Rolling back the gains: Maternal stress undermines pregnancy health after Flint's water switch

Environmental disasters impact disadvantaged communities disproportionately both through the epidemiological challenge of exposure, but also by undermining the progress of public health efforts. This paper studies changes to smoking cessation, breastfeeding, and weight gain during pregnancy in the p...

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Bibliographic Details
Published in:Health economics Vol. 30; no. 3; pp. 564 - 584
Main Authors: Danagoulian, Shooshan, Jenkins, Derek
Format: Journal Article
Language:English
Published: England Wiley Periodicals Inc 01.03.2021
Subjects:
Behavior change
Behavior modification
Breastfeeding & lactation
Cancer
Cardiovascular diseases
Childbirth & labor
Deterioration
Diabetes
Disadvantaged
Disasters
environmental health and safety
environmental protection and regulation
Epidemiology
health and poverty
health behavior
Health economics
Health status
Infants
Low birth weight
Maternal and infant welfare
Maternal characteristics
Maternal stress
Mental health
Mothers
pollution control
population health
Pregnancy
Public health
public services
Smoking
Stress
Water quality
Water supply
Weight gain
environmental protection and regulation
environmental health and safety
population health
health behavior
public services
health and poverty
pollution control
ISSN:1057-9230, 1099-1050, 1099-1050
Online Access:Get full text
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Summary:Environmental disasters impact disadvantaged communities disproportionately both through the epidemiological challenge of exposure, but also by undermining the progress of public health efforts. This paper studies changes to smoking cessation, breastfeeding, and weight gain during pregnancy in the period following the switch in water supply in Flint, Michigan, in April 2014. As the switch resulted in immediate and significant deterioration in water quality, eventually leading to its contamination with lead, we estimate a 10.5 percentage point increase in smoking and a 2.1 percentage point decrease in breastfeeding. We show evidence that these changes in maternal behavior are linked to increased stress due to changing water quality. We estimate that the increase in smoking alone is responsible for most of the increase in incidence of low birthweight among infants in Flint, resulting in $700 additional costs per birth. Increased smoking during pregnancy and lower breastfeeding rates in Flint roll back years of public health efforts, resulting in lifetime higher rates of cardiovascular disease, diabetes, and cancer for mothers in the community.
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ISSN:1057-9230
1099-1050
1099-1050
DOI:10.1002/hec.4210