women and white women who were poor was at similarly high levels regardless of whether poverty was determined prior to study entrance or during the study period. Longitudinal analyses showed an exceptionally large increase in risk of low birth weight among children born to women whose prior pregnancy ended in a low-birth-weight infant. These two findings emphasize the importance of factors antecedent to the pregnancy in the genesis of low birth weight.     

Substance use and prenatal care during pregnancy among young women

Data on a cohort of young mothers from the National Longitudinal Survey of Youth were examined for use of alcohol, cigarettes and marijuana during pregnancies leading to first births. A substantial proportion of women (45 percent) were found to have used at least one of these substances. White women were more likely to use a substance during pregnancy than were Hispanic or black women; women with the prospective father present in the household were less likely than other women to use a substance. Compared with well-educated and older women, less-educated and younger women were more likely to smoke cigarettes or marijuana during pregnancy, but were less likely to drink alcohol. Only about 13 percent of women used more than one substance. Nineteen percent of the women received no prenatal care in the first trimester of pregnancy. Less-educated and younger women were least likely to receive early prenatal care. Multivariate analysis found no association between neglect of prenatal care and substance use. Rather, the analysis revealed that the two behaviors shared likely antecedents, such as whether the prospective father was in the home prior to the pregnancy.     

The impact of welfare reform on parents' ability to care for their children's health

OBJECTIVES: Most of the national policy debate regarding welfare assumed that if middle-income mothers could balance work while caring for their children's health and development, mothers leaving welfare for work should be able to do so as well. Yet, previous research has not examined the conditions faced by mothers leaving welfare for work. METHODS: Using data from the National Longitudinal Survey of Youth, this study examined the availability of benefits that working parents commonly use to meet the health and developmental needs of their children; paid sick leave, vacation leave, and flexible hours. RESULTS: In comparison with mothers who had never received welfare, mothers who had been on Aid to Families with Dependent Children were more likely to be caring for at least 1 child with a chronic condition (37% vs 21%, respectively). Yet, they were more likely to lack sick leave for the entire time they worked (36% vs 20%) and less likely to receive other paid leave or flexibility. CONCLUSIONS: If current welfare recipients face similar conditions when they return to work, many will face working conditions that make it difficult or impossible to succeed in the labor force at the same time as meeting their children's health and developmental needs.     

Maternal employment and overweight children

This paper seeks to determine whether a causal relationship exists between maternal employment and childhood weight problems. We use matched mother-child data from the National Longitudinal Survey of Youth (NLSY) and employ econometric techniques to control for observable and unobservable differences across individuals and families that may influence both children's weight and their mothers' work patterns. Our results indicate that a child is more likely to be overweight if his/her mother worked more hours per week over the child's life. Analyses by subgroups show that it is higher socioeconomic status mothers whose work intensity is particularly deleterious for their children's overweight status.     

Child care arrangement and preschool development

Baseline data from the Canadian National Longitudinal Survey of Children and Youth were used to evaluate the associations between child care arrangement and poor developmental attainment (PDA). A weighted total of 521,800 children aged 2 to 3 years were studied (N = 2,709). PDA was assessed by age-standardized motor and social development score. Children were grouped by the predominant type of arrangement: care by someone in the child's own home, in another home (family child care), at a child care centre, or none (child care exclusive to parents). Controlling for socioeconomic status, biological factors and maternal immigration, family dysfunction, hostile parenting and low neighbourhood safety were correlated with PDA and positive parent-child interaction decreased the odds of PDA. Whereas centre child care arrangements were beneficial to development overall (OR = 0.41, 99% CI = 0.18, 0.93), an interaction existed between type of child care and maternal depression; among children with depressed mothers, centre child care was associated with increased odds of PDA. Findings suggest that the associations between child care arrangement and child development involve interactions of factors that influence a child's home environment. Future child development studies exploring these interactions are warranted.     

