Poster #73 - Investments in Childhood Community Resources and Subsequent Adult Health Outcomes

• In Event: Friday Poster Reception

Abstract

Importance: Community resources may benefit children’s long-term health, but the lasting impact of public spending in childhood is unclear. Identifying policies to address residential wealth and opportunity disparities could promote long-term health equity.
Objective: To assess whether childhood exposure to public spending on community resources (public primary and secondary education, libraries, parks and recreation, community development, and housing) is associated with subsequent adult health.
Design: Retrospective cohort study using linked national datasets from 1977–2019.
Setting: Individuals living in U.S. cities with 150,000 residents in 1980. Childhood public finance data covered 1977-2017; adult health was measured in 2019.
Participants: Adults in the 2019 Panel Study of Income Dynamics, born 1960-2000, who lived in a medium to large city before age 18.
Exposure: Total per-capita spending on community resources, summed across city, county, and school district levels for the year and city when the respondent was age nine.
Main Outcome(s) and Measure(s): The main outcome was overall adult health rated as fair or poor.
Secondary outcomes included cardiovascular disease, anxiety, and depression diagnoses. We used weighted linear probability models adjusted for demographics. Predicted margins compared the 25th and 75th percentiles of spending. Analysis was performed from 2024-2026.
Results: Among 2,214 adults (average age 39, 52% female, 53%), 17% reported fair/poor health, 22% cardiovascular disease, and 10% anxiety or depression. A 1% increase in childhood community resource spending was associated with a 0.20 percentage point (95% CI: 0.04%, 0.35%) decrease in adult fair/poor health and a 0.25 percentage point (95% CI: 0.07%, 0.44%) decrease in adult cardiovascular disease. To contextualize the magnitude, shifting from 25th to 75th spending percentile decreased the predicted probability of reporting adult fair/poor health from 19% to 13%. Education and library spending correlated with better overall health; education, community development, and housing spending were linked with lower cardiovascular disease. No association was found with anxiety or depression.
Conclusions and Relevance: In this cohort study of U.S. adults, greater childhood exposure to community resource spending was associated with improved overall and cardiovascular health in adulthood. Variation in public spending levels may partially explain geographic differences in U.S. health outcomes.

Author

• Jaime Michelle La Charite, University of California - Los Angeles
  Presenting Author