Marriage rates among people with disabilities (save the data edition)

Cross posted on the Families as They Really Are blog.

Disability is a very broad concept, representing a wide array of conditions that are not easily captured in a simple demographic survey. However, disabilities are very prevalent, especially in an aging society, and the people who experience disabilities differ in important ways from those who do not. Previously I reported — in a preliminary way — that people with disabilities are much more likely to divorce than those without. Here I present some numbers on marriage rates.

This isn’t the kind of thorough, probing analysis this subject requires. But I have two reasons to do it now. First is that I hope to motivate other people to pursue this issue in greater depth. And second, I want to highlight the importance of the data I’m using — the American Community Survey (ACS) — because it might be not available for much longer. These questions have been slated for demolition by the U.S. Census Bureau on cost-saving grounds. I put details about this issue — and how to register your opinion with the federal government — at the end of the post.

Disabilities

The ACS asks five disability questions (I put the shorthand label after each):

  1. Is this person deaf or does he/she have serious difficulty hearing? (Hearing)
  2. Is this person blind or does he/she have serious difficulty seeing even when wearing glasses? (Vision)
  3. Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions? (Cognitive)
  4. Does this person have serious difficulty walking or climbing stairs? (Ambulatory)
  5. Does this person have difficulty dressing or bathing? (Independent living)

These aren’t perfect questions, but they cover a lot of ground, and the ACS — which involves about 3 million households — can’t get into too much detail.

One great thing about having these questions on the giant ACS is you can use the data to get all the way down to the local level, or into small race/ethnic groups. And with the marital events questions, you can combine disability information and marriage information.

Marriage rates*

Using marital events (did you get married in the last year), marital history (how many times have you been married), detailed race and ethnicity breakdowns, and the disability questions above, I produced the following figure. This uses the combined 2008-2012 ACS data because these are small groups, but even with five years of data these groups get quite small. There are about 90,000 non-Hispanic Whites with a cognitive disability in my sample, but only 356 people who are both White and American Indian with a hearing disability (the smallest group I included). This sample is people ages 18-49 who have never been married (or just got married).

disab-marriage-rates

The overall marriage rate for never-married people ages 18-49 is 71.8 per 1,000. For people with disabilities it’s 41.1 (shown by the blue line). So that’s much lower than for the general population. But there is a very wide variation across these groups, from 15.5 per thousand for Blacks with disabilities in independent living all the way up to above the national average for Whites and White/American Indians with hearing disabilities. (For every condition, Blacks with disabilities have the lowest marriage rates.)

I don’t draw any conclusions here, except that this is an important subject and I hope more people will study it. Also, we need data like this.

In previous posts demonstrating the value of this data source, I wrote about:

Whether you are a researcher or some other member of the concerned public, I hope you will consider dropping the government a line about this before the end of the year.

The information about the planned cuts to the American Community Survey is here: https://www.federalregister.gov/articles/2014/10/31/2014-25912/proposed-information-collection-comment-request-the-american-community-survey-content-review-results:

Direct all written comments to Jennifer Jessup, Departmental Paperwork Clearance Officer, Department of Commerce, Room 6616, 14th and Constitution Avenue NW., Washington, DC 20230 (or via the Internet at jjessup@doc.gov).

Comments will be accepted until December 30.


* Erratum: In the original post I described this as a “first-marriage rate.” However, in checking over the code I used, I see that I used all marriages in the nominator, and never-married people in the denominator. Therefore, this is more accurately described as “marriages per 1000 never-married people.” It would have made more sense to just put first marriages in the numerator. For reference, the first-marriage rates were 54.0 for the total never-married 18-49 population, and 24.5 for those with a disability. I regret the error. 

People with disabilities are more likely to get divorced

File this under things to look into about divorce.

There was a recent paper showing that people who experience the onset of a disability face an increased likelihood of divorce, but that’s about all I found in a quick search. Now that we have the giant American Community Survey, which has both disability status and marital events data, we can ask the simple question: In a given year, are people with a reported disability more likely to report they have been divorced in the previous year? The answer is yes.

Age is a tricky issue with disability, since some risks of disability are cumulative over the life course. To do this quickly I just limited this to people ages 18-49. Otherwise the disability group is dominated by older people who have been married a long time, and who have low divorce rates. Here it is, by type of reported disability for the pooled 2009-2011 ACS:

disability-divorceThose are pretty big effects (odds ratios from 1.4 to 1.9). Over a lifetime these odds would really add up.