Availability of Child Care in Rural Communities: Implications for Workforce Recruitment and Retention

The objective of this study was to identify differences in child care availability by rural–urban location for all counties in Wisconsin, and describe implications for recruitment and retention of health care workforce. We used data on licensed child care slots for young children (age <5), socio-demographic characteristics, women’s and men’s labor force participation, and household structure for all counties in Wisconsin in 2013 (n = 72). Data came from KIDS COUNT, County Health Rankings, and the American Community Survey. We used t tests to analyze bivariate differences in child care availability and community characteristics by metropolitan, micropolitan, and non-core rural location. We then used ordinary least squares regression to analyze the relationship between geographic location and child care slots, adjusting for labor force participation and household structure. Rural counties had significantly fewer licensed child care slots per child than metropolitan and micropolitan counties. These counties also had, on average, higher rates of poverty and higher unemployment than micropolitan and metropolitan counties. The association between geographic location and child care availability remained, even after adjusting for household structure and labor force participation. The number of hours men worked and the percentage of men not working were both negatively associated with available child care slots, whereas there was not a significant relationship between women’s labor force participation and child care availability. Rural areas face health care workforce shortages. Recruitment strategies to overcome shortages must move beyond individual-level incentives to focus on community context and family support, including availability of child care in rural counties.     

The Best of Intentions: A Structural Analysis of the Association between Socioeconomic Disadvantage and Unintended Pregnancy in a Sample of Mothers from the National Longitudinal Survey of Youth (1979)

ObjectivesBirths to less educated women are more likely to be classified as unintended than other births. We question a common interpretation that this association reflects a lack of contraceptive knowledge or self-efficacy among less educated women. We theorize that differences in early life educational advantages structure pregnancy desires and the salience and opportunity costs of precise fertility timing. We hypothesize that net of covariates indicative of early educational disadvantage, mothers with less education are not more likely to report births as unintended compared with mothers who have attained higher levels of education before becoming mothers.MethodsUsing multivariate regression, we analyze a sample of women in the National Longitudinal Survey of Youth (1979) who had their first births by 1994. We test whether an index measure of educational advantage in youth predicts unintended first birth.ResultsUnadjusted results confirm well-documented associations between educational disadvantage and greater likelihood of unintended pregnancy. However, once covariates are controlled, those with high educational advantage in youth are more likely to report their first birth as mistimed (relative risk ratio, 1.57).DiscussionEducational advantage captures expectations about how much education a young woman will obtain before giving birth and is a structural dynamic that precedes proximate factors related to family planning access and behaviors.ConclusionsThese findings highlight the need to incorporate structural factors that condition perceptions of pregnancy intention in the study of unintended pregnancy and to critically reevaluate the conceptualization and interpretation of pregnancy intention measures.     

Prepregnancy Obesity and Birth Outcomes

Objective To investigate the association between prepregnancy obesity and birth outcomes using fixed effect models comparing siblings from the same mother. Methods A total of 7496 births to 3990 mothers from the National Longitudinal Survey of Youth 1979 survey are examined. Outcomes include macrosomia, gestational length, incidence of low birthweight, preterm birth, large and small for gestational age (LGA, SGA), c-section, infant doctor visits, mother’s and infant’s days in hospital post-partum, whether the mother breastfed, and duration of breastfeeding. Association of outcomes with maternal pre-pregnancy obesity was examined using Ordinary Least Squares (OLS) regression to compare across mothers and fixed effects to compare within families. Results In fixed effect models we find no statistically significant association between most outcomes and prepregnancy obesity with the exception of LGA, SGA, low birth weight, and preterm birth. We find that prepregnancy obesity is associated with a with lower risk of low birthweight, SGA, and preterm birth but controlling for prepregnancy obesity, increases in GWG lead to increased risk of LGA. Conclusions Contrary to previous studies, which have found that maternal obesity increases the risk of c-section, macrosomia, and LGA, while decreasing the probability of breastfeeding, our sibling comparison models reveal no such association. In fact, our results suggest a protective effect of obesity in that women who are obese prepregnancy have longer gestation lengths, and are less likely to give birth to a preterm or low birthweight infant.     

