This paper reviews the research of the past two decades that addresses the relationship between family structure and early child health outcomes. Specifically, we focus on family structure’s influence on child health during pregnancy, birth, and infancy. We briefly summarize the most pervasive changes to family structure in the US during recent decades and discuss how early child health is linked to future outcomes for children and adults. We review research that highlights the mechanisms linking family structure to early child health and identify key risk and protective factors for children from the prenatal period through infancy. We conclude with a critical assessment of current policy efforts to strengthen families and make recommendations for how best to address this issue for America’s families going forward.

Key Take Away Points

  • Family structure impacts early child health above and beyond differences in socioeconomic status
  • Family structure impacts children beginning in the prenatal period
  • Marriage promotion policy in the U.S. is likely to be misguided
  • Instead, policy makers should focus on building healthy foundations for marriage and planned childbearing

Author Biography

Laura Freeman Cenegy is a graduate student in the Department of Sociology at Rice University. Mackenzie Brewer is a graduate student in the Department of Sociology at Rice University.


The authors would like to thank Dr. Rachel Tolbert Kimbro for providing many insightful comments on the previous versions of this manuscript.