Adult height and childhood disease

Taller populations are typically richer populations, and taller individuals live longer and earn more. In consequence, adult height has recently become a focus in understanding the relationship between health and wealth. We investigate the childhood determinants of population adult height, focusing on the respective roles of income and of disease. Across a range of European countries and the United States, we find a strong inverse relationship between postneonatal (ages 1 month to 1 year) mortality, interpreted as a measure of the disease and nutritional burden in childhood, and the mean height of those children as adults. Consistent with these findings, we develop a model of selection and stunting in which the early-life burden of undernutrition and disease not only is responsible for mortality in childhood but also leaves a residue of long-term health risks for survivors, risks that express themselves in adult height and in late-life disease. The model predicts that at sufficiently high mortality levels, selection can dominate scarring, leaving a taller population of survivors. We find evidence of this effect in the poorest and highest-mortality countries of the world, supplementing recent findings on the effects of the Great Chinese Famine.     

Divorced Fathers’ Proximity and Children’s Long-Run Outcomes: Evidence From Norwegian Registry Data

This study examines the link between divorced nonresident fathers’ proximity and children’s long-run outcomes, using high-quality data from Norwegian population registers. We follow (from birth to young adulthood) each of 15,992 children born into married households in Norway in the years 1975–1979 whose parents divorced during his or her childhood. We observe the proximity of the child to his or her father in each year following the divorce and link proximity to educational and economic outcomes for the child in young adulthood, controlling for a wide range of observable characteristics of the parents and the child. Our results show that closer proximity to the father following a divorce has, on average, a modest negative association with offspring’s outcomes in young adulthood. The negative associations are stronger among children of highly educated fathers. Complementary Norwegian survey data show that highly educated fathers report more post-divorce conflict with their ex-wives as well as more contact with their children (measured in terms of the number of nights that the child spends at the father’s house). Consequently, the father’s relocation to a more distant location following the divorce may shelter the child from disruptions in the structure of the child’s life as they split time between households and/or from post-divorce interparental conflict.     

Parental underinvestment: A link in the fertility-mortality continuum

Selective parental investment in siblings has been used to describe differential mortality rates. Using data from 986 Filipino women who had an average of 4.8 live births, a LISREL and six sets of regression models support the hypothesis that fertility is linked to underinvestment and that mortality, as a consequence, is linked to high birth order. The analysis also identifies intervening factors associated with this relationship. Age of mother at childbirth showed a strong influence on the relationship of birth order and infant and child mortality; correlations are stronger among older than youger mothers. However, even after the effect of age of mother at childbirth was partialled out, the effect of birth order on infant and child mortality remained significant and substantial. The conclusion is that parental underinvestment represents a link between fertility and mortality during infancy and early childhood that has not been described previously. Policy makers appear to have overlooked parental underinvestment in favor of more obvious economic and health mediators.     

Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.     

Comparing Observed and Unobserved Components of Childhood: Evidence From Finnish Register Data on Midlife Mortality From Siblings and Their Parents

In this study, we argue that the long arm of childhood that determines adult mortality should be thought of as comprising an observed part and its unobserved counterpart, reflecting the observed socioeconomic position of individuals and their parents and unobserved factors shared within a family. Our estimates of the observed and unobserved parts of the long arm of childhood are based on family-level variance in a survival analytic regression model, using siblings nested within families as the units of analysis. The study uses a sample of Finnish siblings born between 1936 and 1950 obtained from Finnish census data. Individuals are followed from ages 35 to 72. To explain familial influence on mortality, we use demographic background factors, the socioeconomic position of the parents, and the individuals’ own socioeconomic position at age 35 as predictors of all-cause and cause-specific mortality. The observed part—demographic and socioeconomic factors, including region; number of siblings; native language; parents’ education and occupation; and individuals’ income, occupation, tenancy status, and education—accounts for between 10 % and 25 % of the total familial influence on mortality. The larger part of the influence of the family on mortality is not explained by observed individual and parental socioeconomic position or demographic background and thus remains an unobserved component of the arm of childhood. This component highlights the need to investigate the influence of childhood circumstances on adult mortality in a comprehensive framework, including demographic, social, behavioral, and genetic information from the family of origin.     

Birth Intervals and Health in Adulthood: A Comparison of Siblings Using Swedish Register Data

A growing body of research has examined whether birth intervals influence perinatal outcomes and child health as well as long-term educational and socioeconomic outcomes. To date, however, very little research has examined whether birth spacing influences long-term health. We use contemporary Swedish population register data to examine the relationship between birth-to-birth intervals and a variety of health outcomes in adulthood: for men, height, physical fitness, and the probability of falling into different body mass index categories; and for men and women, mortality. In models that do not adjust carefully for family background, we find that short and long birth intervals are clearly associated with height, physical fitness, being overweight or obese, and mortality. However, after carefully adjusting for family background using a within-family sibling comparison design, we find that birth spacing is generally not associated with long-term health, although we find that men born after very long birth intervals have a higher probability of being overweight or obese in early adulthood. Overall, we conclude that birth intervals have little independent effect on long-term health outcomes.     

