Population Health and Period Shocks

Period shocks, known in the field of demography as period effects, are environmental changes that occur at a specific time and are experienced by an entire society, affecting all ages and cohorts of people. These events include policy or institutional changes and large public health crises. Evidence of their direct consequences for population health has been extensively documented. Less is known, however, about the indirect health consequences of these shocks. Public health crises are catalysts for changing healthcare systems and practices. They result in significant changes to both institutional norms and individual experiences, which indirectly affect population health, often disproportionately that of historically marginalized race/ethnic groups and women. In HealthShocks (Population Health and Period Shocks), I analyze the example of the COVID-19 pandemic and its consequences for maternal, fetal, and child health to develop a theoretical framework for conceptualizing the indirect pathways that period shocks affect population health and either exacerbate or equalize existing health inequalities. Now is the critical time to analyze the consequences of pandemic shocks for maternal, fetal, and child health. The interaction of changing institutional norms and individual level stress exposure will likely profoundly impact obstetric care and subsequent maternal and fetal health outcomes for decades to come. Beyond the pandemic, understanding the indirect pathways between public health crises and population health is crucial for planning and prevention. HealthShocks addresses these gaps with three aims: Aim 1 will examine how the pandemic has impacted trends in gestational age at birth in European countries. Aim 2 will test whether the pandemic has exacerbated or equalized race/ethnic differences in birth outcomes. Aim 3 develops a theoretical framework of the indirect pathways between period shocks, healthcare institutions, and population health.