Reproducing inequalities: luck, wallets, and the enduring effects of childhood health

Fundamental resource dis/advantages, youth health and adult educational outcomes

Recent studies find lasting effects of poor youth health on educational attainment but use young samples and narrow life course windows of observation to explore outcomes. We apply a life course framework to three sets of Health and Retirement Study birth cohorts to examine early health status effects on education and skills attainment measured late in life. The older cohorts that we study were the earliest recipients of U.S. policies promoting continuing education through the GI Bill, community college expansions and new credentials such as the GED. We examine a wide range of outcomes but focus on GEDs, postsecondary school entry and adult human capital as job-related training. We find that older U.S. cohorts had considerable exposure to these forms of attainment and that the effects of youth health on them vary by outcome: health selection and ascription group effects are weak or fade, respectively, in outcomes associated with delayed or adult attainment. However, poorer health and social disadvantage in youth and barriers associated with ascription carry forward to limit attainment of key credentials such as diplomas and college degrees. We find that the human capital - health gradient is dynamic and that narrow windows of observation in existing studies miss much of it. National context also matters for studying health-education linkages over the life course.

Exploring the intergenerational persistence of mental health: evidence from three generations

This paper uses data from the 1970 British Cohort Study to quantify the intergenerational persistence of mental health, and the long-run economic costs associated with poor parental mental health. We find a strong and significant intergenerational correlation that is robust to different covariate sets, sample restrictions, model specifications and potential endogeneity. Importantly, the intergenerational persistence is economically relevant, with maternal mental health associated with lasting effects on the child's educational attainment, future household income and the probability of having criminal convictions. These results do not disappear after controlling for children's own childhood and adulthood mental health.

Social status attainment during the transition to adulthood

The transition from adolescence to adulthood is a critical time for status attainment, with income, education, work experience, and independence from parents accruing at varying speeds and intensities. This study takes an intergenerational life-course perspective that incorporates parents' and one's own social status to examine the status attainment process from adolescence into adulthood in the domains of economic capital (e.g., income) and human capital (e.g., education, occupation). Survey data from three waves of the National Longitudinal Study of Adolescent Health (analytic n = 8,977) are analyzed using latent class analysis to capture the ebb and flow of social status advantages and disadvantages from adolescence (Wave 1) through young adulthood (Wave 3) into adulthood (Wave 4). The analytic sample is composed of 50.3 % females and 70.2 % Whites, 15.3 % Blacks, 11.0 % Hispanics, and 3.5 % Asians ages 12-18 at Wave 1 and 25-31 at Wave 4. Four latent classes are found for economic capital and five for human capital. The importance of parents' social status is demonstrated by the presence of large groups with persistently low and persistently high social status over time in both domains. The capacity of individuals to determine their own status, however, is shown by equally large groups with upward and downward mobility in both domains. These findings demonstrate the dynamic nature of social status during this critical developmental period.

The importance of illness duration, age at diagnosis and the year of diagnosis for labour participation chances of people with chronic illness: results of a nationwide panel-study in The Netherlands

BACKGROUND

Compared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals' well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain insight into the role of three age related characteristics that may relate to labour participation chances of people with chronic illness: the duration of their illness, how old they were when the chronic disease was diagnosed and the historical year in which the diagnosis was established.

METHODS

We analyzed data of one (first) measurement of several cohorts of people diagnosed with a somatic chronic disease, who (had) participated in the Dutch 'National Panel of people with Chronic illness or Disability' since 1998 (N = 4634 in total). Multi-level logistic regression analyses were conducted to estimate random effects of the age at diagnosis and the year of diagnosis and fixed effects of illness duration on labour participation, while correcting for the effects of socio-demographic and disease characteristics and socio-economic indicators.

RESULTS

A significant part of the variation in labour participation among people with chronic illness relates to the age they had when they were diagnosed. Furthermore, a longer illness duration is significantly associated with a lower chance of being economically active. This is more the case for men than for women. Labour participation of cancer survivors depends on the phase of the illness they find themselves in. No evidence was found that the year in which the diagnosis was established matters for employment chances later in life.

CONCLUSION

Age at diagnosis and illness duration relate to chronically ill people's chances to participate in the labour market, but how and how strong they relate to labour participation depend on gender and the type of chronic disease at stake. Prospective studies are needed to assess illness trajectories of specific diagnostic groups along with the development of their school and work careers.

Early Adult Obesity and U.S. Women's Lifetime Childbearing Experiences

Literature from multiple disciplines suggests that women who are obese during early adulthood may accumulate social and physiological impediments to childbearing across their reproductive lives. This led the authors to investigate whether obese young women have different lifetime childbearing experiences than leaner peers by analyzing data from 1,658 female participants in the 1979 National Longitudinal Survey of Youth. Study sample members were nulliparous women ages 20 - 25 in 1982. The authors examined their childbearing experiences between 1982 and 2006 and found that young women who were obese at baseline had higher odds of remaining childless and increased odds of underachieving fertility intentions than young women who were normal weight at baseline. These results suggest that obesity has long-term ramifications for women's childbearing experiences, with respect to whether and how many children women have in general and relative to the number of children they want.

Childhood (Mis)fortune, Educational Attainment, and Adult Health: Contingent Benefits of a College Degree?