Rural–Urban Child Height for Age Trajectories and Their Heterogeneous Determinants in Four Developing Countries

The large literature on health differentials between rural and urban areas relies almost exclusively on cross-sectional data. Bringing together the demographic literature on area-level health inequalities with the bio-physiological literature on children’s catch-up growth over time, this paper uses panel data to investigate the stability and origins of rural–urban health differentials. Using data from the Young Lives longitudinal study of child poverty, I present evidence of large level differences but similar trends in rural versus urban children’s height for age in four developing countries. Further, observable characteristics of children’s environment such as their household wealth, mother’s education, and epidemiological environment explain these differentials in most contexts. In Peru, where they do not, children’s birthweight and mothers’ health and other characteristics suggest that initial endowments—even before birth—may play an important role in explaining "residual" rural–urban child height inequalities. These latter results imply that prioritizing maternal nutrition and health is essential—particularly where rural–urban height inequalities are large. Interventions to reduce area-level health inequalities should begin even before birth.     

The effect of pregnancy intention on child development

In this paper, we use data from the National Longitudinal Survey of Youth to investigate the empirical link between unintended pregnancy and child health and development. An important contribution of our study is the use of information on siblings to control for unmeasured factors that may confound estimates of the effect of pregnancy intentions on infant and child outcomes. Results from our study indicate that unwanted pregnancy is associated with prenatal and postpartum maternal behaviors that adversely affect infant and child health, but that unwanted pregnancy has little association with birth weight and child cognitive outcomes. Estimates of the association between unwanted pregnancy and maternal behaviors were greatly reduced after controls for unmeasured family background were included in the model. Our results also indicate that there are no significant differences in maternal behaviors or child outcomes between mistimed and wanted pregnancies.     

Neighbourhood Ethnic Density Effects on Behavioural and Cognitive Problems Among Young Racial/Ethnic Minority Children in the US and England: A Cross-National Comparison

Studies on adult racial/ethnic minority populations show that the increased concentration of racial/ethnic minorities in a neighbourhood—a so-called ethnic density effect—is associated with improved health of racial/ethnic minority residents when adjusting for area deprivation. However, this literature has focused mainly on adult populations, individual racial/ethnic groups, and single countries, with no studies focusing on children of different racial/ethnic groups or comparing across nations. This study aims to compare neighbourhood ethnic density effects on young children’s cognitive and behavioural outcomes in the US and in England. We used data from two nationally representative birth cohort studies, the US Early Childhood Longitudinal Study-Birth Cohort and the UK Millennium Cohort Study, to estimate the association between own ethnic density and behavioural and cognitive development at 5 years of age. Findings show substantial heterogeneity in ethnic density effects on child outcomes within and between the two countries, suggesting that ethnic density effects may reflect the wider social and economic context. We argue that researchers should take area deprivation into account when estimating ethnic density effects and when developing policy initiatives targeted at strengthening and improving the health and development of racial and ethnic minority children.     

Gender, resources across the life course, and cognitive functioning in Egypt

In this article, I evaluate the life-course determinants of cognitive functioning among 1,003 women and men aged 50 and older in Ismailia, Egypt. Three questions motivate this analysis: (1) Do older women have poorer cognitive functioning than do older men?; (2) Do cognitive resources accrued in childhood and adulthood have net positive associations with later-life cognitive functioning for women and men?; and (3) To what extent do differences in the amounts and effects of women’s and men’s cognitive resources account for gaps in their cognitive functioning? Compared with men, women have lower Modified-Mini Mental Status Exam (M-MMSE) scores for overall cognitive functioning. Cognitive resources in childhood and adulthood are jointly associated with the M-MMSE score. About 83% of the gender gap in mean M-MMSE scores is attributable to gaps in men’s and women’s attributes across the life course. Gender gaps in childhood cognitive resources—and especially schooling attainment—account for the largest share (18%) of the residual gender gap in cognitive functioning.Preferential investments in the human resources of boys have been common to many resource-poor settings (King and Mason 2001; Lloyd 2005), and the effects of such investments on gender gaps in child health are known (e.g., Hill and Upchurch 1995). Less well known is the extent to which gender gaps in resources that are accrued across the life course account for gender gaps in later-life health, despite known gender differences in the risks of illness, disability, and death. Demographic research on later-life health also has focused on physical conditions, even though dementia and neuropsychiatric disorders account for a large (~3%) and growing share of the disease burden worldwide (World Health Organization [WHO] 2007).This article assesses the determinants of cognitive functioning among older women and men (e.g., those aged 50 and older) in Ismailia, Egypt. It explores whether and to what extent (1) women have poorer cognitive functioning than men, (2) cognitive resources in childhood and adulthood have net positive associations with cognitive functioning for women and men, and (3) differences in the amounts and effects of women’s and men’s cognitive resources account for differences in their cognitive functioning. Egypt is a superb setting in which to conduct this work because of long-standing gender gaps in opportunities across the life course (e.g., Yount 2001; Yount and Sibai forthcoming) and poor knowledge about their potential effects on later-life cognitive functioning.     