Economists would tell you that when a spouse experiences the onset of disability, this is new information for the other spouse, and increases his or her chance of leaving the marriage, since the disability implies a decline in future income. Maybe. But what about people who have disabilities already when they get married, which is presumably the case for most of these people. Is having a difficult life a cause of divorce? Is this related to economic stress, or carework obligations (I checked and found not much gender difference, but men’s disability has slightly stronger effects).

If you are interested in this question, don’t let me stop you from pursuing it – send me your results!

Poverty Poses a Bigger Risk to Pregnancy Than Age

Originally published in TheAtlantic.com.

The problem of income inequality often gets forgotten in conversations about biological clocks.

The dilemma that couples face as they consider having children at older ages is worth dwelling on, and I wouldn’t take that away from Judith Shulevitz’s essay in the New Republic, “How Older Parenthood Will Upend American Society,” which has sparked commentary from Katie Roiphe,Hanna RosinRoss Douthat, and Parade, among many others.
The story is an old one—about the health risks of older parenting and the implications of falling fertility rates for an aging population—even though some of the facts are new. But two points need more attention. First, the overall consequences of the trend toward older parenting are on balance positive, both for women’s equality and for children’s health. And second, social-class inequality is a pressing—and growing—problem in children’s health, and one that is too easily lost in the biological-clock debate.

Older mothers

First, we need to distinguish between the average age of birth parents on the one hand versus the number born at advanced parental ages on the other. As Shulevitz notes, the average age of a first-time mother in the U.S. is now 25. Health-wise, assuming she births the rest of her (small) brood before about age 35, that’s perfect.

Consider two measures of child well-being according to their mothers’ age at birth. First, infant mortality:

cohen_infantmortality.pngSource: Centers for Disease Control.

Health prospects for children improve as women (and their partners) increase their education and incomes, and improve their health behaviors, into their 30s. Beyond that, the health risks start accumulating, weighing against the socioeconomic factors, and the danger increases.

Second, here is the rate of cognitive disability among children according to the age of their mothers at birth, showing a very similar pattern:

cohen_infantmortality2.pngSource: Calculations made for my working paper, available here. To match up children with their birth parents in the Census, I had to limit the sample to children living with two married parents, where both are in their first marriage, so it’s a pretty select group.

Again, the lowest risks are to those born when their parents are in their early 30s, a pattern that holds when I control for education, income, race/ethnicity, gender, and child’s age.

When mothers older than age 40 give birth, which accounted for 3 percent of births in 2011, the risks clearly are increased, and Shulevitz’s story is highly relevant. But, at least in terms of mortality and cognitive disability, an average parental age in the late 20s and early 30s is not only not a problem, it’s ideal.

Unequal health

But the second figure above hints at another problem—inequality in the health of parents and children. On that purple chart, a college graduate in her early 40s has the same risk as a non-graduate in her late 20s. And the social-class gap increases with age. Why is the rate of cognitive disabilities so much higher for the children of older mothers who did not finish college? It’s not because of their biological clocks or genetic mutations, but because of the health of the women giving birth.

For healthy, wealthy older women, the issue of aging eggs and genetic mutations from fathers’ run-down sperm factories is more pressing than it is for the majority of parents, who have not graduated college.

If you look at the distribution of women having babies by age and education, it’s clear that the older-parent phenomenon is disproportionately about more-educated women. (I calculated these from the American Community Survey, because age-by-education is not available in the CDC numbers, so they are a little different.)

cohen_infantmortality3.pngMost of the less-educated mothers are giving birth in their 20s, and a bigger share of the high-age births are to women who’ve graduated college—most of them married and financially better off. But women without college degrees still make up more than half of those having babies after age 35, and the risks their children face have more to do with high blood pressure, obesity, diabetes, and other health conditions than with genetic or epigenetic mutations. Preterm births, low birth-weight and birth complications are major causes of developmental disabilities, and they occur most often among mothers with their own health problems.

Most distressing, the effects of educational (and income) inequality on children’s health have been increasing. Here are the relative odds of infant mortality by maternal education, from 1986 to 2001, from a study in Pediatrics. (This compares the odds to college graduates within each year, so anything over 1.0 means the group has a higher risk than college graduates.)

cohen_infantmortality4.pngThis inequality is absent from Shulevitz’s essay and most of the commentary about it. She writes, of the social pressure mothers like her feel as they age, “Once again, technology has given us the chance to lead our lives in the proper sequence: education, then work, then financial stability, then children”—with no consideration of the 66 percent of people who have reached their early 30s with less than a four-year college degree. For the vast majority of that group, the sequence Shulevitz describes is not relevant.

