Abstract
Child chronic illness/ disability can present significant challenges for children, families and society that require appropriate policy responses; yet little is known about the demands placed on families resources from an economics perspective in terms of its impact on household income and the extra income required to achieve the same standard of living as families who do not have a child with a chronic illness/disability. The paper uses data from the Growing Up in Ireland National survey dataset for nine year olds. It is the first study to empirically investigate the impact of child chronic illness/disability on earnings, standard of living and the extra cost of disability together. It is also the first study to explicitly address endogeneity in the standard of living model by using a two-stage process where residuals were harvested to provide efficient estimates. The findings show that families experience significant disadvantage and economic hardship due to reduced household income and a lower standard of living due to the extra cost of disability that would require considerable income to compensate. Policy implications of these findings suggest that a tiered approach to disability support payments which encompass broader criteria for inclusion based on varying severity levels be introduced to alleviate the financial hardship and compromised economic wellbeing of families affected. In addition, more innovative policies are required to implement appropriate timely access to health and social care services and flexi parental employment, which in turn requires the provision of adequate access to high quality educational and care facilities.
Highlights
Additional needs associated with behavioural, developmental and physical child chronic illness or disability such as the time costs of caring for a child who may be distressed or unwell and needs constant supervision and support, attending medical appointments, out-of-pocket expenditure and psychological impact can impinge upon many dimensions of family wellbeing [1, 2]
The Progressing Disability Services for Children and Young People Programme (2020) [16] is underpinned by a generalized approach that focuses on needs rather than a diagnosis based approach to access services, this is subject to criticism as a specialized approach from the outset may be more beneficial for certain conditions, e.g. autism. This paper addresses these gaps in knowledge using the Growing Up in Ireland national dataset to focus on four key research objectives (1) concentrating on isolating the impact of child chronic illness/disability on family income using an ordinary least-sqaures model, (2) addressing conversion issues resulting in a lower standard of living by examining variations in need across families with and without a child with a chronic illness/disability using a standard of living modelling approach (3) estimate the extra cost of disability in monetary terms based on the relationship between household income and variations in standard of living for families with and without a child with a chronic illness/disability, (4) explicitly address endogeneity in the standard of living model to provide efficient estimates
Households that had a child severely hampered on a daily basis experienced a €260.12 reduction, households with a child who has some limitation incurred a €116.67 reduction in weekly income (OLS = -116.683***); while households with a child who has no limitation in daily activities had a €78.11 reduction in weekly income (OLS = − 78.110**)
Summary
Additional needs associated with behavioural, developmental and physical child chronic illness or disability such as the time costs of caring for a child who may be distressed or unwell and needs constant supervision and support, attending medical appointments, out-of-pocket expenditure and psychological impact can impinge upon many dimensions of family wellbeing [1, 2]. Given the demands placed on trying to sustain employment and manage family responsibilities, it is important to establish what are the economic spillover effects of caring for a child with a chronic illness or disability with regard to generating a household income and maintaining a standard of living. These economic aspects are of particular relevance to this paper for two reasons.
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