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从子宫到智慧:早年接触助产士法与晚年残疾

Womb to wisdom: Early-life exposure to midwifery laws and later-life disability.

作者信息

Noghanibehambari Hamid, Bagheri Hesamaldin, Toranji Mostafa, Vu Hoa, Tavassoli Nasrin

机构信息

College of Business, Austin Peay State University, Marion St, Clarksville, TN 37040, USA.

Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.

出版信息

Soc Sci Med. 2025 May;372:117973. doi: 10.1016/j.socscimed.2025.117973. Epub 2025 Mar 21.

Abstract

Previous research documented that midwifery service quality improvements lead to improving maternal and infants' health outcomes. However, little is known about its influence for later-life outcomes including disability. This paper explores the potential effects of early-life exposure to the establishment of midwifery laws across US states on later-life disability outcomes. Midwifery laws were enacted during the late 19th and early 20th century and required midwives to gain formal education and training to obtain a license in order to legally practice. We use decennial census data over the years 1970-2000 and implement a difference-in-difference method and show that being born in a reform state is associated with significant reductions in various measures of disability, including work disability, cognitive difficulty, ambulatory difficulty, self-care difficulty, and a proxy for severe mental health. We also find significant increases in education, socioeconomic scores, housing wealth, and income. We further discuss the policy implications of the results.

摘要

先前的研究表明,助产服务质量的提高有助于改善孕产妇和婴儿的健康状况。然而,对于其对包括残疾在内的晚年生活结局的影响却知之甚少。本文探讨了美国各州早期接触助产士法的制定对晚年残疾结局的潜在影响。助产士法于19世纪末和20世纪初颁布,要求助产士接受正规教育和培训以获得执照,以便合法执业。我们使用了1970年至2000年期间的十年一次的人口普查数据,并采用了双重差分法,结果表明,在改革州出生与各种残疾指标的显著降低有关,包括工作残疾、认知困难、行动困难、自我照顾困难以及严重心理健康的一个替代指标。我们还发现教育、社会经济得分、住房财富和收入有显著增加。我们进一步讨论了这些结果的政策含义。

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