Maternal education and child health: Is there a strong causal relationship?

Citation: Desai, Sonalde, Alva, Soumya (1998) Maternal education and child health: Is there a strong causal relationship?. Demography (Volume 35) (RSS)
Internet Archive Scholar (search for fulltext): Maternal education and child health: Is there a strong causal relationship?
Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)

Summary

Desai and Alva refute the claims of Caldwell, Cleland, and others that there is a definite independent effect of maternal edu on child health and mortality. They use data from the DHS and community-level fixed-effects models to analyze infant mortality, height for age, and immunization. They find that maternal education is strongly correlated with these variables in the expected direction; however, the immunization relationship is the only one that consistently holds under fixed-effects. The authors assert that the effect of education on immunization does not translate into improvements in mortality. Desaid and Alva do not adequately discuss why the relationships between edu and mortality/height/immunization are stronger and more persistant for Latin America compared to other regions. I'm not totally convinced that Caldwell is wrong. Cleland (1988) makes a point that the associations is stronger for child mortality than infant mortality, but Desai and Alva use a very young sample. Miguel's summary: Using date from the first round of Demographic and Health Surveys for 22 developing countries, Desai and Alva examine the effect of maternal education on 3 markers of child health: infant mortality, children's height-for-age (for children between 12 and 36 months), and immunization status (for children between 12 and 60 months). In contrast to other studies, Desai and Alva argue that although there is a strong correlation between maternal education and markers of child health, a causal relationship is far from established. Education acts as a proxy for the socioeconomic status of the family and geographic area of residence. Introducing controls for husband's education and access to piped water and toilet attenuate the impact of maternal education on infant mortality and children's height-for-age. This effect is further reduced by controlling for area of residence through the use of fixed-effects models. In the final model, maternal education remains statistically significant for children's immunization status in about ? of the countries even after individual-level (socioeconomic) and community-level controls are introduced. This suggests that educated mothers are more likely to engage in health-promoting behavior. It should be noted that this analysis masks potentially positive effects of maternal education through 2 avenues: (1) education may affect access to health facilities at the community level, thereby improving the health of children of educated as well as uneducated mothers in communities with high levels of education, and (2) higher immunization levels for children of educated mothers may reduce the likelihood of diseases like measles for all children in the community, thereby reducing the mortality for children of educated and uneducated mothers in a given community through spillover effects.