Socioeconomic Inequalities in Birth and Pregnancy Outcomes in the Czech Republic between 1990 and 2007: An Exploration of Trends

Abstract

This article explores the impact of the post-socialist transformation of Czech society on the health of newborns from different socioeconomic groups. The authors used six different measures of child health—various con- structs based on birth weight, length of gestation, and vitality—as dependent variables and the mother's educational attainment as the key predictor. They used birth certifi cate data on all singleton births in 1990, 1992, 1994, 1996, 1998, 2000, 2002, 2004 and 2007 (N=912 591). They estimated a series of random-inter- cept multi-level models and report the observed trends in health inequality by maternal education. The analysis consistently and persistently showed large gaps in health between children born to mothers with elementary education on the one hand and all other children on the other hand. While the trends are not entirely congruent across all measures of child health, the authors found more evidence of growing inequality than of declining or stable inequality. Inequality grew most in the 1990s and then stabilised or even declined. They offer two tentative explanations for observed growth in inequality: the selec- tive adjustment hypothesis and the selective childlessness hypothesis.