College-educated adults are healthier than other people in the United States, but selection bias complicates our understanding of how education influences health. This article focuses on the possibility that the health benefits of college may vary according to childhood (mis)fortune and people's propensity to attain a college degree in the first place. Several perspectives from life course sociology offer competing hypotheses as to whether the most or the least advantaged see the greatest return of a college education. The authors use a national survey of middle-age American adults to assess risk of two cardiovascular health problems and mortality. Results from propensity score and hierarchical regression analysis indicate that the protective effect of college attainment is indeed heterogeneous. Further, the greatest returns are among those least likely to experience this life course transition (i.e., compensatory leveling). Explanations for this selection effect are offered, along with several directions for future research on the health benefits of completing college.

Future directions in research on institutional and interpersonal discrimination and children's health

Research evidence indicates that 2 forms of racial discrimination-perceived interpersonal discrimination and racial/ethnic residential segregation (a form of institutional discrimination)-may influence children's health and disparities. Although research on these 2 forms of discrimination and health has primarily focused on adults, smaller bodies of work have documented that perceived interpersonal discrimination and segregation have a negative effect on infants' health, and that perceived interpersonal discrimination may negatively affect children's mental health. Three directions for research are (1) incorporating a life-course perspective into studies of discrimination and children's health, (2) linking residential segregation with geography-of-opportunity conceptual frameworks and measures, and (3) considering residential segregation along with segregation in other contexts that influence children's health (e.g., schools).

Developmental Origins of Disease and Health Disparities: Limitations and Future Directions

The developmental origins of disease (DOD) model seeks to replace the traditional epidemiologic risk factor model with a perspective focused on the long-term consequences of nutritional resource scarcity during early life and the developmental trade-offs it creates. Research into the developmental origins of adult chronic disease has progressed substantially in recent years. However, a number of critical issues remain unexplored and under-developed. This chapter discusses some of those issues while providing an interdisciplinary population health perspective on the future of DOD research, with particular attention paid to health disparities and changes that are needed in health policy and intervention. I argue for research to provide greater specificity of the exposures of interest, a more comprehensive understanding of critical periods, and better theoretical and empirical integration of the developmental origins perspective within the life course and across multiple intergenerational processes.

Health and development among Mexican, black and white preschool children: An integrative approach using latent class analysis

BACKGROUND

Building on an emerging scientific consensus that the concept of child health should encompass chronic conditions, functional abilities, and developmental domains, we delineate the multidimensional health statuses of Mexican, non-Hispanic black, and non-Hispanic white preschool children in the United States. This integrative approach provides the foundation for an in-depth analysis of health disparities.

OBJECTIVE

The research objectives are: (1) to demonstrate a new methodological approach to identifying the major child health statuses; (2) to document differences in the prevalence of those health statuses among children in the largest ethnoracial groups in the U.S.; and (3) to assess whether key sources of disadvantage account for ethnoracial disparities in children's health.

METHODS

With data from a nationally representative sample, we use latent class analysis to estimate a set of latent health statuses that capture the nature of health at age four. The latent class membership of children is predicted using multinomial logistic regression.

RESULTS

Mexican and non-Hispanic black children are more likely than non-Hispanic white children to fall into health statuses distinguished by low cognitive achievement and multiple developmental problems. Mexican children are the most likely to be classified into these problematic health statuses. This pattern persists in multivariate models that incorporate potential explanatory factors, including health at birth, socio-demographic characteristics, home environment, well-child care and center-based child care.

CONCLUSIONS

Latent class analysis is a useful method for incorporating measures of physical conditions, functional problems, and development into a single analysis in order to identify key dimensions of childhood health and locate ethnoracial health disparities.

Going Nuclear? Family Structure and Young Women’s Health in India, 1992–2006

Scholars traditionally argued that industrialization, urbanization, and educational expansion lead to a decline in extended families and complementary rise in nuclear families. Some have suggested that such transitions are good for young married women because living in nuclear families benefits their health. However, extended families may also present advantages for young women’s health that outweigh any disadvantages. Using the Indian National Family Health Survey, this article examines whether young married women living in nuclear families have better health than those in patrilocal extended families. It also examines whether young married women’s living arrangements are changing over time and, if so, how such changes will affect their health. Results show that young married women living in nuclear families do not have better health than those in patrilocal extended families. Of eight health outcomes examined, only five differ significantly by family structure. Further, of the five outcomes that differ, four are patrilocal extended-family advantages and only one is a nuclear-family advantage. From 1992 to 2006, the percentage of young married women residing in nuclear families increased, although the majority remained in patrilocal extended families. This trend toward nuclear families will not benefit young women’s health.

A life course model of self-rated health through adolescence and young adulthood

This paper proposes and tests a life course model of self-rated health (SRH) extending from late childhood to young adulthood, drawing on three waves of panel data from the National Longitudinal Study of Adolescent Health (Add Health). Very little research has examined SRH during the early decades, or whether and how these self-assessments reflect experiences in the family of origin. Background characteristics (parental education, income, and family structure), parental health conditions (asthma, diabetes, obesity, migraines), and early health challenges (physical abuse, presence of a disability, and parental alcoholism and smoking) predict SRH from adolescence to young adulthood. These experiences in the family-of-origin are substantially mediated by the young person's health and health behaviors (as indicated by obesity, depression, smoking, drinking, and inactivity), although direct effects remain (especially for early health challenges). Associations between SRH and these mediators (especially obesity) strengthen with age. In turn, efforts to promote healthy behaviors in young adulthood, after the completion of secondary school, may be especially strategic in the promotion of health in later adulthood.

