In the epidemiological literature, the fetal origins hypothesis associated with David J. Barker posits that chronic, degenerative conditions of adult health, including heart disease and type 2 diabetes, may be triggered by circumstance decades earlier, in utero nutrition in particular. Economists have expanded on this hypothesis, investigating a broader range of fetal shocks and circumstances and have found a wealth of later-life impacts on outcomes including test scores, educational attainment, and income, along with health. In the process, they have provided some of the most credible observational evidence in support of the hypothesis. The magnitude of the impacts is generally large. Thus, the fetal origins hypothesis has not only survived contact with economics, but has flourished.

We examine the effect of maternal education on birth outcomes using Vital Statistics Natality data for 1970 to 1999. We also assess the importance of four channels through which maternal education may improve birth outcomes: use of prenatal care, smoking, marriage, and fertility. In an effort to account for the endogeneity of educational attainment, we use data about the availability of colleges in the woman's county in her seventeenth year as an instrument for maternal education. We nd that higher maternal education improves infant health, as measured by birth weight and gestational age. It also increases the probability that a new mother is married, reduces parity, increases use of prenatal care, and reduces smoking, suggesting that these may be important pathways for the ultimate effect on health. Our results add to the growing body of literature which suggests that estimates of the returns to education which focus only on increases in wages understate the total return.

There are many possible pathways between parental education, income, and health, and between child health and education, but only some of them have been explored in the literature. This essay focuses on links between parental socioeconomic status (as measured by education, income, occupation, or in some cases area of residence) and child health, and between child health and adult education or income. Specifically, I ask two questions: What is the evidence regarding whether parental socioeconomic status affects child health? And, what is the evidence relating child health to future educational and labor market outcomes? I show that there is now strong evidence of both links, suggesting that health could play a role in the intergenerational transmission of economic status.