Children with disabilities and chronic conditions and longer-term parental health

https://doi.org/10.1016/j.socec.2007.01.032Get rights and content

Abstract

This paper uses panel data from the Statistics Canada National Longitudinal Survey of Children and Youth (1994–2000) to study the implications of parenting a child with a disability or chronic condition for subjective assessments of parental health. We find mother's health to be negatively affected, particularly if the disability is longer-term. Within families, the wife's health deteriorates relative to her husband's when they are parenting a child with a disability. These results are consistent with Akerlof and Kranton's [Akerlof, G., Kranton, R., 2000. Economics and identity. The Quarterly Journal of Economics 105(3), 715–753] arguments that ‘identity’ is an important determinant of both behaviour and well-being. For parents of children with disabilities, the behaviour associated with a traditional ‘good mother’ identity (e.g., care-giving) appears to have more adverse health consequences than the behaviour associated with a ‘good father’ identity (e.g., breadwinning).

Introduction

In this paper we ask how parenting a child with a disability or serious chronic condition affects the health of mother and father, particularly over the longer-term. This situation provides a striking example of the general point that, for individuals who are members of a family group, personal well-being will be woven together with the lives of those who are closest.

Section 2 reviews a diverse literature suggesting that individual health is ‘produced’ within families; that poor health experienced by one person might affect the well-being of other family members. Central to this discussion is the point that different norms for the behaviour of a ‘good mother’ compared to a ‘good father’ could mean that parenting a child with a disability will have different implications for mother's well-being than father's.

The main body of the paper presents an empirical investigation of connections between child disability and subjective assessments of over-all parental health using the Statistics Canada National Longitudinal Survey of Children and Youth (NLSCY), a nationally representative panel of Canadian children. A key advantage of the NLSCY is that we track the health status of the child and both parents across time. We are thus able to contrast “current-period-only” associations with those that develop over the longer-term, to compare results for mothers and fathers of the same child, and to study, within families, whether the mother's health deteriorates relative to the father's health in families in which there is a disabled child compared to families in which there is not.

In Section 3 we describe the data in more detail. Section 4 outlines our estimation strategy and empirical results for mothers and fathers separately. Section 5 moves on to estimate changes in maternal health relative to paternal health. Section 6 concludes.

Section snippets

Review of relevant literature

Grossman (1972) argues that individuals produce their own stock of health through the choices they make about how to use the time and money available to them. For example, income can be used to buy healthy food or a fitness club membership; time can be allocated to exercise or doctor visits. If health is neglected period after period, through inadequate allocation of resources to ‘self-preservation,’ health status is predicted to deteriorate.

Despite the insights offered by the individual model

Data

We employ Cycles 1–4 of the Statistics Canada National Longitudinal Survey of Children and Youth, which follows a nationally representative sample of children every 2 years from 1994 to 2000, inclusive.3 We restrict our sample to the cohort of children who are aged between 6 and 15 years in 2000 and who were present in each survey year (i.e., 1994, 1996,

Empirical results on levels of parental health

To estimate implications for parental health of caring for a child with a disability, we estimate ordered probit regressions using current (2000) parental health status as the dependent variable (higher numbers mean poorer health). We first estimate separate regressions for mothers and fathers (though these are parents of the same children). In ‘Model 1,’ our key variable is a dummy equal to one if there is a child with a disability in the family in 2000. In ‘Model 2,’ we use the three dummy

The relative health status of mothers and fathers

The previous section provides evidence that, on average, the health of mothers of children with disabilities falls while the health of fathers is unaffected. However, these estimates do not fully exploit the richness of information available in the NLSCY. That is, since we track the health status of both parents, it is possible for us to test explicitly whether, within families, mother's health falls more than father's when they are parenting a child with a disability. To do this, we estimate

Conclusions

Parents of children with disabilities or chronic conditions provide a striking example of individuals whose personal well-being may be affected by the life of a loved one. Since children with disabilities often have high needs in terms of both time and money, having an identity as a ‘good mother’ or ‘good father’ may lead parents to prioritize the use of time and money for the child, even at the cost of parental health; parental well-being is likely also to be directly affected through concern

Acknowledgements

We thank the CIHR for funding through the “Healthy Balance Research Programme: A Community Alliance for Health Research on Women's Unpaid Caregiving.” Access to detailed Statistics Canada data was provided at the Atlantic Research Data Centre; we thank Arden Bell for vetting output. Earlier versions of the paper were presented at the Boston ASSA meetings (January, 2006), Dalhousie and McMaster seminars, at the Healthy Balance Equity Reference groups, Statistics Canada workshop on “Exploring New

References (27)

  • K. Bolin et al.

    The family as the health producer—when spouses are Nash-bargainers

    Journal of Health Economics

    (2001)
  • D.E. Gray

    Gender and coping: the parents of children with high functioning autism

    Social Science and Medicine

    (2003)
  • G. Akerlof et al.

    Economics and identity

    The Quarterly Journal of Economics

    (2000)
  • Baker, M., Stabile, M., Deri, C. 2001. What do self-reported, objective, measures of health measure? National Bureau of...
  • Beagan, B., Stadnyk, R., Loppie, C., MacDonald, N., Hamilton-Hinch, B., MacDonald, J., 2005. I do it because I love her...
  • K.A. Brown et al.

    Gender differences in parenting a child with cancer

    Social Work in Health Care

    (1996)
  • L. Dyson

    Families of young children with handicaps: parental stress and family functioning

    American Journal on Mental Retardation

    (1991)
  • R.A. Easterlin

    Explaining happiness

    Proceedings of the National Academy of Sciences of the United States of America

    (2003)
  • N. Folbre

    Holding hands at midnight: the paradox of caring labor

    Feminist Economics

    (1995)
  • J. Gornick et al.

    Families that Work: Policies for Reconciling Parenthood and Employment

    (2003)
  • M. Grossman

    On the concept of health capital and the demand for health

    Journal of Political Economy

    (1972)
  • C.A. Havens

    Becoming a resilient family: child disability and the family system

    Access Today

    (2005)
  • L. Jacobson

    The family as producer of health—an extended Grossman model

    Journal of Health Economics

    (2002)
  • Cited by (46)

    • Early childhood health shocks, classroom environment, and social-emotional outcomes

      2023, Journal of Health Economics
      Citation Excerpt :

      Our analysis first contributes to the recent literature that documents the spillover effects of ECHS. The majority of studies in this area focus on the spillover effects on parental socioeconomic outcomes, such as parental labor supply (Breivik and Costa-Ramón, 2022; Deshpande, 2016; Gunnsteinsson and Steingrimsdottir, 2019; Powers, 2003); maternal health (Burton et al., 2008); and marriage stability (Kvist et al., 2013; Reichman et al., 2004). Several studies also show that ECHS could have an impact on siblings’ academic outcomes (Black et al., 2021; Breining 2014; Daysal et al., 2022).

    • Lived experiences of parents of children with disabilities engaged in a support group incorporating equines

      2022, Research in Developmental Disabilities
      Citation Excerpt :

      Significantly reduced physical health is found in caregivers of children with developmental disabilities when compared to control parent groups, especially related to the occurrence of sleep problems, headaches, gastrointestinal difficulties, and respiratory infections (Cantwell et al., 2014). Another mitigating factor that negatively influences parent health is perceived severity of the child’s disability, especially if the disability has been long-standing over a period of many years (Burton et al., 2008; Miodrag et al., 2015). Burton et al. (2008) stated:

    • SPILLOVER EFFECTS OF EARLY-LIFE MEDICAL INTERVENTIONS

      2022, Review of Economics and Statistics
    View all citing articles on Scopus
    View full text