Perceived instrumental support and children's health across the early life course

A large, venerable literature demonstrates the importance of social relationships and social support for health, though much less research examines whether the benefits of social support to mothers extend to children. This paper examines the relationship between mothers' perceptions of instrumental support and children's health using longitudinal data from the U.S. Fragile Families and Child Wellbeing Study (N = 4342), a cohort of American children born in urban areas to mostly unmarried parents. Results suggest mothers' perceptions of instrumental support is positively associated with children's overall health, and this finding persists despite controlling for a host of individual-level characteristics of mothers and children (including a lagged indicator of children's health) and in fixed-effect models. Mothers' economic security and mothers' wellbeing attenuate some, but not all, of the association between perceived instrumental support and children's overall health. In addition, the link between perceived instrumental support and three specific indicators of health - asthma, overweight/obese, and number of emergency room visits - falls to statistical insignificance after accounting for individual-level characteristics, suggesting these associations result from social selection processes. Taken together, these findings suggest the beneficial health consequences of social support may extend to children across the early life course and demonstrate the need to better understand mothers' reports of children's overall health.

Educational Differences in U.S. Adult Mortality: A Cohort Perspective

We use hierarchical cross-classified random-effects models to simultaneously measure age, period, and cohort patterns of mortality risk between 1986 and 2006 for non-Hispanic white and non-Hispanic black men and women with less than a high school education, a high school education, and more than a high school education. We examine all-cause mortality risk and mortality risk from heart disease, lung cancer, and unpreventable cancers. Findings reveal that temporal reductions in black and white men's and women's mortality rates were driven entirely by cohort changes in mortality. Findings also demonstrate that disparate cohort effects between education groups widened the education gap in all-cause mortality risk and mortality risk from heart disease and lung cancer across this time period. Educational disparities in mortality risk from unpreventable cancers, however, did not change. This research uncovers widening educational differences in adult mortality and demonstrates that a cohort perspective provides valuable insights for understanding recent temporal changes in U.S. mortality risk.

Intergenerational predictors of birth weight in the Philippines: correlations with mother's and father's birth weight and test of maternal constraint

BACKGROUND

Birth weight (BW) predicts many health outcomes, but the relative contributions of genes and environmental factors to BW remain uncertain. Some studies report stronger mother-offspring than father-offspring BW correlations, with attenuated father-offspring BW correlations when the mother is stunted. These findings have been interpreted as evidence that maternal genetic or environmental factors play an important role in determining birth size, with small maternal size constraining paternal genetic contributions to offspring BW. Here we evaluate mother-offspring and father-offspring birth weight (BW) associations and evaluate whether maternal stunting constrains genetic contributions to offspring birth size.

METHODS/PRINCIPAL FINDINGS

Data include BW of offspring (n = 1,101) born to female members (n = 382) and spouses of male members (n = 275) of a birth cohort (born 1983-84) in Metropolitan Cebu, Philippines. Regression was used to relate parental and offspring BW adjusting for confounders. Resampling testing was used to evaluate whether false paternity could explain any evidence for excess matrilineal inheritance. In a pooled model adjusting for maternal height and confounders, parental BW was a borderline-significantly stronger predictor of offspring BW in mothers compared to fathers (sex of parent interaction p = 0.068). In separate multivariate models, each kg in mother's and father's BW predicted a 271±53 g (p<0.00001) and 132±55 g (p = 0.017) increase in offspring BW, respectively. Resampling statistics suggested that false paternity rates of >25% and likely 50% would be needed to explain these differences. There was no interaction between maternal stature and maternal BW (interaction p = 0.520) or paternal BW (p = 0.545).

CONCLUSIONS/SIGNIFICANCE

Each kg change in mother's BW predicted twice the change in offspring BW as predicted by a change in father's BW, consistent with an intergenerational maternal effect on offspring BW. Evidence for excess matrilineal BW heritability at all levels of maternal stature points to indirect genetic, mitochondrial, or epigenetic maternal contributions to offspring fetal growth.

The impact of childhood sickness on adult socioeconomic outcomes: evidence from late 19th century America

We use family fixed-effects models to estimate the impact of childhood health on adult literacy, labor force outcomes, and marital status among pairs of white brothers observed as children in the 1880 U.S. Census and then as adults in the 1900-1930 Censuses. Given our focus on the 19th century, we observed a wider array of infectious, chronic, and traumatic health problems than is observed using data that are more recent; our results thus provide some insights into circumstances in modern developing countries where similar health problems are more frequently observed. Compared to their healthy siblings, sick brothers were less likely to be located (and thus more likely to be dead) 20-50 years after their 1880 enumeration. Sick brothers were also less likely to be literate, to have ever been married, and to have reported an occupation. However, among those with occupations, sick and healthy brothers tended to do similar kinds of work. We discuss the implications of our results for research on the impact of childhood health on socioeconomic outcomes in developed and developing countries.