Small-for-Gestational-Age Births are Associated with Maternal Relationship Status: A Population-Wide Analysis

Objectives To examine the association between maternal relationship status during pregnancy and infant birth outcomes. Methods Observational study of the National Longitudinal Survey of Youth 1979, a nationally representative sample of 12,686 men and women between the ages of 14 and 21. We used data from surveys of women reporting childbirth between 1979 and 2004. Relationship status was defined as relationship with an opposite-sex partner in the child’s birth year. Relationship stability was defined as the consistency in relationship status in the 1 year before, of, and after the child’s birth. Childbirth outcome included small-for-gestational age (SGA) infant. We applied random effects logistic regression models to assess the association between relationship status and stability and childbirth outcome—adjusting for maternal race, infant sex, history of miscarriage, employment, maternal age, multiparity, cohort-entry year, household poverty status, and tobacco use. Results The study included 4439 women with 8348 live births. In fully adjusted models, term SGA infants were more commonly born to partnered women (AOR 1.81; 95 % CI 1.20–2.73) and unmarried women (AOR 1.82; CI 1.34–2.47; LRT p value 0.0001), compared to married women. SGA infants were also more commonly born in unstable relationships (AOR 1.72; 95 % CI 1.14–2.63; LRT p value 0.01) compared to stable relationships. Conclusions for Practice Maternal relationship status and stability during pregnancy is independently associated with risk of SGA infant birth.     

Maternal Work and Birth Outcome Disparities

Objectives: We tested relations between aspects of maternal work and birth outcomes in a national sample and in subgroups known to experience disparities. Methods: Three indices of work attributes (Status and Recognition, Physical Demands, and Exposure to Conflict) were derived by factor analysis of variables extracted from the Department of Labor's O*Net database. The indices were linked to the National Longitudinal Survey of Youth using occupation codes for the primary jobs held by women who gave birth between 1979 and 2000 and worked during the quarter prior to birth (n = 3,386 births to n = 2,508 mothers). Multiple regression was used to model birth outcomes as functions of the work attribute indices, controlling for several measures of socioeconomic status and risk factors for adverse birth outcomes. Results: In the full sample, work-related Physical Demands were associated with lower average birthweight and increased odds of preterm birth while Status and Recognition was associated with higher average birthweight and lower odds of fetal growth restriction. In stratified models, Status and Recognition was associated with higher birth weight among women with low (versus high) income and with lower odds of preterm birth among women with low (versus high) education. Physical Demands were associated with higher rates of preterm birth among women with low (versus high) income and education and among African-American mothers (compared to Whites). Conclusions: The work environment is an important predictor of healthy births. Relations between maternal work attributes and birth outcomes differ by race/ethnicity and socioeconomic status and according to the outcome under investigation. Further research with measures of work attributes specific to maternal work experiences is recommended to confirm our findings.     

Association between Increased Emergency Contraception Availability and Risky Sexual Practices

ObjectiveWe studied whether increased emergency contraception availability for women over age 18 was associated with a higher probability of risky sexual practices.DataA total of 34,030 individual/year observations on 3,786 women aged 18 and older were extracted from the National Longitudinal Survey of Youth, 1997 from October 1999 through November 2009.FindingsWe found different results when estimating the state and federal changes separately. The national change was associated with a reduction in the probability of sexual activity, a reduction in the likelihood of reporting multiple partnerships, and there was no relationship between the national policy change and unprotected sexual activity. There was no relationship between the probability of sexual activity or multiple partnerships for women in states with their own policy changes, but we did find that women in these states were more likely to report unprotected sex.     

Does Change in Young Men's Employment Influence Fathering?

