The "Long-arm" of chronic conditions in childhood: Evidence from Canada using linked survey-administrative data

Emmanuelle Arpin; Claire de Oliveira; Arjumand Siddiqi; Audrey Laporte

doi:10.1016/j.ehb.2023.101257

The "Long-arm" of chronic conditions in childhood: Evidence from Canada using linked survey-administrative data

Econ Hum Biol. 2023 Aug:50:101257. doi: 10.1016/j.ehb.2023.101257. Epub 2023 May 4.

Authors

Emmanuelle Arpin¹, Claire de Oliveira², Arjumand Siddiqi³, Audrey Laporte⁴

Affiliations

¹ 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. Electronic address: emmanuelle.arpin@mail.utoronto.ca.
² 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.
³ Dalla Lana School of Public Health, University of Toronto, 155 College St 6th Floor, Toronto, ON M5T 3M6, Canada; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.
⁴ 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.

PMID: 37348288
DOI: 10.1016/j.ehb.2023.101257

Abstract

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.

Keywords: Canada; Child health; Data linkage; Long-run effects; Mental/developmental health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Canada / epidemiology
Child
Chronic Disease
Humans
Longitudinal Studies
Mental Disorders*
Mental Health