Abstract
Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects’ fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13–18%), 13% (95% CI: 10–15%), and 14% (95% CI: 12–17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups.
Highlights
Individual health is not static and often changes as a result of the exposure to various life events [1,2]
Males were more likely to report poor adult health outcomes measured by self-report health, cognition, and physical function than females, but these differences are statistically insignificant
In the multivariate logistic regression results without correcting for endogeneity we found that: a good childhood health status increased the probability of good self-reported adult health, good adult cognitive function, and good adult physical function by 16%, 13%, and 14%, respectively
Summary
Individual health is not static and often changes as a result of the exposure to various life events [1,2]. Previous research shows that a poor childhood health status has a long-range negative influence on adult health outcomes in terms of self-reported health status, chronic diseases, and successful aging [3,4,5,6,7,8,9,10,11,12,13]. The question of whether and to what extent poor childhood nutrition and health in the 1950s and 1960s has affected adult health outcomes in China remains unclear. The present study seeks to address this issue by estimating the effects of childhood health on adult health outcomes in people between 45 and 61 years of age in 2011. If childhood health is found to be associated with health in adulthood in China, public health interventions focusing on childhood health will lead to additional long-range benefits
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