How are Parents’ Work Schedules Associated with Their Children’s Health and Health Care Utilization?

• In Event: Determinants and Consequences of Work Schedule Quality for Child and Family Well-Being

Abstract

In the United States’ 24/7 economy, many low-wage workers experience poor quality work schedules, including nonstandard, variable, and unpredictable schedules. This is concerning because poor quality schedules are expected to harm children’s health and development by reducing families’ resources for investing in children (i.e., parents’ time and economic, physical, and psychological wellbeing) and disrupting family processes (i.e., parenting) (Li et al., 2014; Walther & Pilarz, 2024). While prior research has found that parents’ poor quality work schedules are associated with poorer socioemotional wellbeing in young children (e.g., Schneider & Harknett, 2022; Walther & Pilarz, 2024), less attention has been paid to how work schedule quality is associated with young children’s health outcomes. Given that socioeconomic disparities in health begin early in life (Chen et al., 2006), unpacking the consequences of poor quality schedules is critical to understanding family inequality and policy levers for mitigating their harmful effects. This study addresses this gap by examining associations between four dimensions of work schedule quality and health-related outcomes among families with young children.  

Using data from the 2021 National Health Interview Survey, we focus on children under age 6 and restrict our sample to children with an employed parent (sample size: N=1,606). Health outcomes include: parent-reported child health status (excellent vs. very good, good, fair, or poor) and child injury in the past three months. Healthcare utilization outcomes include: whether the child had any ER/ED visit and any urgent care visit in the past year. We examine four dimensions of work schedule quality: nonstandard schedule (regular evening, regular night, rotating shifts vs. regular daytime hours), variable schedule (i.e.,  schedule changes on a regular basis), unpredictable schedule (i.e., schedule changes with <1 week’s notice), and inflexible schedule (i.e., very/somewhat difficult to change schedule vs. very/somewhat easy). To minimize selection bias in work schedule quality, we employ propensity score weighted regression models, using boosted logistic regression – a machine learning approach – to estimate propensity scores. We examine parental physical and mental health outcomes as possible mechanisms.   

Nonstandard work schedules were associated with a 9%-11% lower probability of children being reported in excellent health, with larger effects among mothers (rather than fathers) and parents without a college degree (versus those with). We found suggestive evidence that nonstandard work schedules were associated with increased injury risk but found no associations with health care utilization outcomes. Other aspects of work schedule quality were not statistically significantly associated with any child health-related outcomes. Analyses of mechanisms suggest that each indicator of poor work schedule quality is associated with poorer parental mental health. 

Health in early childhood has critical implications for children’s health and socioeconomic trajectories throughout the life course. Our findings suggest that parental work schedule quality might contribute to poor parental and child health and to socioeconomic disparities in early childhood health. This research offers valuable insights for real-world local, state, and federal policymaking by identifying potential points of intervention to improve child health during a critical developmental period.

Author

• Stephanie Hong, Stony Brook University
  Presenting Author