Childhood Health, Sibling Outcomes Childhood Health, Sibling Outcomes and the and the 1918 Influenza 1918 Influenza Pandemic Pandemic John Parman John Parman College of William & Mary and NBER College of William & Mary and NBER July 11, 2013 Introduction Childhood health and adult outcomes The Pandemic of 1918 Dataset construction Estimation Results Conclusions State Gym at Iowa State University; Image Special Collections Department, ISU Library
Childhood Health, Motivation Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William There is an increasing body of evidence that poor & Mary and NBER health as a child has lasting impacts on educational and Introduction labor market outcomes Childhood health and adult A portion of this relationship is driven by biology, with outcomes poor infant and childhood health being correlated with The Pandemic of 1918 adult health complications Dataset construction However, there is also an economic channel: poor Estimation childhood health changes the relative prices faced by Results parents when investing in children Conclusions Raises the possibility that even healthy children will have their outcomes affected by unhealthy siblings
Childhood Health, Brief overview of paper Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William & Mary and NBER I create a new dataset linking adult health and educational attainment to childhood household Introduction Childhood health characteristics and adult outcomes I estimate the effects of having a sibling in utero during The Pandemic of the pandemic on educational and health outcomes 1918 Dataset Results suggest that parents shifted resources to older construction children when a child received a negative health shock Estimation The effects are large and suggest health shocks or Results Conclusions interventions can dramatically alter the relative outcomes of siblings
Childhood Health, Childhood Health and Adult Outcomes Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William & Mary and NBER There is a growing body of empirical evidence linking childhood health to adult socioeconomic and health Introduction outcomes Childhood health and adult One strand of the literature looks at health differences outcomes between twins or siblings to control for household fixed The Pandemic of 1918 effects Dataset construction Another strand focuses on shocks to childhood health Estimation that target specific birth cohorts Results The studies generally find that poor health in early Conclusions childhood is associated with poor economic and health outcomes as an adult
Childhood Health, Childhood Health and Adult Outcomes Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William & Mary and NBER Possible mechanisms for the link between childhood health Introduction and adult outcomes: Childhood health Direct effect of poor childhood health on school and adult outcomes attendance and productivity The Pandemic of 1918 Poor health hindering cognitive development Dataset construction In utero health affecting metabolism leading to later Estimation chronic health issues Results Parents altering investment decisions based on Conclusions children’s health
Childhood Health, Childhood Health and Adult Outcomes Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William & Mary and NBER Parents altering investment decisions implies sibling outcomes may be affected: Introduction Childhood health Becker and Tomes framework predicts increased and adult outcomes investment in less healthy child if health shock affects The Pandemic of endowment but not price of increasing child quality 1918 Investment will reinforce sibling inequality if health Dataset construction shock leads to higher price of increasing child quality Estimation More recent models (Behrman et al., Ejrnæs & P¨ ortner, Results Adhvaryu & Nyshadham) incorporate aversion to Conclusions inequality in outcomes across children
Childhood Health, The Influenza Pandemic of 1918 Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William & Mary and NBER Introduction Childhood health and adult outcomes The Pandemic of 1918 Dataset construction Estimation Results Conclusions Credit: Office of the Public Health Service Historian (image at www.flu.gov)
