Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Canadian Center for Health Economics, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Canadian Center for Health Economics, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Centre for Health Economics and Hull York Medical School, University of York, Heslington, York YO10 5DD, UK; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 1000 Queen Street West, Toronto, ON M6J 1H4, Canada.
Econ Hum Biol. 2023 Aug;50:101257. doi: 10.1016/j.ehb.2023.101257. Epub 2023 May 4.
The objective of this study was to investigate the relationship between health conditions in childhood (ages 4-11), and health and socioeconomic outcomes in adulthood (ages 21-33). This study takes advantage of a new linkage between the National Longitudinal Survey of Children and Youth (NLSCY) and administrative tax data from the T1 Family File (T1FF) from Statistics Canada. The NLSCY includes rich longitudinal information on child development, while the T1FF includes administrative tax information on each child in adulthood (e.g., income, social assistance). The primary measures of child health relate to the diagnosis of a chronic condition, affecting the child's physical or mental/developmental health. The results suggest that mental/developmental health conditions in childhood more negatively influence adult health and socioeconomic conditions, compared to physical health conditions. Interaction models reveal modest heterogenous effects; for example, there is some evidence of a cushioning effect from higher household income in childhood, as well as an exacerbating negative effect from lower birth weight for mental/developmental health conditions. Using a covariate decomposition approach to explore underlying pathways, the results reveal that associations between health in early life and outcomes in adulthood are partially explained by differences in cognitive skills (i.e., mathematics test scores) in adolescence (ages 16-17). Results may encourage policy investments to mitigate the occurrence of health conditions in childhood and to ensure timely access to educational supports and health services for children with chronic conditions.
本研究旨在探讨儿童时期（4-11 岁）的健康状况与成年时期（21-33 岁）的健康和社会经济状况之间的关系。本研究利用了加拿大统计局的国家儿童纵向调查（NLSCY）与 T1 家庭档案（T1FF）之间的新链接，T1FF 包含了成年后每个孩子的行政税务信息（例如收入、社会援助）。NLSCY 包含了有关儿童发展的丰富纵向信息，而 T1FF 包含了成年后每个孩子的行政税务信息（例如收入、社会援助）。儿童健康的主要衡量标准与慢性疾病的诊断有关，这些疾病会影响儿童的身体或精神/发育健康。研究结果表明，与身体健康状况相比，儿童时期的精神/发育健康状况对成年后的健康和社会经济状况有更负面的影响。交互模型显示出适度的异质效应；例如，有证据表明，童年时期家庭收入较高会产生缓冲效应，而对于精神/发育健康状况，较低的出生体重则会产生加剧的负面影响。通过使用协变量分解方法来探索潜在途径，结果表明，早期生命中的健康状况与成年后结果之间的关联部分可以通过青春期（16-17 岁）的认知技能（即数学考试成绩）差异来解释。研究结果可能鼓励政策投资，以减轻儿童时期健康状况的发生，并确保患有慢性疾病的儿童能够及时获得教育支持和医疗服务。