Health Endowment at Birth and Variation in Intergenerational Economic Mobility: Evidence From U.S. County Birth Cohorts

New estimates of intergenerational economic mobility reveal substantial variation in the spatial distribution of opportunity in the United States. Efforts to explain this variation in economic mobility have conspicuously omitted health despite it being a key pathway for the transmission of economic position across generations. We begin to fill this gap in the literature by examining the relationship between health endowment at birth and intergenerational economic mobility across county birth cohorts in the United States, drawing on estimates from two population-level data sets. Exploiting variation across counties and over time, we find a negative relationship between the incidence of low-weight births and the level of economic mobility as measured in adulthood for the county birth cohorts in our sample. Our results build on a large and growing literature detailing the role of early childhood health in the transmission of economic status across generations and suggest that the incidence of low-weight births is negatively associated with intergenerational economic mobility.     

Age at Arrival and Life Chances Among Childhood Immigrants

This study examines the causal relationship between childhood immigrants’ age at arrival and their life chances as adults. I analyze panel data on siblings from Norwegian administrative registries, which enables me to disentangle the effect of age at arrival on adult socioeconomic outcomes from all fixed family-level conditions and endowments shared by siblings. Results from sibling fixed-effects models reveal a progressively stronger adverse influence of immigration at later stages of childhood on completed education, employment, adult earnings, occupational attainment, and social welfare assistance. The persistence of these relationships within families indicates that experiences related to the timing of childhood immigration have causal effects on later-life outcomes. These age-at-arrival effects are considerably stronger among children who arrive from geographically distant and economically less-developed origin regions than among children originating from developed countries. The age-at-arrival effects vary less by parental education and child gender. On the whole, the findings indicate that childhood immigration after an early-life formative period tends to constrain later human capital formation and economic opportunities over the life course.     

The education effect on population health: a reassessment

Demographic research frequently reports consistent and significant associations between formal educational attainment and a range of health risks such as smoking, drug abuse, and accidents, as well as the contraction of many diseases, and health outcomes such as mortality—almost all indicating the same conclusion: better-educated individuals are healthier and live longer. Despite the substantial reporting of a robust education effect, there is inadequate appreciation of its independent influence and role as a causal agent. To address the effect of education on health in general, three contributions are provided: 1) a macro-level summary of the dimensions of the worldwide educational revolution and a reassessment of its causal role in the health of individuals and in the demographic health transition are carried out; 2) a meta-analysis of methodologically sophisticated studies of the effect of educational attainment on all-cause mortality is conducted to establish the independence and robustness of the education effect on health; and 3) a schooling-cognition hypothesis about the influence of education as a powerful determinant of health is developed in light of new multidisciplinary cognitive research.     

Maternal Age and Offspring Adult Health: Evidence From the Health and Retirement Study

Advanced maternal age is associated with negative offspring health outcomes. This interpretation often relies on physiological processes related to aging, such as decreasing oocyte quality. We use a large, population-based sample of American adults to analyze how selection and lifespan overlap between generations influence the maternal age?Coffspring adult health association. We find that offspring born to mothers younger than age 25 or older than 35 have worse outcomes with respect to mortality, self-rated health, height, obesity, and the number of diagnosed conditions than those born to mothers aged 25?C34. Controls for maternal education and age at which the child lost the mother eliminate the effect for advanced maternal age up to age 45. The association between young maternal age and negative offspring outcomes is robust to these controls. Our findings suggest that the advanced maternal age?Coffspring adult health association reflects selection and factors related to lifespan overlap. These may include shared frailty or parental investment but are not directly related to the physiological health of the mother during conception, fetal development, or birth. The results for young maternal age add to the evidence suggesting that children born to young mothers might be better off if the parents waited a few years.     

