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Economic hardship is often exacerbated during pregnancy, childbirth, and infancy. This period is laden with additional expenses at a time when women might be reducing work hours. Purchasing and eating healthy food is particularly important during pregnancy but can be costly. Once the baby is born, increased expenses include health care and childcare, as well as material goods such as diapers. As a result, pregnancy can both lead to and worsen financial burden among expectant and new parents.1
DISPARITIES IN PERINATAL HEALTH
Poverty is highly correlated with multiple conditions that can harm pregnant and postpartum women and their children. Low income is associated with food insecurity, unstable housing, and unhealthy neighborhood conditions, all of which can be detrimental to maternal and infant health. Moreover, poverty, particularly during the perinatal period, can increase maternal stress, which can lead to mental health disorders and physical chronic disease, thus increasing the risk of maternal morbidity and mortality.2 This is of great concern given that in recent years maternal deaths because of cardiovascular disease and other medical conditions have increased in the United States. Overall, women giving birth in the United States suffer from higher rates of morbidity and mortality than those in similarly large and developed countries, and large racial/ethnic disparities exist.3
The pregnancy-related death rate among Black women is almost three times higher than among White women, and more than three times higher than among Hispanic women.3 Disparities are evident even after controlling for social and economic factors, highlighting the role that racism and discrimination likely play in these differences. 3 In this issue of AJPH, Hanna et al. (p. 2020) describe how Rx Kids, a community-wide, universal, and unconditional prenatal and infant cash transfer program, addresses these disparities by investing in families in Flint, Michigan, a community consisting mostly of Black residents with high rates of poverty.
WHAT WE LEARNED FROM RX KIDS
Women enrolled in Rx Kids receive a one-time sum of $1500 during pregnancy and $500 per month postnatally for 12 months. The authors present evidence of the effectiveness of the Rx Kids program in alleviating economic hardship and improving maternal health and well-being. Specifically, participation in Rx Kids was associated with decreases in not having enough food, owing past due rent or mortgage,...