Chipping away at health: More on the relationship between income and child health

Health Affairs

Volumn 26, Issue 2, 2007, Pages 331-344

  Currie, Janet ^a   Lin, Wanchuan ^b  

^a Och Spine at New York Presbyterian Hospitals   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ARTICLE; CHILD; CHILD HEALTH CARE; CHILD WELFARE; CHILDHOOD MORTALITY; COMPARATIVE STUDY; ECONOMICS; FEMALE; HEALTH CARE QUALITY; HEALTH STATUS; HEALTH SURVEY; HUMAN; INCOME; INSURANCE; MALE; POVERTY; PRESCHOOL CHILD; RISK ASSESSMENT; SOCIAL CLASS; SOCIOECONOMICS; UNITED STATES;

ADOLESCENT; CHILD; CHILD HEALTH SERVICES; CHILD MORTALITY; CHILD WELFARE; CHILD, PRESCHOOL; FEMALE; HEALTH STATUS; HEALTH SURVEYS; HUMANS; INCOME; INSURANCE COVERAGE; MALE; POVERTY; QUALITY OF HEALTH CARE; RISK ASSESSMENT; SOCIAL CLASS; SOCIOECONOMIC FACTORS; UNITED STATES;

EID: 33947312470     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.2.331     Document Type: Article

References (29)