In fact, if Shulevitz had considered economic inequality, she might not have been quite as worried about advancing parental age. When she worries that a 35-year-old mother has a life expectancy of just 46 more years—years to be a mother to her child—the table she consulted applies to the whole population. She should breathe a little bit easier: Among 40-year-old white college graduateswomen are expected to live an average extra five years compared with those who have a high school education only.

When it comes to parents’ age versus social class, the challenges are not either/or. We should be concerned about both. But addressing the health problems of parents—especially mothers—with less than a college degree and below-average incomes is the more pressing issue—both for potential lives saved or improved and for social equality.

Cash welfare down, food stamps, disability, marriage fiasco and extreme poverty up

In the New York Times, Jason DeParle has a very good article on the struggle to survive among poor single mothers, post welfare-reform, during the recession. Bottom line: Although millions more families are receiving food stamps, millions have lost benefits they really needed, and the crisis for people at the very bottom has reached extreme proportions as government turns away from their needs.

There are good experts and links in the story. I would only suggest two other things to consider, with a couple quick links.

Disability

First, among those worst affected are single mothers with health problems. Getting disability benefits is much harder than it used to be to get cash welfare (AFDC/TANF), and as the cash welfare support has been reformed away, employment opportunities and  disability benefits have not risen enough to keep many of them afloat. I explored this in a policy brief back in 2006, and haven’t updated the numbers since, but I’m still pretty confident in the conclusion:

Among single mothers with disabilities in the United States, the rock of disability has met the hard place of welfare reform, and the result is official poverty rates of 56% (only marginally minimized by household extension), employment rates below 1-in-5, and an increasing tendency to surrender residential independence for basic survival or wellbeing. For this group of about 700,000 mothers, more than 20% of whom live below half the poverty line, only sustained policy attention from government and, ultimately, substantial transfers of wealth, will lead to adequate standards of living.

Marriage fiascos

The other note is that, while welfare benefits have been slashed and material suffering has increased for the very poor, the government has embarked on the ridiculous fiasco of “marriage promotion,” which has had no demonstrable benefit for poor people who aren’t married. This is not just a plaything. Funded out of the TANF program budget, it has taken hundreds of millions of dollars worth of support out of the pockets of former welfare recipients.

That’s something to keep in mind as you read about poor mothers trying to eke out survival in today’s story.

Related reading

In absence of welfare, gov’t delivers poor children to big pharma

Now our shambolic welfare system drives children into the arms of big pharma.

Now we learn from the Boston Globe that poor mothers and their children are increasingly turning to federal disability support for children. In the process, which requires a diagnosis, more of their children are being diagnosed (and medicated) as mental health patients, creating a web of perverse incentives — the kind we don’t seem to impose on the rich (see Rock v. Hard Place).

Caring for children is a job, but when it’s not paid it doesn’t put food on the table, or a table in the house (or a roof on the house). So a single parent needs a paid job and help (paid or not) with the children — without welfare or other income source. As we know, welfare is not there for poor single-parent families, and wasn’t even before during the recession.

A few years ago, I belatedly noticed that disabilities throw off this indelicate getting-by work-family balance — by increasing the care needed and reducing the capacity to work. And, unsurprisingly but little-noticed, the process of caring for children with disabilities includes a very strong set of mechanisms sorting them into living arrangements under the care of women.

As the old welfare system was shedding its wards, women with disabilities were falling through the cracks: more likely to be in poverty, relatively less likely to be employed, and less likely to be receiving state support of any kind — and increasingly turning to extended household living arrangements.

It turns out some of those welfare-receiving single mothers had disabilities, but the old AFDC/TANF had been easier to qualify for than disability support (which may require — for a diagnosis, at least — decent health care), and many were not successfully making the transition (even though states were pushing them toward disability, to meet federal pressure for shrinking “welfare” rolls). In that paper, I concluded:

U.S. social policy does not proceed from the assumption that unpaid carework, and care for children in particular, is an essential public good. Therefore, the practice of caring for children instead of working for pay is easily classified as “idleness,” and public compensation for the time and effort expended is considered charity or demeaned as dependence. … Among single mothers with disabilities in the United States, the rock of disability has met the hard place of welfare reform, and the result is official poverty rates of 56% 32(only marginally minimized by household extension), employment rates below 1-in-5, and an increasing tendency to surrender residential independence for basic survival or wellbeing. For this group of about 700,000 mothers, more than 20% of whom live below half the poverty line, only sustained policy attention … [etc. etc.].

For some reason the authorities haven’t yet taken my advice. Must be because we didn’t have blogs back then.