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Exploring Socio-Economic Inequalities in Low Birth Weight: A Statistical Decomposition Approach.

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Title: Exploring Socio-Economic Inequalities in Low Birth Weight: A Statistical Decomposition Approach.
Authors: Zhang X; School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.; School of Economics and Management, Shangluo University, Shangluo, Shaanxi Province, China., Shah AA; School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China., Han L; School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Source: American journal of human biology : the official journal of the Human Biology Council [Am J Hum Biol] 2025 Dec; Vol. 37 (12), pp. e70173.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 8915029 Publication Model: Print Cited Medium: Internet ISSN: 1520-6300 (Electronic) Linking ISSN: 10420533 NLM ISO Abbreviation: Am J Hum Biol Subsets: MEDLINE
Imprint Name(s): Publication: New York, NY : Wiley-Blackwell
Original Publication: New York, NY : Alan R. Liss, Inc., c1989-
MeSH Terms: Infant, Low Birth Weight* , Socioeconomic Factors*, Humans ; Infant, Newborn ; Female ; Adult ; Male ; Pakistan/epidemiology ; Young Adult ; Infant ; Adolescent ; Rural Population/statistics & numerical data
Abstract: Background: Low birth weight is a critical predictor of child mortality and morbidity, contributing to both immediate health complications after birth and long-term health issues later in life. Globally, it remains a major public health challenge, particularly in low- and middle-income countries, where poor maternal nutrition, limited access to quality healthcare, and poverty exacerbate the risk. Regions such as Sub-Saharan Africa and South Asia carry the highest burden, accounting for the majority of low birth weight cases worldwide. Within this context, Pakistan stands out as one of the countries with the highest rates of child mortality and malnutrition, making the issue of low birth weight especially pressing.
Methodology: Utilizing the Demographic and Health Survey of 2017-18, multiple analytical techniques were used including logistic regression, standard, Wagestaff, Erreygers concentration index analysis and concentration curves.
Results: The study indicates that low birth weight (LBW) is disproportionately concentrated among socio-economically disadvantaged groups. Negative and significant concentration indices for household wealth, maternal education, and paternal education show that children from poorer and less educated families are at higher risk of LBW. Further analysis reveals that the relationship between household wealth, parental education and LBW is nonlinear in the context of rural-urban division. Rural children from middle and higher-income families show a slightly elevated risk as compared with urban. Similarly, mother's education seems less effective against LBW. However, father's education might help as LBW is slightly reduced among higher educated fathers. This counterintuitive pattern may be influenced by factors such as multiple births, cesarean deliveries, antenatal care utilization, or other socio-cultural dynamics. For example rural women might have less decision-making autonomy regarding health and meeting other necessities of life.
Conclusion: The study finds that low birth weight (LBW) is disproportionately concentrated among socio-economically disadvantaged groups, with household wealth and parental education serving as strong protective factors. However children from middle and higher-income households, in rural areas, may also experience a slightly elevated risk of LBW as compared to urban populations Father's education might play a more protective role against low birth weight among rural areas.
(© 2025 Wiley Periodicals LLC.)
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Grant Information: 2021F012 Shaanxi Provincial Social Science Foundation Research Program; 2025YB0148 Shaanxi Provincial Philosophy and Social Sciences Research Special Fund Project; SGH24Y2308 Shaanxi Province Education Science "14th Five-Year" Plan Program
Contributed Indexing: Keywords: concentration index; decomposition; low birth weight; rural urban; socio‐economic inequalities
Entry Date(s): Date Created: 20251130 Date Completed: 20251130 Latest Revision: 20251130
Update Code: 20251201
DOI: 10.1002/ajhb.70173
PMID: 41320666
Database: MEDLINE
Description
Abstract:Background: Low birth weight is a critical predictor of child mortality and morbidity, contributing to both immediate health complications after birth and long-term health issues later in life. Globally, it remains a major public health challenge, particularly in low- and middle-income countries, where poor maternal nutrition, limited access to quality healthcare, and poverty exacerbate the risk. Regions such as Sub-Saharan Africa and South Asia carry the highest burden, accounting for the majority of low birth weight cases worldwide. Within this context, Pakistan stands out as one of the countries with the highest rates of child mortality and malnutrition, making the issue of low birth weight especially pressing.<br />Methodology: Utilizing the Demographic and Health Survey of 2017-18, multiple analytical techniques were used including logistic regression, standard, Wagestaff, Erreygers concentration index analysis and concentration curves.<br />Results: The study indicates that low birth weight (LBW) is disproportionately concentrated among socio-economically disadvantaged groups. Negative and significant concentration indices for household wealth, maternal education, and paternal education show that children from poorer and less educated families are at higher risk of LBW. Further analysis reveals that the relationship between household wealth, parental education and LBW is nonlinear in the context of rural-urban division. Rural children from middle and higher-income families show a slightly elevated risk as compared with urban. Similarly, mother's education seems less effective against LBW. However, father's education might help as LBW is slightly reduced among higher educated fathers. This counterintuitive pattern may be influenced by factors such as multiple births, cesarean deliveries, antenatal care utilization, or other socio-cultural dynamics. For example rural women might have less decision-making autonomy regarding health and meeting other necessities of life.<br />Conclusion: The study finds that low birth weight (LBW) is disproportionately concentrated among socio-economically disadvantaged groups, with household wealth and parental education serving as strong protective factors. However children from middle and higher-income households, in rural areas, may also experience a slightly elevated risk of LBW as compared to urban populations Father's education might play a more protective role against low birth weight among rural areas.<br /> (© 2025 Wiley Periodicals LLC.)
ISSN:1520-6300
DOI:10.1002/ajhb.70173