Early childhood economic disadvantage and the health of Hispanic children

This research provides a longitudinal view of early childhood economic deprivation and its associations with health among young Hispanic children born in the United States. Of additional interest is whether economic deprivation is associated with child health similarly across all Hispanic children or whether associations differ by maternal nativity or country of origin. Fragile Families and Child Wellbeing data and multinomial logistic regression are used to estimate the effects of total years in poverty, material hardship, and lack of health insurance on Hispanic children's health status at age 5 and change in health status between ages 1 and 5. Results show that multiple measures of early childhood economic deprivation have additive negative associations with Hispanic child health, and that living more years in poverty is associated with declining health status among young Hispanic children. Interaction effects indicate that early childhood poverty has stronger associations with lower age 5 health status and declining health between ages 1 and 5 for children with foreign-born Hispanic mothers than for those with native-born Hispanic mothers. No differences were found in the associations between economic deprivation and child health by maternal country of origin. These results suggest an important role of economic resources for protecting Hispanic child health, and that poor Hispanic children with immigrant mothers may be at particularly high risk of developing health problems as they move out of infancy and into early childhood.

Ready or Not: Predicting High and Low School Readiness Among Teen Parents' Children

Past research has documented compromised development for teenage mothers' children compared to others, but less is known about predictors of school readiness among these children or among teenage fathers' children. Our multidimensional measures of high and low school readiness incorporated math, reading, and behavior scores and parent-reported health. Using parent interviews and direct assessments from the Early Childhood Longitudinal Study-Birth Cohort, we predicted high and low school readiness shortly before kindergarten among children born to a teenage mother and/or father (N≈800). Factors from five structural and interpersonal domains based on the School Transition Model were measured at two time points, including change between those time points, to capture the dynamic nature of early childhood. Four domains (socioeconomic resources, maternal characteristics, parenting, and exposure to adults) predicted high or low school readiness, but often not both. Promising factors associated with both high and low readiness among teen parents' children came from four domains: maternal education and gains in education (socioeconomic), maternal age of at least 18 and fewer depressive symptoms (maternal characteristics), socioemotional parenting quality and home environment improvements (parenting), and living with fewer children and receiving nonparental child care in infancy (exposure to adults). The findings preliminarily suggest policies that might improve school readiness: encouraging maternal education while supplying child care, focusing teen pregnancy prevention efforts on school-age girls, basic socioeconomic supports, and investments in mental health and high-quality home environments and parenting.

Child growth in urban deprived settings: does household poverty status matter? At which stage of child development?

This paper uses longitudinal data from two informal settlements of Nairobi, Kenya to examine patterns of child growth and how these are affected by four different dimensions of poverty at the household level namely, expenditures poverty, assets poverty, food poverty, and subjective poverty. The descriptive results show a grim picture, with the prevalence of overall stunting reaching nearly 60% in the age group 15-17 months and remaining almost constant thereafter. There is a strong association between food poverty and stunting among children aged 6-11 months (p<0.01), while assets poverty and subjective poverty have stronger relationships (p<0.01) with undernutrition at older age (24 months or older for assets poverty, and 12 months or older for subjective poverty). The effect of expenditures poverty does not reach statistical significant in any age group. These findings shed light on the degree of vulnerability of urban poor infants and children and on the influences of various aspects of poverty measures.

Prenatal Health, Educational Attainment, and Intergenerational Inequality: The Northern Finland Birth Cohort 1966 Study

In this article, we study the effects of prenatal health on educational attainment and on the reproduction of family background inequalities in education. Using Finnish birth cohort data, we analyze several maternal and fetal health variables, many of which have not been featured in the literature on long-term socioeconomic effects of health despite the effects of these variables on birth and short-term health outcomes. We find strong negative effects of mother’s prenatal smoking on educational attainment, which are stronger if the mother smoked heavily but are not significant if she quit during the first trimester. Anemia during pregnancy is also associated with lower levels of attained education. Other indicators of prenatal health (pre-pregnancy obesity, mother’s antenatal depressed mood, hypertension and preeclampsia, early prenatal care visits, premature birth, and small size for gestational age) do not predict educational attainment. Our measures explain little of the educational inequalities by parents’ class or education. However, smoking explains 12%—and all health variables together, 19%—of the lower educational attainment of children born to unmarried mothers. Our findings point to the usefulness of proximate health measures in addition to general ones. They also point to the potentially important role played by early health in intergenerational processes.

Social stratification and adolescent overweight in the United States: how income and educational resources matter across families and schools

The current study examines how poverty and education in both the family and school contexts influence adolescent weight. Prior research has produced an incomplete and often counterintuitive picture. We develop a framework to better understand how income and education operate alone and in conjunction with each other across families and schools. We test it by analyzing data from Wave 1 of the U.S.-based National Longitudinal Study of Adolescent Health (N = 16,133 in 132 schools) collected in 1994-1995. Using hierarchical logistic regression models and parallel indicators of family- and school-level poverty and educational resources, we find that at the family-level, parent's education, but not poverty status, is associated with adolescent overweight. At the school-level, the concentration of poverty within a school, but not the average level of parent's education, is associated with adolescent overweight. Further, increases in school poverty diminish the effectiveness of adolescents' own parents' education for protecting against the risks of overweight. The findings make a significant contribution by moving beyond the investigation of a single socioeconomic resource or social context. The findings push us to more fully consider when, where, and why money and education matter independently and jointly across health-related contexts.

