The Effect of Adverse Childhood Health Conditions on Family Structure

• In Event: Policy Perspectives on Relationship Stability and Divorce

Abstract

Research Question: More than one in four children experience chronic conditions each year in the US. Childhood conditions affect not only children’s health but also parents’ labor supply, caregiving responsibilities, and household well-being, potentially altering family stability and subsequent fertility decisions. This study aims to explore the effect of having a child with an adverse health condition on parental divorce and the decision to have an additional child.

Contribution: Existing evidence relies primarily on small survey samples or focuses on individual conditions, making it difficult to assess the overall effects of childhood health conditions or compare their impacts across conditions. We use uniquely linked Michigan administrative records, including birth, Medicaid, and divorce records, to identify the timing of first diagnoses across ten serious childhood health conditions.

Method: We use propensity score matching to construct comparable groups of families with and without a child diagnosed with a serious health condition, based on a rich set of observed demographic, socioeconomic, and family characteristics. We then use survival analysis to examine whether and how the timing of a child’s adverse health condition is associated with subsequent family outcomes. Specifically, we estimate Cox proportional hazards models to assess the relationship between having a child with a serious health condition and the hazard of parental divorce, as well as the hazard of having an additional child among families that remain intact.

Key Findings: We find that having a child with a serious health condition increases the hazard of parental divorce by 13.5 percent and accelerates the timing of parental divorce by 10.3 percent. Among intact families with a first-born child, these health conditions also reduce the hazard of having a second child by 7.7 percent and delay the timing of the second birth by 8.6 percent. This paper provides the first comprehensive evidence on how a broad range of childhood health conditions influences parental divorce and subsequent fertility decisions, highlighting the broader family consequences that should be considered when designing policies for children with serious health conditions.

Authors

• Huong Nguyen, Wayne State University
  Presenting Author

• Owen Michael Fleming, Wayne State University
  Non-Presenting Co-Author