Skip to main content

Do Higher Wages During Pregnancy Lead to Healthier Babies?

A new paper suggests that a higher minimum wage during pregnancy improves infant health.

By Dwyer Gunn


(Photo: Daniel Berehulak/Getty Images)

Over the last decade, the minimum wage has emerged as a defining economic issue of our time. Several stateshavepassed increases recently, and the topic emerged as a key distinction between Bernie Sanders and Hillary Clinton during the Democratic primary.

To date, much of the debate around the minimum wage has centered on its economic effects: Advocates of minimum-wage hikes argue they’re necessary to help low-income workers attain a higher standard of living and reverse the declines of recent decades; opponents argue minimum wage hikes will increase unemployment and encourage employers to outsource jobs or replace low-income workers with computers.

A workingpaper published earlier this week by the National Bureau of Economic Research suggests that wage-hike advocates can add another argument to their arsenal: healthier newborns.

The authors of the new paper — George Wehby, Dhaval Dave, and Robert Kaestner — analyzed how state-level variations in the minimum wage affected infant health indicators for all births in the United States between 1989 and 2012. Wehby, Dave, and Kaestner found that minimum-wage increases are associated with birth-weight increases, due to longer pregnancies and better fetal growth rates. Specifically, for women with a high school degree, a $1,000 increase in annual household income is associated with a 2.8 percent decrease in the likelihood they’ll give birth to a low-weight baby. The authors believe the improvements in infant health were caused by behavioral changes — increased amounts of prenatal care and lower rates of maternal smoking.

For many Americans, inequality begins in the womb.

In some respects, the relationship between a woman’s income during pregnancy and the health of her baby seems obvious — wealthier women have access to better nutrition and care, and are likely less stressed than poorer women. And researchers have demonstrated that dramatic shocks in utero have negative effects. In a series of papers, Columbia University economist Douglas Almond (together with several co-authors) found that prenatal exposure to Ramadan (which involves fasting) resulted in poorer infant health outcomes, lower test scores in childhood, and higher rates of mental or learning disabilities as adults. In another paper, Almond and his co-authors found that in utero exposure to relatively low levels of radioactivity resulted in cognitive deficits later in life. (Likewise, famines and civil wars aren’t so good for babies-to-be.)

But, until recently, there hasn’t actually been much concrete evidence on the effects of prenatal exposure to relatively small changes in income or resources, such as those that occur thanks to minimum-wage increases or changes in the social safety net. That, however, is changing. A 2008 paper by Almond, Hilary Hoynes, and Diane Whitmore Schanzenbach that studied the rollout of the food stamp program in the 1960s and ’70s found that third-trimester exposure to the program improved infant health outcomes. In related work, the same researchers found that children exposed to the program in utero and in childhood were healthier and more economically self-sufficient as adults.

And it’s not just food stamps or the minimum wage that produce improvements in infant health outcomes. In a 2015 paper published in the American Economic Journal, Hoynes, Doug Miller, and David Simon evaluated the effects of the Earned Income Tax Credit on infant health. The researchers found that the EITC increased birth weight and reduced the incidence of low birth weight. Interestingly, the authors attribute the improvements to the same factors as the authors of the recent minimum wage paper — increased prenatal care and lower levels of maternal smoking.

There’s a desperately needed debate raging right now in this country about inequality. Productivity growth is anemic, the employment prospects for high school-educated Americans remain grim, almost all Americans have seen their wages stall, and the rich-poor life expectancy gap has only widened (although, to that last point, research actually paints a rosier picture for younger Americans). While these economic trends have affected everyone, minorities have been hit particularly hard. For many Americans, inequality begins in the womb, and remains troublingly persistent throughout life.

All too often, however, debates over economic or social safety net policies focus primarily on the immediate cost and fail to account for the far-reaching effects of such changes. Yet time and again, research has demonstrated that investing in children (even in utero!) — be it via high-quality early childhood education, nutrition programs, health insurance, or an increase to parents’ incomes — pays for itself many times over.