Healthier students are better learners: a missing link in school reforms to close the achievement gap

OBJECTIVES

This article provides an introduction to the October 2011 special issue of the Journal of School Health on "Healthier Students Are Better Learners."

METHODS

Literature was reviewed and synthesized to identify health problems affecting school-aged youth that are highly prevalent, disproportionately affect urban minority youth, directly and indirectly causally affect academic achievement, and can be feasibly and effectively addressed through school health programs and services.

RESULTS

Based on these criteria, 7 educationally relevant health disparities were selected as strategic priorities to help close the achievement gap: (1) vision, (2) asthma, (3) teen pregnancy, (4) aggression and violence, (5) physical activity, (6) breakfast, and (7) inattention and hyperactivity. Research clearly shows that these health problems influence students' motivation and ability to learn. Disparities among urban minority youth are outlined, along with the causal pathways through which each adversely affects academic achievement, including sensory perceptions, cognition, school connectedness, absenteeism, and dropping out. Evidence-based approaches that schools can implement to address these problems are presented. These health problems and the causal pathways they influence have interactive and a synergistic effect, which is why they must be addressed collectively using a coordinated approach.

CONCLUSIONS

No matter how well teachers are prepared to teach, no matter what accountability measures are put in place, no matter what governing structures are established for schools, educational progress will be profoundly limited if students are not motivated and able to learn. Particular health problems play a major role in limiting the motivation and ability to learn of urban minority youth. This is why reducing these disparities through a coordinated approach warrants validation as a cohesive school improvement initiative to close the achievement gap. Local, state, and national policies for implementing this recommendation are suggested.

Adolescent IQ and survival in the Wisconsin longitudinal study

OBJECTIVE

This study attempts to explain the ubiquitous positive correlation between cognitive ability (IQ) and survival.

METHODS

A sample of 10,317 Wisconsin high school graduates of 1957 was followed until 2009, from ages 18 to 68 years. Mortality was analyzed using a Weibull survival model that includes gender, social background, Henmon-Nelson IQ, and rank in high school class.

RESULTS

Rank in high school class, a cumulative measure of responsible performance during high school, entirely mediates the relationship between adolescent IQ and survival. Its effect on survival is 3 times greater than that of IQ, and it accounts for about 10% of the female advantage in survival.

DISCUSSION

Cognitive functioning may improve survival by promoting responsible and timely patterns of behavior that are firmly in place by late adolescence. Prior research suggests that conscientiousness, one of the "Big Five" personality characteristics, plays a key role in this relationship.

Childhood health and labor market inequality over the life course

The authors use data from the Health and Retirement Study's Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.

Nonmarital Childbearing, Union History, and Women's Health at Midlife

Despite high rates of nonmarital childbearing in the U.S., little is known about the health of women who have nonmarital births. We use data from the NLSY79 to examine differences in age 40 self-assessed health between women who had a premarital birth and those whose first birth occurred within marriage. We then differentiate women with a premarital first birth according to their subsequent union histories and estimate the effect of marrying or cohabiting versus remaining never-married on midlife self-assessed health, paying particular attention to the paternity status of the mother's partner and the stability of marital unions. To partially address selection bias, we employ multivariate propensity score techniques. Results suggest that premarital childbearing is negatively associated with midlife health for white and black (but not Hispanic) women. We find no evidence that these negative health consequences of nonmarital childbearing are mitigated by either marriage or cohabitation for black women. For other women, only enduring marriage to the biological father is associated with better health than remaining unpartnered.

Do Nonresidential Fathers' Financial Support and Contact Improve Children's Health?

Nonresidential father investment of time and money has been shown to ameliorate the negative consequences of family dissolution on children's behavior and achievement; however, no research has shown whether this investment also has positive effects on child health. Using data from the Early Childhood Longitudinal Survey, Kindergarten cohort, this research uses a two-wave cross-lagged model to examine how child support and contact are associated with maternal reports of children's physical health over time following parental separation. Child support in kindergarten is not associated with child health in third grade. Instead, children who are healthier in kindergarten receive greater financial support from their father. Although contact and child support are positively related, greater contact is not associated with better child health.

Breastfeeding and later psychosocial development in the Philippines

OBJECTIVES

Evaluate whether breastfeeding (BF) duration predicts later psychosocial development (PD) in a large low socioeconomic status (SES) sample in the Philippines.

METHODS

The sample consists of 2,752 children aged 5-6 years who were measured in 2004 as part of the Philippine government's Early Childhood Development Project. Duration of any BF was the primary independent variable in regression models predicting a cumulative index of PD that has been shown previously to predict school readiness.

RESULTS

In this sample, mothers who breastfed their children for longer tended to have lower educational attainment and to come from lower income households. Despite this, BF duration was a positive predictor of future PD measured in late childhood, but only after adjustment for SES and related confounders.

CONCLUSIONS

These findings add to growing evidence that BF could provide lasting economic and social benefits and underscore the importance of continuing current public health efforts to promote BF in the Philippines and across the globe.