1. This generalization holds within but not necessarily across U.S. ethnic groups. For example, although immigrant Latinos are generally poorer than non-Hispanic whites, they have equally good birth outcomes.
2. For the United States, see A. Case, D. Lubotsky, and C. Paxson, "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review 92, no. 5 (2002): 1308-1334.
3. For Canada, see J. Currie and M. Stabile, "Socioeconomic Status and Health: Why Is the Relationship Stronger for Older Children?" American Economic Review 93, no. 5 (2003): 1813-1823.
4. For the United Kingdom, see A. Currie, M.A. Shields, and S.W. Price, "Is the Child Health/Family Income Gradient Universal? Evidence from England," Discussion Paper no. 1328 (Bonn: IZA, 2004).
5. U.S. Bureau of the Census, "People in Families by Family Structure, Age, and Sex, Iterated by Income-to-Poverty Ratio and Race: 2004," http://pubdb3.census.gov/macro/032005/pov/new02_100_01.htm (accessed 27 December 2006).
6. P.W. Newacheck, "Poverty and Childhood Chronic Illness," Archives of Pediatrics and Adolescent Medicine 148, no. 11 (1994): 1143-1149;
7. P.W. Newacheck and N. Halfon, "Prevalence and Impact of Disabling Chronic Conditions in Childhood," American Journal of Public Health 88, no. 4 (1998): 610-617;
8. and Case et al., "Economic Status and Health."
9. For further information, see National Center for Health Statistics, "National Health Interview Survey (NHIS)," 21 December 2006, http://www.cdc.gov/nchs/about/major/nhis/quest_data_related_doc.htm (accessed 27 December 2006).
10. Case et al., "Economic Status and Health."
11. See S. Black, P. Devereux, and K. Salvanes, "From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes," NBER Working Paper no. 11796 (Cambridge, Mass.: National Bureau of Economic Research, 2005);
12. J. Currie and E.Moretti, "Biology as Destiny? Short and Long-Run Determinants of Intergenerational Transmission of Birth Weight," NBER Working Paper no. 11567 (Cambridge, Mass.: NBER, 2005);
13. P. Oreopoulos et al., "Short, Medium, and Long Term Consequences of Poor Infant Health: An Analysis using Siblings and Twins," NBER Working Paper no. 11998 (Cambridge, Mass.: NBER, 2005);
14. and H. Royer, "Separated at Girth: Estimating the Long-Run and Intergenerational Effects of Low Birth Weight Using Twins" (Ann Arbor: School of Public Health, University of Michigan, 2005).
15. K.M. Linnet et al., "Gestational Age, Birth Weight, and the Risk of Hyperkinetic Disorder," Archives of Disease in Childhood 91, no. 8 (2006): 655-660.
16. U.S. Environmental Protection Agency, "Asthma Facts," Pub. no. EPA 402-F-04-019, May 2006, http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en. pdf (accessed 3 January 2007).
17. As of 1999, one in five children suffered some impairment from a mental health condition, 11 percent were moderately impaired, and 5 percentwere seriously impaired. This latter figure is similar to what we report in Exhibit 1. U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General, 1999, http://mentalhealth.samhsa.gov/cmhs/ surgeongeneral/surgeongeneralrpt.asp (accessed 3 January 2007).
18. To construct the measure of whether mental health problems cause limits, we used answers to questions about whether learning disabilities, developmental delays, mental retardation, or other mental problems cause limits.
19. For discussion of inadequate asthma management, see J.S. Halterman et al., "Inadequate Therapy for Asthma among Children in the United States," Pediatrics 105, no. 1, Part 3 (2000): 272-276.
20. See J. Currie and M. Stabile, "Child Mental Health and Human Capital Accumulation: The Case of ADHD," Journal of Health Economics (forthcoming);
21. and R.A. Barkley et al., "The Adolescent Outcome of Hyperactive Children Diagnosed by Research Criteria: I. An Eight-Year Prospective Follow-Up Study," Journal of the American Academy of Child and Adolescent Psychiatry 29, no. 4 (1990): 546-557.
22. Also see R. Miech et al., "Low Socioeconomic Status and Mental Disorders: A Longitudinal Study of Selection and Causation during Young Adulthood," American Journal of Sociology 104, no. 4 (1999): 1096-1131.
23. R.J. Bonnie, C.E. Fulco, and C.T. Liverman, eds., Reducing the Burden of Injury (Washington: National Academies Press, 1999).
24. We also estimated ordered probits using the five health states (1 = excellent, 5 = poor). When we did this, we got estimates that were qualitatively similar to those in Exhibit 2. Specifically, the coefficients on "poor" for the four age groups were 0.215, 0.179, 0.260, and 0.266. All are statistically significant.
25. We also found that the relationship between income and health is smaller in the 0-1 age range than in the 2-3 age range, so our use of 2-3-year-olds rather than 0-3-year-olds changed our results somewhat relative to those of Case and colleagues. If we estimated ordered probits that use the full five-point health scale rather than dichotomizing health status for 1986 to 1995, used the exact same age ranges, dropped missing income, and used log (income) rather than poverty, we got results very similar to those of Case and colleagues. When we did this, we got estimates for the four age groups of -0.13, -0.16, -0.20, and -0.22, which can be compared to Case and colleagues' reported estimates of -0.11, -0.16, -0.19, and -0.22.
26. To reduce the number of measures to be included, we conducted age-specific factor analyses of the specific health measures on the overall health measure and kept any factor that had a weight of more than 0.3.
27. Centers for Disease Control and Prevention, Preventing Chronic Diseases: Investing Wisely in Health, Preventing Dental Caries (Washington: CDC, 6 April 2004). In addition to the lack of information about acute illnesses, injuries, and dental caries, it would be useful to track obesity and relate it to overall health status.
28. See A.A. Hedley et al., "Prevalence of Overweight and Obesity among U.S. Children, Adolescents, and Adults, 1999-2002," Journal of the American Medical Association 291, no. 23 (2004): 2847-2850. Although the NHIS does collect information about child height and weight, the data are not considered to be of high quality and are not released in the public-use data set.
29. Alternatively, low-income mothers may report worse health status for any objective measures of health. See P. Franks, M.R. Gold, and K. Fiscella, "Sociodemographics, Self-Rated Health, and Mortality in the U.S.," Social Science and Medicine 56, no. 12 (2003): 2505-2514. However, in this case, one might expect to see more significant interaction terms in Exhibit 4.