Kelly Noonan

Impact of Child Disability on the Family

Families with disabled children represent a sizeable share of all American households. Living with a disabled child can have profound effects on the entire family, which in turn can affect the health and well-being of the child who is disabled. Much needs to be learned about how children’s health affects their parents, siblings, and other family members and about how family characteristics and resources modify those associations. Numerous programs and organizations provide resources for disabled children and their families, but the system is extremely fragmented and difficult to navigate. This commentary reviews what is known about the effects of child disability on the family, provides an overview of the complex needs of and multitude of resources available to families of disabled children, and concludes with suggested directions for practice, research, and public policy.

Was the economic crisis of 2008 good for Icelanders? Impact on health behaviors

This study uses the 2008 economic crisis in Iceland to identify the effects of a macroeconomic downturn on a range of health behaviors. We use longitudinal survey data that include pre- and post-reports from the same individuals on a range of health-compromising and health-promoting behaviors. We find that the crisis led to large and significant reductions in health-compromising behaviors (such as smoking, drinking alcohol or soft drinks, and eating sweets) and certain health-promoting behaviors (consumption of fruits and vegetables), but to increases in other health-promoting behaviors (consumption of fish oil and recommended sleep). The magnitudes of effects for smoking are somewhat larger than what has been found in past research in other contexts, while those for alcohol, fruits, and vegetables are in line with estimates from other studies. Changes in work hours, real income, financial assets, mortgage debt, and mental health, together, explain the effects of the crisis on some behaviors (such as consumption of sweets and fast food), while the effects of the crisis on most other behaviors appear to have operated largely through price increases.

Infant health production functions: what a difference the data make

We examine the extent to which infant health production functions are sensitive to model specification and measurement error. We focus on the importance of typically unobserved but theoretically important variables (typically unobserved variables, TUVs), other non-standard covariates (NSCs), input reporting, and characterization of infant health. The TUVs represent wantedness, taste for risky behavior, and maternal health endowment. The NSCs include father characteristics. We estimate the effects of prenatal drug use, prenatal cigarette smoking, and first trimester prenatal care on birth weight, low birth weight, and a measure of abnormal infant health conditions. We compare estimates using self-reported inputs versus input measures that combine information from medical records and self-reports. We find that TUVs and NSCs are significantly associated with both inputs and outcomes, but that excluding them from infant health production functions does not appreciably affect the input estimates. However, using self-reported inputs leads to overestimated effects of inputs, particularly prenatal care, on outcomes, and using a direct measure of infant health does not always yield input estimates similar to those when using birth weight outcomes. The findings have implications for research, data collection, and public health policy.

Termination of parental rights: Which foster care children are affected?

Abstract In 1997, the Adoption and Safe Families Act (ASFA) was passed with a primary goal of expediting the process of placing foster children with permanent or adoptive families. In order to meet this goal, ASFA requires states to terminate parental rights if a child has been in foster care for 15 of the most recent 22 months. Prior empirical research on foster care dependence supports the provision in ASFA to expedite the discharge process because over time children are progressively less likely to be discharged from foster care. However, very little research has examined what impact terminating parental rights will have on this goal. One of the first steps is to examine which children are most likely to see the rights of their parents terminated and how these children differ from those children who are returned home. Using a competing risks hazard model we find many differences between the children who are sent home and those children whose parents have their rights terminated.

Lifecycle Effects of a Recession on Health Behaviors: Boom, Bust, and Recovery in Iceland

This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality.

Life Shocks and Crime: A Test of the “Turning Point” Hypothesis

Other researchers have posited that important events in men’s lives—such as employment, marriage, and parenthood—strengthen their social ties and lead them to refrain from crime. A challenge in empirically testing this hypothesis has been the issue of self-selection into life transitions. This study contributes to this literature by estimating the effects of an exogenous life shock on crime. We use data from the Fragile Families and Child Wellbeing Study, augmented with information from hospital medical records, to estimate the effects of the birth of a child with a severe health problem on the likelihood that the infant’s father engages in illegal activities. We conduct a number of auxiliary analyses to examine exogeneity assumptions. We find that having an infant born with a severe health condition increases the likelihood that the father is convicted of a crime in the three-year period following the birth of the child, and at least part of the effect appears to operate through work and changes in parental relationships. These results provide evidence that life events can cause crime and, as such, support the “turning point” hypothesis.

Maternal Depression as a Risk Factor for Family Homelessness

OBJECTIVES We estimated the effects of maternal depression during the postpartum year, which is often an unexpected event, on subsequent homelessness and risk of homelessness in a national sample of urban, mostly low-income mothers. METHODS We used logistic regression models to estimate associations between maternal depression during the postpartum year and both homelessness and risk of homelessness 2 to 3 years later, controlling for maternal and family history of depression, prenatal housing problems, and other covariates. Risk factors for homelessness included experiencing evictions or frequent moves and moving in with family or friends and not paying rent. RESULTS We found robust associations between maternal depression during the postpartum year and subsequent homelessness and risk of homelessness, even among mothers who had no history of mental illness, whose own mothers did not have a history of depressive symptoms, and who had no previous housing problems. CONCLUSIONS This study provides robust evidence that maternal mental illness places families with young children at risk for homelessness, contributes to the scant literature elucidating directional and causal links between mental illness and homelessness, and contributes to a stagnant but important literature on family homelessness.

Low Birth Weight and Cognitive Outcomes: Evidence for a Gradient Relationship in an Urban, Poor, African American Birth Cohort.

This study is one of the first to investigate the relationship between low birth weight and cognitive outcomes in an urban, poor, prospectively designed African-American birth cohort. Multivariate analyses of the Pathways to Adulthood study, a subset of the Johns Hopkins Collaborative Perinatal study, compared low birth weight African-American children with normal birth weight AfricanAmerican children on the Wechsler Intelligence Scale for Children (WISC) at seven years of age. When controlling for various sociodemographic factors, associations were obtained for the very low birth weight group (less than 2000 g) indicating an overall 7 point IQ difference. Milder associations were reported in the moderately low birth weight (MLBW) group (2000 to 2500 g) resulting in a 3 IQ point decrement compared to a normal birth weight reference group. There were no differential effects for gender. Our study revealed a gradient relationship between low birth weight/preterm birth and cognitive ability. Implications for school psychology prevention, assessment, and intervention are discussed.

Effects of maternal depression on family food insecurity

We use data from the Early Childhood Longitudinal Study-Birth Cohort to estimate the effects of maternal depression, a condition that is fairly common and can be severe, on food insecurity, a hardship that has increased substantially in the U.S. Using various model specifications, we find convincing evidence that severe maternal depression increases the likelihood that young children experience food insecurity by 23-79%, with estimates depending on model specification and measures of depression and food insecurity. For household food insecurity, the corresponding estimates are 11-69%. We also find that maternal depression increases reliance on several types of public programs, suggesting that the programs play a buffering role.

Demand for Illicit Drugs Among Pregnant Women

We use postpartum survey data linked to medical records and city-level drug prices to estimate the demand for illicit drugs among pregnant women. We find that a