A multigenerational view of inequality

The study of intergenerational mobility and most population research are governed by a two-generation (parent-to-offspring) view of intergenerational influence, to the neglect of the effects of grandparents and other ancestors and nonresident contemporary kin. While appropriate for some populations in some periods, this perspective may omit important sources of intergenerational continuity of family-based social inequality. Social institutions, which transcend individual lives, help support multigenerational influence, particularly at the extreme top and bottom of the social hierarchy, but to some extent in the middle as well. Multigenerational influence also works through demographic processes because families influence subsequent generations through differential fertility and survival, migration, and marriage patterns, as well as through direct transmission of socioeconomic rewards, statuses, and positions. Future research should attend more closely to multigenerational effects; to the tandem nature of demographic and socioeconomic reproduction; and to data, measures, and models that transcend co-resident nuclear families.

Infant health, race/ethnicity, and early educational outcomes using the ECLS-B

Using data from the "Early Childhood Longitudinal Study—Birth Cohort," this article emphasizes the central role of poor infant health as a mechanism in the formation of early educational disparities. Results indicate that the varying prevalence of poor infant health across racial/ethnic groups explains a significant portion of the black disadvantage and a moderate portion of the Asian advantage relative to whites in math and reading skills at age four. Results also demonstrate that infant health is an equal opportunity offender across social groups as children with poor health are equally disadvantaged in terms of early cognitive development, regardless of racial/ethnic status. Overall, results indicate that health at birth has important consequences for individual educational achievement and racial/ethnic disparities in cognitive development and school readiness.

Family structure and child health outcomes in the United States

We use categorical and logistic regression models to investigate the extent that family structure affects children’s health outcomes at age five (i.e., child’s type of health insurance coverage, the use of a routine medical doctor, and report of being in excellent health) using a sample of 4,898 children from the "Fragile Families and Child Well-Being Study." We find that children with married biological parents are most likely to have private health insurance compared with each of three other relationship statuses. With each additional child in the home, a child is less likely to have private insurance compared with no insurance and Medicaid insurance. Children with cohabiting biological parents are less likely to have a routine doctor compared with children of married biological parents, yet having additional children in the household is not associated with having a routine doctor. Children with biological parents who are not romantically involved and those with additional children in the household are less likely to be in excellent health, all else being equal.

Social focus on health and children’s well-being

This special section on children’s health and well-being is an outgrowth of the 2010 International Sociological Association’s (ISA) World Congress in Gothenburg, Sweden. Within the Congress, the Research Committee 53, Sociology of Childhood, organized a panel focused on the health and well-being of children. Together, this collection makes two distinct contributions: first in terms of considering children’s health disparities as an area of concern within sociology, and second by considering children’s health as a factor that shapes other areas of children’s well-being. In addition, these papers offer novel empirical research on children’s health and varied methodological and theoretical orientations. Each paper also makes contributions to social policy, first in the area of infant health affecting later educational outcomes, second in the area of family structure and children’s health, and additionally in understanding type 2 diabetes for children at the individual and structural levels. Finally, these studies highlight the interplay—between the individuals’ health on the one hand and structure and culture on the other—as children’s life chances are shaped.

Children of misfortune: early adversity and cumulative inequality in perceived life trajectories

Adversity early in life may alter pathways of aging, but what interpretive processes can soften the blow of early insults? Drawing from cumulative inequality theory, the authors analyze trajectories of life evaluations and then consider whether early adversity offsets favorable expectations for the future. Results reveal that early adversity contributes to more negative views of the past but rising expectations for the future. Early adversity also has enduring effects on life evaluations, offsetting the influence of buoyant expectations. The findings draw attention to the limits of human agency under the constraints of early adversity-a process described as biographical structuration.

Childhood Morbidity and Health in Early Adulthood: Life course linkages in a high morbidity context

This paper examines whether morbidity in early and later childhood is associated with health later in life. I investigate the relationship between five types of childhood morbidity and risk factors for cardiovascular disease among Guatemalan adults who experienced high levels of morbidity in childhood. The analysis is based on the Human Capital Study (2002-2004), a recent follow-up of the INCAP Longitudinal Study conducted between 1969 and 1977. I find that most types of childhood morbidity are associated with poorer adult health, independent of family background, adult socioeconomic status, and health behaviors. Higher levels of infections in childhood were associated with a low level of high density lipoprotein (HDL), and higher level of triglycerides, plasma glucose, waist circumference, and obesity (but not hypertension). These results are consistent with the literature that finds that childhood morbidity is associated with increased morbidity and mortality at older ages. However, diarrheal disease in later childhood was associated with lower levels of some risk factors, as measured by triglycerides and plasma glucose, suggesting that exposure to bacteria after infancy may be beneficial for some measures of adult health.

Mothers' depression and educational attainment and their children's academic trajectories

In this study, we take a dynamic approach to studying the connections among mothers' education, their depression, and their children's academic trajectories during elementary school. Applying latent growth curve modeling to longitudinal data from the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development (N = 1,012), we find that maternal depression does not mediate the association between mothers' education and children's achievement. Instead, maternal education moderates the association between maternal depression and children's achievement. Specifically, maternal depression only predicted lower achievement for children of women who did not pursue higher education. These results highlight the role of mothers' mental health in the intergenerational linkage between mothers' and children's educational experiences.

