Intersecting fertility: Educational disparities in Black older women’s health outcomes

Scarce studies have examined an intersection of women's fertility and education and their impacts on racially stratified women's later-life health. This study examined the health outcomes of women aged sixty-five and older by comparing Black and non-Black women. It focused on analyzing how the number of children a woman had, and her level of education, can constitutively impact her later-life health outcomes. We used data from the National Health Interview Survey (2010-2018) and the intersectionality and fundamental causes of disease theories. Logistic regression findings suggested that being Black, having a lower education status, and having two or more children were significantly associated with higher activity limitation, disability, and poorer self-rated health as compared to their counterparts. The significantly higher odds interaction effects were found between race and education, as well as race and parity, indicating the stronger influence of lower levels of education and a larger number of children on activity limitations and disability for older Blacks than non-Black women. These interactions were weaker in terms of self-rated health status. The three-way interactions between race, fertility, and education were significantly lower. This indicates weaker or smaller gains associated with high fertility and lower education on disability and activity limitations status among Blacks than non-Black older women. This new study suggests a unique contribution of Black women's fertility history as an additional determinant of their later life health when intersected with other upstream factors like education.