Children with disabilities and chronic conditions and longer-term parental health
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)
- et al.
The family as the health producer—when spouses are Nash-bargainers
Journal of Health Economics
(2001) Gender and coping: the parents of children with high functioning autism
Social Science and Medicine
(2003)- 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...
- et al.
Gender differences in parenting a child with cancer
Social Work in Health Care
(1996) Families of young children with handicaps: parental stress and family functioning
American Journal on Mental Retardation
(1991)Explaining happiness
Proceedings of the National Academy of Sciences of the United States of America
(2003)Holding hands at midnight: the paradox of caring labor
Feminist Economics
(1995)- et al.
Families that Work: Policies for Reconciling Parenthood and Employment
(2003)
On the concept of health capital and the demand for health
Journal of Political Economy
Becoming a resilient family: child disability and the family system
Access Today
The family as producer of health—an extended Grossman model
Journal of Health Economics
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