Arpin Emmanuelle, de Oliveira Claire, Siddiqi Arjumand, Laporte Audrey
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.
SSM Popul Health. 2023 Jun 21;23:101451. doi: 10.1016/j.ssmph.2023.101451. eCollection 2023 Sep.
Research on the long-term effects of health in early life has predominantly relied on parametric methods to assess differences between groups of children. However, this approach leaves a wealth of distributional information untapped. The objective of this study was to assess distributional differences in earnings and mental health in young adulthood between individuals who suffered a chronic illness in childhood compared to those who did not using the non-parametric relative distributions framework. Using data from the Panel Study of Income Dynamics, we find that young adults who suffered a chronic illness in childhood fare worse in terms of earnings and mental health scores in adulthood, particularly for individuals reporting a childhood mental health/developmental disorder. Covariate decompositions suggest that chronic conditions in childhood may indirectly affect later outcomes through educational attainment: had the two groups had similar levels of educational attainment, the proportion of individuals with a report of a chronic condition in childhood in the lower decile of the relative earnings distribution would have been reduced by about 20 percentage points. Findings may inform policy aimed at mitigating longer run effects of health conditions in childhood and may generate hypotheses to be explored in parametric analyses.
对生命早期健康的长期影响的研究主要依靠参数方法来评估儿童群体之间的差异。然而,这种方法未充分利用大量的分布信息。本研究的目的是使用非参数相对分布框架,评估童年时期患有慢性病的个体与未患慢性病的个体在成年早期的收入和心理健康方面的分布差异。利用收入动态面板研究的数据,我们发现童年时期患有慢性病的年轻人在成年后的收入和心理健康得分方面表现更差,尤其是对于报告有童年心理健康/发育障碍的个体。协变量分解表明,童年时期的慢性病可能通过教育程度间接影响后期结果:如果两组的教育程度相似,童年时期报告患有慢性病的个体在相对收入分布较低十分位数中的比例将减少约20个百分点。研究结果可为旨在减轻童年健康状况长期影响的政策提供参考,并可能产生有待在参数分析中探索的假设。