Using Fragile Families
Data to Study Health
Baseline Health Measures
Mother: prenatal health behaviors (smoking drinking,
drug use); prenatal care use (month); general health
status (5 point scale); health insurance type
Father: health behaviors (smoking, drinking, drug use)
general health status (5 point scale); serious health
problem that limits work (reported by mother)
Child: birth weight
Follow-Up Measures (1 and 3 years)
Mother: general health status (5 point scale); serious health problem
that limits work; substance use (cigarettes, alcohol, illicit drugs—
marijuana, other)
3 years only: prescribed medications; hospitalizations; ER use;
height and weight; health insurance; regular source of health care
Father: same as mothers
Child: breastfeeding (1 year); general health status (5 point scale);
physical disabilities; illnesses; injuries; ER use; hospitalizations (for
accidents/injuries; for illnesses); asthma (diagnosis, attack, ER
use); lead poisoning (3 years); weight; height (3 years); well child
care; regular source of health care; second hand smoke
Collaborative Project:
Medical Records and Neighborhoods
•
Collect new data from hospital birth records
of Fragile Families mothers and babies
•
Geocode Fragile Families survey records
and attach neighborhood characteristics
Funded by NICHD and RWJ Foundation
Medical Records Data
•
•
•
•
•
•
•
Pre-existing Medical Conditions
Lab Test Results
Psychosocial History
Obstetrical History
Labor/Delivery Complications
Newborn Information
Detailed Notes
So far…
Medical Records Data Completed in 10 Cities:
Austin, Corpus Christi, San Antonio,
Oakland, San Jose, Baltimore, Philadelphia,
Boston, Jacksonville, Norfolk
…plus a subset of records in Newark
Going into the field in Indianapolis next week
Sneak Preview
•
17% of mothers had STDs during pregnancy
•
32% of mothers had bacterial vaginosis or
other genitourinary infection during pregnancy
•
38% of mothers were obese (BMI >= 30)
•
11% of mothers used illicit drugs prenatally
•
12% of infants in NICU
Neighborhoods
Neighborhoods confer health disadvantages above and
beyond those accruing from individual level poverty:
• Housing and other buildings old, in poor condition
• Environmental pollutants
Role of Neighborhoods
Low birthweight: tract-level income
Lead poisoning: areas with low housing values, where
most homes were built before 1950, with higher
density, with higher rates of poverty, with poorly
educated population, with lower rates of owneroccupied housing
Asthma: low-income neighborhoods, indoor and
outdoor environmental pollutants
Two Sets of Analyses
#1
Analyze determinants of poor infant and
child health
#2
Assess how poor child health affects
family resources
Determinants of Child Health
Effects of prenatal use of illicit drugs on preterm birth,
low birth weight, and longer-term child health outcomes
Effects of fathers on infant and child health outcomes
(parents’ relationship status, behaviors)
Neighborhood factors and racial disparities in preterm
birth and low birth weight
Effects on Family Resources
Poor child health (from survey):
Decreases likelihood that parents of one year old
children live together by 9-10 percentage points
Reduces mother's probability of being employed by 8
percentage points and hours of work by 3 per week
Reduces father’s probability of being employed by 8
percentage points and hours of work by 5 per week,
net of effects on mother’s employment
Other Family Resources
•
•
•
•
•
•
•
Living with extended family
Public assistance
Child support
Subsequent education
Child care
Pediatric health care
Participation in preschool programs