Family-friendly workplace policies in the United States: Associations with maternal and child health
2016-05
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Family-friendly workplace policies in the United States: Associations with maternal and child health
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2016-05
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Women in the United States face uniquely challenging circumstances regarding employment and childbirth. Unlike all but two other countries worldwide, the U.S. does not guarantee paid leave to employed women who give birth, and the 12 weeks of unpaid leave provided under the Family and Medical Leave Act falls far short of most industrialized nations. This dissertation examines the associations between family-friendly workplace policies such as paid maternity leave and indicators for maternal and child health outcomes, care utilization, and access to health care services in the U.S. context. Data from Listening to Mothers III, a national survey of U.S. women ages 18-45 who gave birth in 2011-12, were used to conduct multivariate logistic regression predicting infant health, maternal physical/mental health, and maternal health behavior outcomes by use and duration of paid maternity leave among 700 women who indicated working during pregnancy. A second aim explored the associations between workplace accommodations during pregnancy and women’s access to health insurance coverage after childbirth, via employment continuity. Data from the National Survey of Family Growth 2006-10 were then used to examine variations in access to paid and unpaid maternity leave across U.S. states by state-level leave policies among a sample of 2,708 U.S. women ages 18-44 who gave birth in 2001-2010. Across all three aims, paid maternity leave was consistently associated with positive indicators for maternal and infant health. Women taking paid maternity leave had significantly lower odds of re-hospitalizing themselves and their infants after giving birth and higher odds of positive health behaviors. Availability of maternity leave predicted women’s return to work postpartum, and in turn, lowered the odds of losing health insurance coverage. Women in states with more generous maternity leave policies were more likely to take leave, and for longer durations; this association was especially pronounced for lower-income women, suggesting that public policies may play an important role in addressing socio-demographic disparities in maternal/child health via access to paid maternity leave. Future research, especially using longitudinal or prospective cohort designs, is recommended to shed further light on the potential benefits of expanded access to paid leave for maternal/child health.
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University of Minnesota Ph.D. dissertation.May 2016. Major: Health Services Research, Policy and Administration. Advisor: Katy Kozhimannil. 1 computer file (PDF); vii, 172 pages.
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Jou, Judy. (2016). Family-friendly workplace policies in the United States: Associations with maternal and child health. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/199065.
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