Maternal Educational Attainment and Child Health in the United States

Purpose: To identify how child health status differs by mother's educational attainment for the overall US population and by race/ethnicity and to assess whether these disparities have changed from 2000 to 2017. Design: Repeated cross-sectional data from the 2000-2017 National Health Interview Survey (NHIS). Setting: United States. Participants: Children aged 1 to 17 years from a nationally representative sample of the noninstitutionalized US population (N = 199 427). Measures: Reported child health status, mother's educational attainment, child's race/ethnicity, and control variables were measured using the NHIS. Analysis: Using logistic regression models, we assessed the relationship between maternal education and child health. Missing data were imputed. Results: Children whose mothers had less than a high school education (odds ratio [OR] = 3.84, 95% confidence interval [CI]: 3.62-4.07), high school diploma or equivalent (OR = 2.57, 95% CI: 2.44-2.70), or some college (OR = 1.90, 95% CI: 1.80-2.00) had worse reported health status compared to children whose mothers graduated college. These associations were strongest among non-Hispanic white children, with significantly (P < .05) smaller associations observed for non-Hispanic black, Mexican origin, and other Hispanic children. The associations were smaller but persisted with inclusion of controls. From 2000 to 2017, child health disparities slightly narrowed or remained stagnant among white, non-Hispanic black, and other Hispanic children but widened for Mexican origin children (P < .05). Conclusion: Maternal education disparities in child health are wide and have persisted.