Economic security policy and birth outcomes among socio-economically disadvantaged women

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Project Summary A growing body of work has demonstrated that increases in the generosity of cash and in-kind benefits received by low-income women from economic security policies (ESPs) are associated with improved birth outcomes, particularly low birth weight (LBW) (less than 5 pounds, 8 ounces) and preterm birth (PTB) (before 37 weeks). Because single ESPs rarely fill all economic gaps, most low-income families do not use ESPs in isolation, but rather “package” them to make ends meet. While the effects of Supplemental Nutrition Assistance Program, the Earned Income Tax Credit, and the minimum wage have been studied extensively, there have been few studies of Unemployment Insurance and no identified studies of the combined effects of these four ESPs. This study builds on existing research that demonstrates positive overall effects of individual ESP generosity on birth outcomes among the low-income population and differential effects based on social statuses. The study also draws from research showing that more generous ESPs improve correlates of maternal-fetal health. Using the Panel Study of Income Dynamics, a nationally representative, longitudinal data set, this study will examine how individual ESPs and ESP combinations compare to one another in terms of the size of their effects on LBW and PTB. Additionally, this study will be the first to determine the relative contribution of four potential mediators explaining the link between ESP generosity and birth outcomes (i.e., healthcare access, food insecurity, psychological distress, and prenatal health behaviors). Lastly, this study will identify whether the effects of ESP generosity is moderated by poverty level, race, marital status, and education. As the US social safety net has shifted to one that rewards labor market participation, ESPs have become a more familiar feature of working poor households. These households—low-income, but working— account for the majority of poverty in the US and their ranks are likely to grow in the wake of the Great Recession and the COVID-19 pandemic. This suggests a pressing need for information on which policies generate the greatest returns, how they influence birth outcomes, and for whom they are most effective. As such, this research will contribute significantly to scientific and policy efforts to reduce rates of LBW and PTB among low-income women and reduce inequalities in birth outcomes.