OCHS 2000 Childhood Health Status And Intergenerational Socioeconomic Mobility Cam Mustard, ScD

1. OCHS 2000 Childhood Health Status And Intergenerational Socioeconomic Mobility Cam Mustard, ScD Christina Kalcevich, MA Institute for Work & Health

2. Childhood Health Status and • Intergenerational Socioeconomic Mobility • The unequal distribution of health status among adults • relative to socioeconomic position is understood to • arise from two processes: • the effects of socioeconomic disadvantage on health status (social causation), and • the effects of health status (both current health and potentially health early in the lifecourse) on socioeconomic status (health selection)

3. Childhood Health Status and Intergenerational Socioeconomic Mobility The effect of health status deficits in childhood and adolescence on socioeconomic attainment in early adulthood is not well described in Canada Prior to completion of 2000 OCHS Follow-up, no Canadian studies of representative samples of children followed to early adulthood with childhood measures of health and function

4. Childhood Health Status and Intergenerational Socioeconomic Mobility Results recently reported from the 1958 British birth cohort found health selection effects were present in a British national sample of young adults followed from birth Health in childhood and adolescence had modest effects on social class gradients in self-rated health at age 23 and at age 33 (inter-generational mobility). At labour market entry, adolescents with poor health were more likely to be downwardly mobile and less likely to be upwardly mobile relative to their healthier peers (intra-generational mobility) Manor O, Matthews S, Power C. Health selection: the role of inter- and intra-generational mobility on social inequalities in health. Social Science and Medicine 2003;57:2217-2227.

5. Methods: OCHS 2000 Enrolled 3,294 children aged 4-16 in 1983. Sample was resurveyed in 1987 Sample was traced and re-surveyed in 2000, when respondents were aged 21-33 Results in this paper report on 2,352 adult OCHS respondents Health domains measured in 1983 and 1987 included chronic health conditions, functional limitations, conduct disorder, hyperactivity, emotional problems and externalizing problem behavior. Parental socioeconomic status during respondent childhood and adolescence was measured by highest educational attainment of either parent, and separately, highest occupation attainment of either parent

6. Methods: OCHS 2000 Respondent socioeconomic position in early adulthood was measured similarly to parents Dependent variable in these analyses was a three-level change score, indicating respondent socioeconomic position relative to highest parental socioeconomic position (young adult lower than parent, young adult equivalent to parent, young adult higher than parent) Health status in young adulthood was measured by a single item five-level measure of perceived health status Polytomous logistic regression was used to estimate the effect of child and adolescent health status on socioeconomic attainment in young adulthood

7. Results

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11. Childhood Health/Behavioral Risk Factors for Downward Socioeconomic Mobility in Early Adulthood Health/Behavioral risk factor: Hyperactivity

12. Socioeconomic health status inequalities in early adulthood Percent with good, fair or poor health status

13. Socioeconomic health status inequalities in early adulthood Odds Ratios for poor health (good, fair or poor health status)

14. Childhood Health Status and Intergenerational Socioeconomic Mobility Conclusions (1) In the OCHS sample, behavioral disorder in childhood/ adolescence had enduring effects on role attainment in young adulthood The 10% of OCHS respondents with hyperactive behavioral profile in childhood were more likely to achieve lower educational attainment than parent and were less likely to achieve higher occupational attainment than parents

15. Childhood Health Status and Intergenerational Socioeconomic Mobility Conclusions (2) In the OCHS sample, health status in early adulthood showed an important socioeconomic gradient. This gradient was not explained by childhood/adolescent health status. These findings generally replicated results from the 1958 NCDS, confirming that socioeconomic mobility of young adults is influenced only marginally by childhood and adolescent health status