This study examined the association between paternal and maternal employment changes and changes in the frequency of fathers praising, showing affection, disciplining, and reading to children. Data were drawn from the Young Adult supplement to the National Longitudinal Survey of Youth, 1979, in particular, young adults (18-29) who were living with a child and a partner between 2000 and 2006. Supporting economic theory regarding substitutability across partners, fathers were more involved when both they and their partners were employed full-time and they were less involved when their employment exceeded that of their partner. Although fathers also tended to be less involved when they worked less than their partners, fathers who held traditional gender role attitudes were more involved than those who held nontraditional gender role attitudes. The results suggest the important part fathers' attitudes and values have in determining their involvement with their children under differing employment conditions.     

Employment change and the role of the medical home for married and single-mother families with children with special health care needs

One in five U.S. households with children has at least one child with a special health care need (USDHHS, 2004). Like most parents, those with children with special health care needs struggle to balance child-rearing responsibilities with employment demands. This research examines factors affecting married parents' and single-mother's employment change decisions focusing specifically on whether having a medical home influences these decisions. This study includes 38,569 children with special health care needs from birth through age 17 surveyed in the 2005–2006 National Survey of Children with Special Health Care Needs. The employment model is estimated using multinomial logistic regression with the choice of a parent to maintain their current level of employment, reduce work hours, or stop working as the dependent variable. Independent variables are those characterizing the needs of the child, the resources of the family, and the socio-demographic characteristics of the family. Components of the medical home variable include: 1) having a usual source of care; 2) care provided is “family centered”; 3) receipt of care coordination services; and 4) receipt of needed referrals. Half of the children in our sample met criteria in all four facets. If the child has a medical home, the relative risk of a parent choosing to cut hours rather than not change hours decreases by 51%. The relative risk of choosing to stop working rather than not change hours decreases by an estimated 64%. Care coordination services significantly reduce the odds of changing employment status. Our results suggest that the medical home is a moderating factor in parental decisions concerning change in employment status.     

Determinants of breastfeeding duration in Peninsular Malaysia

The health benefits of breastfeeding to infants and mothers have been well recognised. This study applies linear regression analysis to assess the determinants of breastfeeding duration of first born using data from the Second Malaysian Family Life Survey. The proportion of women who breastfed their first child is 82 percent, of which 97 percent reported their breastfeeding duration. The distribution of breastfeeding duration has a mean of 5.7 months and a median of two months. Important determinants of breastfeeding duration include maternal age, ethnicity, period of first birth, husband's occupation and work status of the woman.     

Changes in Nonresident Father‐Child Contact From 1976 to 2002

To study changes in nonresident father contact since the 1970s, we pooled data from 4 national surveys: the National Survey of Children (1976), the National Survey of Families and Households (1987 – 1988), the National Longitudinal Survey of Youth (1996), and the National Survey of America’s Families (2002). On the basis of mothers’ reports, levels of contact rose significantly across surveys. Paying child support and having a nonmarital birth were strongly related to contact frequency. The increase in contact may be beneficial in general but problematic if it occurs within the context of hostile interparental relationships. Because nonresident fathers are having more contact with their children now than in the past, an increasing need exists for practitioners to help parents find ways to separate their former romantic roles from their ongoing parental roles and to develop at least minimally cooperative coparental relationships.     

The effects of family structure and regular places of care on preventive health care for children

Data from the 1982 National Access to Medical Care Survey were examined to answer questions on preventive health care received by children in families with one or two working parents and possible differences among their various regular sources of care. Evidence supports the general and expected conclusion that children of single female workers are most at risk. Children from these non-traditional families appeared to benefit most from care given in the offices and clinics of private physicians, while those of such families enrolled in health maintenance organizations benefitted least. When compared with HMO enrollees from the other two types of families (those where men were working and women stayed home, or where both parents worked), children of single parents were least likely to have received tine tests or DPT inoculations. Finding implications are discussed with suggestions for further research including investigating the effects of modifying hours of service and the provision of institutional supports for working parents.