Preventing (the Effects of) Low Birth Weight

In The Starting Gate, Conley, Strully, and Bennett relay that a family history of low birth weight drastically increases one’s own risk of being born low birth weight. If low birth weight parents are of a high socioeconomic class, however, the effect of their own low birth weight on their children’s birth weight decreases. Quite similarly, having been born low birth weight drastically hinders educational achievement and as a consequence, long-term economic prospects as well. If a low birth weight child is raised in a household of a high socioeconomic class, however the biological effects of low birth weight diminish. Therefore, a family’s social and biological assets interact with one another and either replicate or diminish/terminate economic and health inequalities across generations.

Because biological factors cannot be directly altered at this time, a more simple and direct solution to combat the above interaction between society and biology as well as the deleterious effects of low birth weight across generations seems to be to increase the socioeconomic status of individuals, who are at both biological and social risk, so that they have access to the commodities that are protective against the deleterious effects of low birth weight.

Conley, Strully, and Bennett’s suggested modifications to existing policies, such that family histories of low birth weight be taken into account in determining eligibility and benefit-level criteria and that pregnancies be considered “qualifying events” that raise the income eligibility criteria of various social programs benefiting low-income families, including WIC, TANF, etc, seem very practical, reasonable and realistic. It is actually quite surprising that they have not been implemented thus far, especially in the case of TANF, in which a pregnant mother (with no prior children) is not considered as two individuals, nor as a family. While TANF is geared towards needy families; isn’t it inherently obvious that a pregnant mother is bringing a child into a world and will thus become a family? Doesn’t it seem practical and reasonable to provide cash assistance to a pregnant mother, so that she can have a more healthy pregnancy and bring a healthier child into the world? Such a preventive measure would reduce later costly educational and health care expenditures related to raising an “unhealthy” child (i.e. low birth weight child suffering from numerous consequences/impairments/hurdles).

Like any other redefinition of eligibility criteria to social programs, which increases the number of people who qualify for the programs, result in the question of where the money to pay for these additional qualifiers will come from, Conley, Strutt, and Bennett make a strong claim for the fact that the money that is spent on treating the deleterious effects of low birth weight (i.e. health effects, such as cerebral palsy, mental retardation, etc) is far greater than that we would spend to prevent low birth-weight and its deleterious effects in the first place. Again, preventive measures seem to be where money should be allocated.

Conley, Strutt, and Bennett do claim that one hindrance to implementing these policy changes is the implications it would have on abortion laws and vice versa. Although this point was not emphasized in the book, I found it be interesting given our prior discussion about abortion below as well as during recitation. In the TANF program, for example, if a pregnant woman were counted as two, we are inherently treating the unborn fetus as a living being. While this may not be disagreeable to advocates of the pro-life movement, opposition could be raised for a number of different reasons. A reasonable policy change may be to begin providing cash assistance to low-income pregnant women, who have carried their fetus past the point of legal abortion.