The intergenerational transmission of mental and physical health in the United Kingdom.

As health is increasingly recognized as a key component of human welfare, a new line of research on intergenerational mobility has emerged that focuses on broad measures of health. We extend this research to consider two key components of health: physical health and mental health. We use rich survey data from the United Kingdom linking the health of adult children at around age 30 to their parents. We estimate that the rank-rank slope in health is 0.17 and the intergenerational health association is 0.19 suggesting relatively rapid mobility compared to other outcomes such as income. We find that while both mental and physical health have a similar degree of intergenerational persistence, parents' mental health is much more strongly associated with broad measures of adult children's health than parents' physical health. We also show that the primacy of parent mental health over physical health on children's health appears to emerge during early adolescence. Finally, we construct a comprehensive measure of welfare by combining income and health and estimate a rank-rank association of 0.27. This is considerably lower than the comparable estimate of 0.43 from the US suggesting that there is greater mobility in welfare in the UK than in the US.

The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants.

In March 2015, the State of Hawaii stopped covering the majority of migrants from countries belonging to the Compact of Free Association (COFA) in its Medicaid program. COFA migrants were required to obtain private insurance in the exchanges established under the Affordable Care Act. Using statewide hospital discharge data, we show that Medicaid-funded hospitalizations and emergency room visits declined in this population by 31% and 19%, respectively. Utilization funded by private insurance did increase but not enough to offset the declines in Medicaid-funded utilization. We show that the expiration of benefits increased uninsured ER visits. Finally, we exploit a feature of the policy change to provide evidence that the declines in utilization are due to higher rates of uninsured migrants rather than higher levels of cost sharing on private plans.

The Mortality Effects of Reduced Medicaid Coverage Among International Migrants in Hawaii: 2012-2018.

Objectives. To study the impact on mortality in Hawaii from the revoked state Medicaid program coverage in March 2015 for most Compact of Free Association (COFA) migrants who were nonblind, nondisabled, and nonpregnant.Methods. We computed quarterly crude mortality rates for COFA migrants, Whites, and Japanese Americans from March 2012 to November 2018. We employed a difference-in-difference research design to estimate the impact of the Medicaid expiration on log mortality rates.Results. We saw larger increases in COFA migrant mortality rates than White mortality rates after March 2015. By 2018, the increase was 43% larger for COFA migrants (P = .003). Mortality trends over this period were similar for Whites and Japanese Americans, who were not affected by the policy.Conclusions. Mortality rates of COFA migrants increased after Medicaid benefits expired despite the availability of state-funded premium coverage for private insurance and significant outreach efforts to reduce the impact of this coverage change.

The intergenerational transmission of health in the United States: A latent variables analysis.

Social scientists have long documented that many components of socioeconomic status such as income and education have strong ties across generations. However, health status, arguably a more critical component of welfare, has largely been ignored. We fill this void by providing the first estimates of the Intergenerational Health Association (IHA) that are explicitly based on a nonlinear latent variable model. We develop an estimation procedure for a nonlinear model with categorical outcomes in which the latent index is a mixed linear model and contains covariates that might not vary within cross-sectional units. Adjusting for only age and gender, we estimate an IHA of 0.3 indicating that about one third of a parent's health status gets transmitted to their children. Once we add additional mediators to the model, we show that education, and particularly children's education, is an important transmission channel in that it reduces the IHA by one third. Finally, we show that estimates of the IHA from nonlinear models are only moderately higher than those from linear models, whereas rank-based mobility estimates are identical.

Health and health inequality during the great recession: Evidence from the PSID.

We estimate the impact of the Great Recession of 2007-2009 on health outcomes in the United States. We show that a one percentage point increase in the unemployment rate resulted in a 7.8-8.8% increase in reports of poor health. In addition, mental health was adversely impacted. These effects were concentrated among those with strong labor force attachments. Whites, the less educated, and women were the most impacted demographic groups.

An Analysis of Sibling Correlations in Health using Latent Variable Models.

We investigate sibling correlations in youth health status using the Panel Study of Income Dynamics. We do so by estimating the covariance structure of a system of equations in latent variables using methods that have hitherto not been used in the literature on intergenerational transmissions of health. Across a battery of outcomes, we find that between 50 and 60% of health status can be attributed to shared familial or neighborhood characteristics. Taking the principal component across all outcomes, we obtain a sibling correlation of about 53%. These estimates, which are larger than previous estimates of sibling correlations in health that rely on linear models, are more in-line with sibling correlations in income and suggest that health status, like other measures of socioeconomic success, is strongly influenced by family background. Copyright © 2017 John Wiley & Sons, Ltd.