Social Relationships and Health Behavior Across Life Course

Sociological theory and research point to the importance of social relationships in affecting health behavior. This work tends to focus on specific stages of the life course, with a division between research on childhood/adolescent and adult populations. Yet recent advances demonstrate that early life course experiences shape health outcomes well into adulthood. We synthesize disparate bodies of research on social ties and health behavior throughout the life course, with attention to explaining how various social ties influence health behaviors at different life stages and how these processes accumulate and reverberate throughout the life course.

Maternal employment and the health of low-income young children

This study examines whether maternal employment affects the health status of low-income, elementary-school-aged children using instrumental variables estimation and experimental data from a welfare-to-work program implemented in the early 1990s. Maternal report of child health status is predicted as a function of exogenous variation in maternal employment associated with random assignment to the experimental group. IV estimates show a modest adverse effect of maternal employment on children's health. Making use of data from another welfare-to-work program we propose that any adverse effect on child health may be tempered by increased family income and access to public health insurance coverage, findings with direct relevance to a number of current policy discussions. In a secondary analysis using fixed effects techniques on longitudinal survey data collected in 1998 and 2001, we find a comparable adverse effect of maternal employment on child health that supports the external validity of our primary result.

An integrative approach to health

In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental, and physical well-being; for studying health among the young as an important marker for future health and well-being across the life course; and for understanding health disparities among the young as both causes and consequences of social stratification. An integrative approach bridges biomedical sciences with social and behavioral sciences by understanding the linkages between social, behavioral, psychological, and biological factors in health. It is furthermore vital that integration occur in all steps of the research process: in theory, design, data collection, and analysis. I use the National Longitudinal Study of Adolescent Health, or Add Health, as an example of an integrative approach to health and of the importance of adolescence and the transition to adulthood years for setting health trajectories into adulthood. Evidence is also presented on the linkages between health trajectories during adolescence and the transition to adulthood and social stratification in adulthood.

Perceived social position and health: Is there a reciprocal relationship?

Recent work exploring the relationship between socioeconomic status and health has employed a psychosocial concept called perceived social position as a predictor of health. Perceived social position is likely the "cognitive averaging" (Singh-Manoux, Marmot, & Adler, 2005) of socioeconomic characteristics over time and, like other socioeconomic factors, is subject to interplay with health over the life course. Based on the hypothesis that health can also affect perceived social position, in this paper we used structural equation modeling to examine whether perceived social position and three different health outcomes were reciprocally related in the Wisconsin Longitudinal Study, a longitudinal cohort study of older adults in the United States. The relationship between perceived social position and health differed across health outcomes-self-reported health, the Health Utilities Index, and depressive symptoms-as well as across operationalization of perceived social position-compared to the population of the United States, compared to one's community, and a latent variable of which the two items are indicators. We found that perceived social position affected self-reported health when operationalized as latent and US perceived social position, yet there was a reciprocal relationship between self-reported health and community perceived social position. There was a reciprocal relationship between perceived social position and the Health Utilities Index, and depressive symptoms affected perceived social position for all operationalization of perceived social position. The findings suggest that the causal relationship hypothesized in prior studies--that perceived social position affects health--does not necessarily hold in empirical models of reciprocal relationships. Future research should interrogate the relationship between perceived social position and health rather than assume the direction of causality in their relationship.

Understanding links between adolescent health and educational attainment

The educational and economic consequences of poor health during childhood and adolescence have become increasingly clear, with a resurgence of evidence leading researchers to reconsider the potentially significant contribution of early-life health to population welfare both within and across generations. Meaningful relationships between early-life health and educational attainment raise important questions about how health may influence educational success in young adulthood and beyond, as well as for whom its influence is strongest. Using data from the National Longitudinal Survey of Youth 1997, I examine how adolescents'health and social status act together to create educational disparities in young adulthood, focusing on two questions in particular. First, does the link between adolescent health and educational attainment vary across socioeconomic and racial/ethnic groups? Second, what academic factors explain the connection between adolescent health and educational attainment? The findings suggest that poorer health in adolescence is strongly negatively related to educational attainment, net of both observed confounders and unobserved, time-invariant characteristics within households. The reduction in attainment is particularly large for non-Hispanic white adolescents, suggesting that the negative educational consequences of poor health are not limited to only the most socially disadvantaged adolescents. Finally, I find that the link between adolescent health and educational attainment is explained by academic factors related to educational participation and, most importantly, academic performance, rather than by reduced educational expectations. These findings add complexity to our understanding of how the educational consequences of poor health apply across the social hierarchy, as well as why poor health may lead adolescents to complete less schooling.

Recent developments in longitudinal studies of aging in the United States

We review recent developments in longitudinal studies of aging, focusing on the Wisconsin Longitudinal Study (WLS) and the Health and Retirement Study (HRS). Both studies are part of a trend toward biosocial surveys in which biological measurement is joined with traditional survey techniques, and a related trend toward greater harmonization across studies. Both studies have collected DNA samples and are working toward genotyping that would allow broadly based association studies. Increased attention to psychological measurement of personality and of cognitive ability using adaptive testing structures has also been shared across the studies. The HRS has expanded its economic measurement to longitudinal studies of consumption and to broader-based measurement of pension and Social Security wealth. It has added biomarkers of cardiovascular risk. The WLS has developed an integrated approach to the study of death and bereavement and an innovative use of high school yearbook photographs to capture information about health in early life of its participants.

