The long shadow cast by childhood physical and mental problems on adult life
Robert Joycea, and
James P. Smithb,1
+ Author Affiliations
aInstitute for Fiscal Studies, London WC1E 7AE, United Kingdom; and
bRAND Corporation, Santa Monica, CA 90407-2138
Edited by Kenneth Wachter, University of California, Berkeley, CA, and approved February 8, 2011 (received for review November 11, 2010)
In this article we assess and compare long-term adult socioeconomic status impacts from having experienced psychological and physical health problems in childhood. To do so, we use unique prospective data from the British National ...view middle of the document...
Effects of psychological health disorders during childhood are far more important over a lifetime than physical health problems.
Using prospectively collected data beginning during the week of birth, repeated at three additional ages in childhood and adolescence, and extended into adulthood to age 50 y, this study investigates long-term adult impacts of having experienced psychological and physical health problems during childhood. Stimulated by the work of Barker (1), recent research has established evidence of a strong link between various aspects of poor physical health during childhood (and even in utero) and adult health (2⇓⇓⇓⇓–7) and economic outcomes later during adulthood (8, 9). Much less studied have been long-term health and socioeconomic (SES) consequences of psychological conditions experienced during childhood (10, 11). This is even more surprising given the substantial rise in psychological disorders affecting young people in the United Kingdom in the past 25 y (12, 13).
Recently, Smith and Smith (14) used retrospective questions in the American Panel Study of Income Dynamics to find that impacts of childhood psychological problems on adult SES are large—a lifetime cost in lost family income of approximately $300,000 and total lifetime economic cost for all those affected of $2.1 trillion. An advantage of that study is that it compared siblings, so it was able to control for unobserved family and neighborhood effects, which were found not to be critical for this question. A disadvantage of that research is that it relied on retrospective self-reports of childhood physical and psychological problems, reports that could be colored by adult experiences, including those in the psychological domain. That disadvantage will be rectified here by using prospective panel data measuring at key points in childhood and adulthood the physical and psychological health of respondents alongside measures of the family and economic circumstances of their lives.
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The National Child Development Study (NCDS) is a continuing longitudinal study following lives of a single cohort of 17,634 children born in Britain during 1 week of March 1958 (15). To date there have been nine waves of data collection to monitor their physical, educational, and social development. Four waves took place during childhood (birth and 7, 11, and 16 y) and five waves during adult years (age 23, 33, 42, 46, and 50 y). Seventy-one percent of the original respondents were in the study at the fifth wave, and discrimination between responders and nonresponders had not been marked (16). We do not use the age-46-y wave because it lacks some of our main SES outcomes [family income, social security receipts, and gross hourly wages (a routing error meant that 70% of earners were not asked how many hours per week they work)].
This study collected excellent contemporaneous information in childhood on physical and...