Investments, Life Events, and Health Within and Across Generations

项目总结 越来越多的研究文献表明，早期生活环境在塑造儿童和 成年人的幸福。我们现在知道，在宫内和生命早期暴露在受损的健康环境中 (例如，疾病暴露、营养不良)往往会产生负面影响，一直持续到成年。许多 政府计划旨在通过提供更好的营养、健康等途径来抵消这些负面影响 关爱和早期教育。最近的研究发现，儿童能够获得其中的一些方案(例如，食物 邮票、WIC、Head Start、Medicaid)导致个人晚年健康和经济状况的改善 结果。综上所述，这两篇文献--记录负面健康“电击”的影响和 积极投资的影响--表明早期的影响具有长期的影响。然而，我们知道 令人惊讶的是，我们几乎不知道为什么这种影响会持续下去，也不知道以后的投资可以缓解的范围 早期生活创伤的长期影响。我们也不知道后来的积极投资在多大程度上 维持(甚至放大)早期社会投资的有益影响。此外，现有的研究通常 专注于单独检查特定健康事件或投资的影响，而忽略额外的 事件或后来的投资可能会改变早期生活经历的轨迹。该项目的一个主要目标是 以测试这些程序如何在整个生命过程中相互作用，并进入下一代。我们会 还要调查晚年生活干预是否可以减少早期健康冲击的持续影响。至 为了实现这些目标，我们将利用政策在空间和时间上的变化，包括县级 20世纪80年代食品券和WIC计划最初“推出”的变化以及各州水平的差异 医疗补助计划的扩大。我们将把这些计划数据链接到不同的行政和调查数据来源， 这将为我们提供非常大的样本，最大限度地提高统计能力，提高我们发现 调解器，并检测交互效果的存在。描述政策如何推出的数据集，以及 将向所有感兴趣的研究人员提供相关的工作量和支出。这些项目加在一起， 将使我们能够审查广泛的中期和长期成果，并将提供新的 关于旨在缓解健康和经济不平等的政府政策效力的信息。为 例如，了解公共卫生投资在多大程度上减轻了健康“侮辱”的影响 确定哪些政府干预可以最有效地减少长期 健康不平等。我们的工作对于理解安全网在防治中的作用也是至关重要的。 弱势儿童面临的许多早期生活挑战。最后，我们的工作将直接告知经济 人力资本和技能形成技术的模型。 1

PROJECT SUMMARY A growing body of research documents that early-life environments play an important role in shaping child and adult well-being. We now know that in-utero and early-life exposure to compromised health environments (e.g., disease exposure, malnutrition) often produces adverse effects that persist well into adulthood. Many government programs aim to counteract these negative effects by providing better access to nutrition, health care, and early education. Recent studies find that childhood access to some of these programs (e.g., Food Stamps, WIC, Head Start, Medicaid) lead to later-life improvements in individuals' health and economic outcomes. Taken together, these two literatures—documenting the impacts of negative health “shocks” and the impacts of positive investments—make clear that early-life influences have long-lasting effects. Yet, we know surprisingly little about why the effects persist, nor do we know the scope for later-life investments to mitigate the long-run effects of early-life trauma. We also do not know the extent to which later positive investments sustain (or even amplify) the beneficial impacts of early social investments. Moreover, existing studies typically focus on examining the impacts of specific health events or investments in isolation and ignore how additional events or later investments might alter the trajectory of early-life experiences. A key aim of this project will be to test how these programs interact with each other across the life course and into the next generation. We will also investigate whether later-life interventions can reduce the persistent effects of early-life health shocks. To achieve these goals, we will leverage policy variation across space and over time, including county-level variation in the initial “rollout” of the Food Stamp and WIC programs, and state level differences in the 1980s Medicaid expansions. We will link these program data to different sources of administrative and survey data, which will provide us with very large samples that maximize statistical power, increase our ability to uncover mediators, and detect the presence of interactive effects. The dataset describing how the policies rolled out and associated caseloads and spending will be made available to all interested researchers. Together, these projects will allow us to examine a wide range of intermediate- and long-term outcomes and will provide new information on the efficacy of government policies intended to mitigate health and economic inequalities. For example, understanding the extent to which public health investments mitigate the effects of health “insults” is an important step towards identifying which government interventions can most effectively reduce long-run health inequalities. Our work will also be critical for understanding the role of the safety net in combating many early life challenges faced by disadvantaged children. Finally, our work will directly inform economic models of human capital and technology of skill-formation. 1