The impact of internal displacement on child mortality in post-earthquake Haiti: a difference-in-differences analysis.

BACKGROUND: The Haiti earthquake in 2010 resulted in 1.5 million internally displaced people (IDP), yet little is known about the impact of displacement on health. In this study, we estimate the impact of displacement on infant and child mortality and key health-behavior mechanisms. METHODS: We employ a difference-in-differences (DID) design with coarsened exact matching (CEM) to ensure comparability among groups with different displacement status using the 2012 Haiti Demographic and Health Survey (DHS). The participants are 21,417 births reported by a nationally representative sample of 14,287 women aged 15-49. The main independent variables are household displacement status which includes households living in camps, IDP households (not in camps), and households not displaced. The main outcomes are infant and child mortality; health status (height-for-age, anemia); uptake of public health interventions (bed net use, spraying against mosquitoes, and vaccinations); and other conditions (hunger; cholera). RESULTS: Births from the camp households have higher infant mortality (OR = 2.34, 95 % CI 1.15 to 4.75) and child mortality (OR = 2.34, 95 % CI 1.10 to 5.00) than those in non-camp IDP households following the earthquake. These odds are higher despite better access to food, water, bed net use, mosquito spraying, and vaccines among camp households. CONCLUSIONS: IDP populations are heterogeneous and households that are displaced outside of camps may be self-selected or self-insured. Meanwhile, even households not displaced by a disaster may face challenges in access to basic necessities and health services. Efforts are needed to identify vulnerable populations to provide targeted assistance in post-disaster relief.

Unemployment and mortality: evidence from the PSID.

We use micro-data to investigate the relationship between unemployment and mortality in the United States using Logistic regression on a sample of over 16,000 individuals. We consider baselines from 1984 to 1993 and investigate mortality up to ten years from the baseline. We show that poor local labor market conditions are associated with higher mortality risk for working-aged men and, specifically, that a one percentage point increase in the unemployment rate increases their probability of dying within one year of baseline by 6%. There is little to no such relationship for people with weaker labor force attachments such as women or the elderly. Our results contribute to a growing body of work that suggests that poor economic conditions pose health risks and illustrate an important contrast with studies based on aggregate data.

Health status and the allocation of time.

We consider the relationship between health and time allocation in the American Time Use Survey. Better health is associated with large positive effects on home production and larger positive effects on market production, but less consumption of leisure. Theoretically, if market- and home-produced goods are perfect substitutes, the positive correlation between health and home production implies that health exerts larger effects on home than on market efficiency. Notably, these correlations are higher for single people than for married people, perhaps reflecting a lack of market substitutes for the time of married people.

Weight gain in adolescents and their peers.

Despite the urgent public health implications, relatively little is yet known about the effect of peers on adolescent weight gain. We describe trends and features of adolescent BMI in a nationally representative dataset and document correlations in weight gain among peers. We find strong correlations between own body mass index (BMI) and peers' BMI's. Though the correlations are especially strong in the upper ends of the BMI distribution, the relationship is smooth and holds over almost the entire range of adolescent BMI. Furthermore, the results are robust to the inclusion of school fixed effects and basic controls for other confounding factors such as race, sex, and age. Some recent research in this area considers whether or not adolescent weight gain is caused by peers. We discuss the econometric issues in plausibly estimating such effects while accounting for growth spurts and difficulties in defining adolescent obesity. While our work identifies correlations between adolescent BMI and peers' BMI, it is not intended to and cannot fully address the existence of endogenous peer effects.

Selective migration and health in the USA, 1984-93.

Using data from the Panel Study of Income Dynamics, we investigated the impact of health on domestic migration within the USA. We find that, for men below 60 years of age, a move from the middle to the bottom of the health distribution reduces mobility by 32-40 per cent. Non-random attrition from the panel implies that these are lower bounds. By contrast, we find evidence that, among older men, there is higher mobility at the top and bottom of the health distribution than there is in the middle. For women, we find no evidence of a relationship between their own health and mobility, although spouse's health does affect the mobility of married women.

Business cycles, migration and health.

We investigate the proposition that illness poses as an obstacle to one's ability to use migration to hedge the business cycle. We employ data on migration, regional unemployment rates and health status from 10 years (1984-1993) of the US Panel Study of Income Dynamics. Our results provide considerable for support this proposition. The evidence is the strongest for men, but we also find weaker evidence for married women. These results suggest that--ceterus paribus--aggregate health outcomes in an area should improve when the regional economy expands.