Persistent racial, ethnic, and economic inequality in infant and child health in the US continues to be a matter of both research and policy interest. While previous research has documented the inequality itself and many of its covariates, more detailed work is necessary to identify the specific pathways through which individual, structural, and policy factors work to generate this health differential. In our research on infant health in New Jersey, we currently are analyzing the effects of these factors on prenatal care use and a number of birth outcomes. We will build on this foundation in two ways: first, by replicating our multilevel analyses on birth outcomes using data from the national Fragile Families and Child Wellbeing Study. To do this, we will geocode the respondents' addresses and also abstract the mothers' and children's medical records. The rich Fragile Families data will also allow us to expand the explanatory factors we include. Second, we will broaden our focus from birth outcomes to child health using both the Fragile Families survey and data on the children of the mothers in the HealthStart expanded prenatal/pediatric services program in New Jersey. Since the Fragile Families data are being collected during a period of welfare reform and the expansion of health insurance for children through the new Children's Health Insurance Program, we will specifically analyze the impact that city- and state- specific policy environments have on child health. Together, these analyses will allow us to disentangle some of the most important questions surrounding infant and child health inequalities in the United States. The findings will be of theoretical interest to the research community and have direct policy application. In addition, the creation of the enhanced Fragile Families data will serve researchers interested in other aspects of child development and family life.
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