Decent Living Standards: Material Prerequisites for Human Wellbeing

Children whose parents experience adverse social, economic, or health-related living conditions are more likely to face similar types of disadvantage in their adult life. However, a limitation of many earlier studies is that they do not account for the multidimensionality of the concept of living conditions, and that the child generation’s life courses are targeted as static and independent from the societal context in which they are imbedded. The current investigation addressed these aspects by focusing on the complexity, duration, and timing of disadvantage with regard to how adverse circumstances in the family of origin are associated with trajectories of social, economic, and health-related living conditions across adulthood. We also examined the role of educational attainment for these associations. Analyses were based a Swedish cohort born in 1953 (n = 14,294). We first conducted sequence analysis, followed by hierarchical cluster analysis, to generate ‘outcome profiles’, i.e. trajectories of adult disadvantage. Second, several indicators of adverse circumstances in childhood were analysed by means of multinominal regression analysis, showing the odds of ending up in the different trajectories. The results indicated that individuals who grew up under adverse conditions were more likely to experience disadvantaged social, economic, and health-related trajectories. This was particularly the case for trajectories characterised by a high degree of complexity, i.e. coexisting disadvantages, and—among men only—by a longer duration of disadvantage. Educational attainment was identified as a powerful mediator, suggesting that efforts to increase equal educational opportunity may be a way of reducing the intergenerational transmission of disadvantage.     

Determinants of Educational Attainment in Rural Thailand: A Life Course Approach

Using data from rural Thailand, we examine the determinants of educational attainment of school-age children. We organize our analysis around three central principles of the life course perspective: the embeddedness of lives in historical time and place, linked or interconnected lives, and the timing of lives. We examine these principles using comparisons within cohorts and between cohorts. We find that educational attainment is related to a combination of factors related to each of these principles. Specifically, despite a serious economic downturn occurring midway through our study, we nonetheless found that educational levels were higher following the downturn than preceding it. Interconnections to parents and siblings also affected educational outcomes, as did the timing of life events such as migration, marriage, and childbearing. For the latter, mother??s education and migration both positively affected educational attainment. For the former, having more siblings, both those in the household and those migrating, reduced education.     

A Four-Country Study on the Relationship Between Parental Educational Homogamy and Children’s Health from Infancy to Adolescence

This study explores the relationship between parental educational similarity—educational concordance (homogamy) or discordance (heterogamy)—and children’s health outcomes. Its contribution is threefold. First and foremost, I use longitudinal data on children’s health outcomes tracking children from age 1 to 15, thus being able to assess whether the relationship changes at key life-course and developmental stages of children. This is an important addition to the relevant literature, where the focus is solely on outcomes at birth. Second, I look at different health outcomes, namely height-for-age (HFA) and BMI-for-age (BFA) z-scores, alongside their dichotomized counterparts, stunting and thinness. Third, I conduct the same set of analyses in Ethiopia, India, Peru, and Vietnam, thus providing multi-context evidence from countries at different levels of development and with different socio-economic characteristics and gender dynamics. Results reveal important heterogeneity across contexts. In Ethiopia and India, parental educational homogamy is associated with worse health outcomes in infancy and childhood, while associations are positive in Peru and, foremost, Vietnam. Complementary estimates from matching techniques show that these associations tend to fade after age 1, except in Vietnam, where the positive relationship persists through adolescence, thus supporting the homogamy-benefit hypothesis not only at birth, but also across the early life course. Insights from this study contribute to the inequality debate on the intergenerational transmission of advantage and disadvantage and shed additional light on the relationship between early-life conditions and later-life outcomes in critical periods of children’s lives.

     

Education Gains Attributable to Fertility Decline: Patterns by Gender,Period, and Country in Latin America and Asia

We investigate the heterogeneity across countries and time in the relationship between mother’s fertility and children’s educational attainment—the quantity-quality (Q-Q) trade-off—by using census data from 17 countries in Asia and Latin America, with data from each country spanning multiple census years. For each country-year, we estimate micro-level instrumental variables models predicting secondary school attainment using number of siblings of the child, instrumented by the sex composition of the first two births in the family. We then analyze correlates of Q-Q trade-off patterns across countries. On average, one additional sibling in the family reduces the probability of secondary education by 6 percentage points for girls and 4 percentage points for boys. This Q-Q trade-off is significantly associated with the level of son preference, slightly decreasing over time and with fertility, but it does not significantly differ by educational level of the country.     

Number of children and later-life mortality among Finns born 1938–50

We investigated the association between number of offspring and later-life mortality of Finnish men and women born 1938–50, and whether the association was explained by living conditions in own childhood and adulthood, chronic conditions, fertility timing, and unobserved characteristics common to siblings. We used a longitudinal 1950 census sample to estimate mortality at ages 50–72. Relative to parents of two children, all-cause mortality is highest among childless men and women, and elevated among those with one child, independently of observed confounders. Fixed-effect models, which control for unobserved characteristics shared by siblings, clearly support these findings among men. Cardiovascular mortality is higher among men with no, one, or at least four children than among those with two. Living conditions in adulthood contribute to the association between the number of children and mortality to a greater extent than childhood background, and chronic conditions contribute to the excess mortality of the childless.