Social relationships and health: a flashpoint for health policy

Social relationships--both quantity and quality--affect mental health, health behavior, physical health, and mortality risk. Sociologists have played a central role in establishing the link between social relationships and health outcomes, identifying explanations for this link, and discovering social variation (e.g., by gender and race) at the population level. Studies show that social relationships have short- and long-term effects on health, for better and for worse, and that these effects emerge in childhood and cascade throughout life to foster cumulative advantage or disadvantage in health. This article describes key research themes in the study of social relationships and health, and it highlights policy implications suggested by this research.

Early childhood health, reproduction of economic inequalities and the persistence of health and mortality differentials

The persistence of adult health and mortality socioeconomic inequalities and the equally stubborn reproduction of social class inequalities are salient features in modern societies that puzzle researchers in seemingly unconnected research fields. Neither can be satisfactorily explained with standard theoretical frameworks. In the domain of health and mortality, it is unclear if and to what an extent adult health and mortality disparities across socioeconomic status (SES) are the product of attributes of the positions themselves, the partial result of health conditions established earlier in life that influence both adult health and economic success, or the outcome of the reverse impact of health status on SES. In the domain of social stratification, the transmission of inequalities across generations has been remarkably resistant to satisfactory explanations. Although the literature on social stratification is by and large silent about the role played by early health status in shaping adult socioeconomic opportunities, new research on human capital formation suggests this is a serious error of omission. In this paper we propose to investigate the connections between these two domains. We use data from male respondents of the 1958 British Cohort to estimate (a) the influence of early health conditions on adult SES and (b) the contribution of early health status to observed adult health differentials. The model incorporates early conditions as determinants of traits that enhance (inhibit) social mobility and also conventional and unconventional factors that affect adult health and socioeconomic status. Our findings reveal that early childhood health plays a small, but non-trivial role as a determinant of adult SES and the adult socioeconomic gradient in health. These findings enrich current explanations of SES inequalities and of adult health and mortality disparities.

Long-term mortality consequences of childhood family context in Liaoning, China, 1749-1909

We examine the effects on adult and old age mortality of childhood living arrangements and other aspects of family context in early life. We focus on features of family context that have already been shown to be associated with infant or child mortality in historical and developing country populations. We apply discrete-time event-history analysis to longitudinal, individual-level household register data for a rural population in northeast China from the eighteenth and nineteenth centuries. Loss of a mother in childhood, a short preceding birth interval, and high maternal age were all associated with elevated mortality risks later in life. Such effects persist in a model with fixed effects that account for unobserved characteristics of the community and household. An important implication of these results is that in high-mortality populations, features of early-life family context that are associated with elevated infant and child mortality may also predict adverse mortality outcomes in adulthood.

Old-Age Wealth in Mexico: The Role of Reproductive, Human Capital, and Employment Decisions

The authors examined relationships between the wealth of older adults and their early-life decisions regarding investment in human capital, family formation, and work activities in Mexico, using the 2001 Mexican Health and Aging Study. The authors examined correlates of accumulated financial wealth by gender and across three age cohorts: 50 to 59, 60 to 69, and 70 years or older. The authors outline the changing context these cohorts experienced during their lifetimes; describe patterns of net financial worth by main covariates across groups defined by age, sex, and marital status; and present the results of multivariate models of net worth. Simulations were conducted to illustrate patterns of net worth associated with alternative scenarios depicting differing representative combinations of life-course characteristics by age cohort. The findings suggest that old-age financial wealth in Mexico is more closely associated with family formation and human capital decisions than with employment decisions over the lifetime.

Declines in late-life disability: the role of early- and mid-life factors

Investigations into the reasons for declines in late-life disability have largely focused on the role of contemporaneous factors. Adopting a life-course perspective as a backdrop, in this paper we ask whether there also has been a role for selected early- and mid-life factors in the decline, and if so whether these factors have been operating through changes in the risks of disability onset or recovery. Drawing on five waves from 1995 to 2004 of the U.S. Health and Retirement Study, we found for the 75 years and older population in the United States that the prevalence of difficulty with activities of daily living (ADL) declined from 30.2% in 1995 to 26.0% in 2004, whereas the trend in difficulty with instrumental activities of daily living (IADL) was flat. Onset of ADL limitations also was reduced during this period while recovery increased. Changes in the educational composition of the older population were linked to declines in the prevalence of ADL limitations, but there were also modest contributions of changes in mother's education, self-rated childhood health, and lifetime occupation. Declines in late-life vision impairments and increases in wealth also contributed substantially to the downward trend, and had chronic conditions not increased, it would have been even larger. Reductions in the onset of ADL limitations were partly driven by changes in educational attainment of respondents and their mothers and, in late-life, better vision and wealth. In contrast, the recovery trend was not accounted for by changes in early- or mid-life factors. We conclude that early- and mid-life factors have contributed along with late-life factors to U.S. late-life disability trends mainly through their influence on the onset of, rather than recovery from, limitations.