Investments, Life Events, and Health Within and Across Generations

项目摘要 越来越多的研究文献表明，早期生活环境在塑造儿童和 成人的幸福我们现在知道，在子宫内和生命早期暴露于有害的健康环境， (e.g.,疾病暴露、营养不良）往往会产生持续到成年期的不良影响。许多 政府计划旨在通过提供更好的获得营养、健康、 护理和早期教育。最近的研究发现，儿童对其中一些项目的接触（例如，食品 邮票，WIC，开端，医疗补助）导致个人的健康和经济晚年的改善 结果。总之，这两个文献-记录了负面健康"冲击"的影响， 积极投资的影响-明确早期生活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些影响会持续下去，我们也不知道晚年投资可以减轻这种影响的范围 早期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（甚至扩大）早期社会投资的有益影响。此外，现有的研究通常 侧重于孤立地审查特定卫生事件或投资的影响，而忽视其他 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 来测试这些程序如何在生命过程中相互作用，并进入下一代。我们将 还调查晚年干预是否可以减少早期健康冲击的持续影响。到 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，包括县级政策 食品券和WIC计划最初“推出”的变化，以及20世纪80年代州一级的差异 医疗补助扩张。我们将把这些计划数据与不同来源的行政和调查数据联系起来， 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 调解人，并检测存在的相互作用的影响。描述政策如何推出的数据集， 将向所有感兴趣的研究人员提供相关的案件量和支出。总之，这些项目 将使我们能够审查广泛的中期和长期成果，并将提供新的 关于政府旨在减少健康和经济不平等的政策的效力的信息。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， 确定哪些政府干预措施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打击恐怖主义方面的作用也至关重要。 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 人力资本模型和技能形成技术。 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