The Intergenerational Transmission of Health Disadvantage: Can Education Disrupt It?

J Health Soc Behav. 2024 Apr 29:221465241246250. doi: 10.1177/00221465241246250. Online ahead of print.

Abstract

In low-income countries, intergenerational processes can culminate in the replication of extreme forms of health disadvantage between mothers and adult daughters, including experiencing a young child's death. The preventable nature of most child deaths raises questions of whether social resources can protect women from enduring this adversity like their mothers. This study examined whether education-widely touted as a vehicle for social mobility in resource-poor countries-disrupts the intergenerational cycle of maternal bereavement. We estimated multilevel discrete-time survival models of women's hazard of child loss using Demographic and Health Survey Program data (N = 195,744 women in 345 subnational regions in 32 African countries). Women's educational attainment minimizes the salience of their mothers' bereavement history for their own probability of child loss; however, mothers' background becomes irrelevant only among women with ≥10 years of schooling. Education's neutralizing influence is most prominent in the highest mortality-burdened communities.

Keywords: bereavement; child death; education; health disadvantage; intergenerational inequality.