Academic journal article The Future of Children

Children's Health and Social Mobility

Academic journal article The Future of Children

Children's Health and Social Mobility

Article excerpt


Children from low-income families are more likely than other children to have serious health problems. And, as Anne Case and Christina Paxson show, childhood health problems can prevent poor children from achieving economic success as adults.

Income-related disparities in childhood health are evident at birth or even before, and the disparities grow more pronounced as children grow older. Not only do poor children have more severe health problems than wealthier children, but they fare less well than wealthier children who have the same problems. They also receive less and lower-quality medical care for their problems. And poor families may be less well equipped to manage their children's health problems, which could worsen their effects.

The available U.S. data sets do not allow researchers to track individuals' health and economic well-being from birth into adulthood, but three British data sets are producing growing evidence that health in childhood is a determinant of educational attainment, which in turn affects adults' employment opportunities and wages. Children in poor health are also more likely to have poor health as adults, and their health as adults adversely affects their economic status.

Case and Paxson note that eliminating income-related disparities in health problems in childhood would do little to reduce earnings disparities between richer and poorer adults. However, they emphasize that, for children in poor health, improvement in physical condition in childhood would lead to substantial improvement in economic circumstances.

The authors cite several areas, including expanded prenatal care, maternal smoking cessation programs, and nutrition programs, as deserving particular attention. They contend that increased access to health care is not sufficient to improve children's health. The next wave of policies should focus on improving the quality of health care and strengthening the ability of parents to manage their children's health problems.


Do health problems in childhood make it harder to achieve economic success in adulthood? The question is important for all children, but it is especially so for children from low-income families because they are more likely than other children to have health problems. An income-related gap in health is evident as soon as children are born, and it widens as they grow older. Although not all physical and mental health conditions are more common among low-income children, many of the most serious conditions are. Moreover, the health problems of lower-income children appear to be more poorly managed. The "double disadvantage" of low income and poor health may combine to prevent poor children from achieving economic success as they become adults.

Poor childhood health could limit economic success later in life for several reasons. One may be that children with health problems tend to be less well educated than other children: they may have greater difficulty learning and may leave school when they are younger. Another reason may be that less healthy children become less healthy adults. Adults in poor health may find it more difficult to hold down good jobs or to work as many hours as their healthy peers. Because poor health in childhood may affect economic success in adulthood in a variety of ways, we will discuss evidence on a range of adult outcomes, including schooling, health, and labor market success. The general thrust of the evidence is that health in childhood has long-term consequences for economic success.

Improving the health of children is a policy goal worth pursuing whether or not childhood health is related to adult economic success. But the research finding that children's health affects their standard of living as adults suggests the particular importance of policies and programs that improve the health of all children, and especially lower-income children. …

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