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Associate Professor of Sociology, University of Virginia 

Why Pediatricians Love Wedding Bells

Bryce J. Christensen and Robert W. Patterson

America’s physicians are eager to use their skills to safeguard the health of the nation’s babies, especially those born to poor parents. A study by researchers at the University of Pennsylvania and the State University of New York at Stony Brook, however, indicates that those doctors have their best chance to work with those babies when their parents are married.

The researchers began their inquiry into the needs of babies in poor households aware that although Medicaid covers 30 million children and although 20 percent of these children are at “significant risk for developmental, behavioral, or social delays,” only 20–60 percent receive the well-child care (WCC) recommended by pediatricians. In explaining the importance of WCC, the researchers cite previous studies have shown that such care is “associated with a lower likelihood of preventable hospitalization” and studies demonstrating that babies benefit greatly from the vaccinations given as part of WCC.

To determine when babies born to poor parents are most likely to receive recommended well-baby care, the researchers studied 744 mothers of babies born at a large urban hospital. It is entirely predictable that in a sample of mothers selected to be representative of a low-income population eligible for Medicaid, the overwhelming majority (87 percent) were unmarried. However, it was the married minority (13 percent) who stood out favorably when the researchers analyzed the social characteristics of those most likely to participate in WCC. Indeed, when they ran the data through their most sophisticated statistical multivariable model, the researchers found that married mothers were almost twice as likely as unmarried peers to participate in WCC (Odds Ratio, 1.71).

In their concluding comments, the researchers examine various “interventions [that] have attempted to improve the delivery of WCC.” But their own findings suggest that any intervention that does not set the wedding bells ringing again is likely to leave babies in jeopardy.

(Anje C. Van Berckelaer, Nandita Mitra, and Susmita Pati, “Predictors of Well Child Care Adherence Over Time in a Cohort of Urban Medicaid-Eligible Infants,” BMC Pediatrics 11 [May 15, 2011]: 36.)