Childhood Health, The Timing of the Pandemic Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William & Mary and NBER Introduction Childhood health and adult outcomes The Pandemic of 1918 Dataset construction Estimation Results Conclusions
Childhood Health, The Timing of the Pandemic Sibling Outcomes and the 1918 Influenza Pandemic John Parman College of William 50 & Mary and NBER 45 40 Introduction Crude death rate 35 Childhood health 30 and adult outcomes 25 20 The Pandemic of 1918 15 C 10 10 Dataset construction 5 0 Estimation Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Results Conclusions Deaths per 1,000 people by month, 1918-1919
Childhood Health, The Distribution of Flu Deaths Sibling Outcomes and the 1918 Influenza Pandemic John Parman 2500 College of William 1918 & Mary and NBER Specific death rate e 2000 1919-1921 Introduction 1500 1915-1917 Childhood health 1000 and adult outcomes 500 The Pandemic of 1918 0 Dataset construction Estimation Results Conclusions Age Age Deaths from influenza or pneumonia per 100,000 people by age group
Childhood Health, The Distribution of Flu Deaths Sibling Outcomes and the 1918 Influenza Pandemic 0.20 John Parman College of William & Mary and NBER 0.19 Introduction Prevented From Work By a Disability 0.18 Childhood health and adult 0.17 outcomes The Pandemic of 0.16 1918 Dataset 0.15 construction Estimation 0.14 Results 0.13 Conclusions 0.12 1917.5 1918 1918.5 1919 1919.5 1920 1920.5 1921 Quarter of Birth 1980 male disability rate, Figure 7 from Almond (2006)
Childhood Health, Placing the Pandemic in Context Sibling Outcomes and the 1918 Influenza 50000 Pandemic FIN USA 2000 KWT John Parman IRL BEL College of William 40000 ISL & Mary and NBER GDP per capita (2010 US $) GBR 1990 NZL ITA Introduction 30000 ESP 1980 ISR CYP Childhood health and adult GRC 1970 outcomes SVN BHR OMN 20000 PRT MLT SAU 1960 The Pandemic of TTO 1940 1918 EST 1950 BRB HRV CHL HUN URY POL 10000 LTU BRA LVA Dataset SYC TUR KAZ MEX LBN MYS BWA construction ROM MUS PAN 1920 GRD BGR 1930 AZE DMA SUR COL 1910 1900 SRB BLR MDV PER DOM NAM THA DZA JAM 1890 JOR 1880 TUN BLZ TON Estimation UKR ALB SLV CPV FJI PRY IDN SWZ WSM IRQ ARM GEO MNG MAR VUT GTM BTN BOL PHL MDA UZB VNM DJI LSO GHA SLB MRT NIC KHM PAK KEN SEN TCD BGD TJK ERI CAF 0 Results 1 2 3 4 5 Conclusions Total fertility rate Modern cross-country data US historical data GDP per capita and total fertility rate by country for 2010 and by decade for the US
Childhood Health, Placing the Pandemic in Context Sibling Outcomes and the 1918 Influenza Pandemic 1890 150 John Parman College of William & Mary and NBER 1900 Infant mortality rate Introduction NER MLI 100 1910 CAF DJI Childhood health TCD and adult MWI BFA outcomes MOZ LSO GNQ ETH 1920 GIN PAK MRT The Pandemic of 1930 BDI SEN BGD KHM AZE 1918 50 GHA BTN VUT NAM BOL ERI IRQ TJK CPV 1940 MNG Dataset MAR MDV TTOTUR IDN construction PER GTM DZA KAZ 1950 DOM 1960 PRY NIC UZB WSM BLZ LBN BRA VNM PHL SLV ARM SLB SUR COL MEX ALB THA TON 1970 BGR OMN GEO MYS JOR JAM MDA Estimation BRB ARE BWA GRD FJI ROM MUS 1980 PAN BHR URY CYP UKR LVA 1990 KWT EST QAT 2000 CHL BLR LTU SRB POL PRT HRV CUB USA HUN SVN DNK LUX BEL GBR GRC IRL FIN MLT NLD 0 Results 40 50 60 70 80 Conclusions Life expectancy Modern cross-country data US historical data Infant mortality rates and life expectancy by country for 2010 and by decade for the US
Childhood Health, Placing the Pandemic in Context Sibling Outcomes and the 1918 Influenza Pandemic 100 GEO ARM UKR BLR LVA LTU EST CUB AZE KAZ TJK 1970 1980 TON ALB ITA John Parman HRV URY BGR ROM SRB CYP ESP 1960 MNG College of William MDV 1940 GRC 1950 CHL & Mary and NBER PHL 1930 95 QAT KWT THA 1920 PAN SUR MEX COL VNM MYS 1910 MLT Introduction IDN SYC BHR JOR BOL GNQ 90 Literacy rate BRA LSO PER Childhood health OMN 1900 DOM TUN STP NAM and adult SWZ MUS 1890 outcomes JAM SAU 85 KEN SLV The Pandemic of 1880 1918 80 VUT 1870 Dataset construction IRQ NIC BWA KHM Estimation DZA 75 GTM MWI Results 60 70 80 90 100 Conclusions Enrollment rate Modern cross-country data US historical data Literacy rates and enrollment rates by country for 2010 and by decade for the US
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