Early Trouble, Long-term Consequences: Family Instability in Childhood and the Intent to Seek Formal Health Care

• In Event: 393 - Section on Children and Youth Paper Session. Pre and Post-Natal Influences on Children

Abstract

One premise of the U.S. Affordable Care Act is that mandatory health care insurance will encourage people to use formal health care to treat health problems. Most research supports this assumption, finding that having health care predicts getting treatment, independent of health problems and prior medical history. The decision to seek health care may however be influenced by less proximate factors. A life course approach suggests that childhood experiences initiate health and health care use trajectories that operate in adulthood. This study explores the impact of one experience, family instability, on the intention to seek formal health services in adulthood. It also investigates how potential consequences of family instability—childhood poverty and unhappiness for example—mediate the association. It examines the intention for two distinct health problems, depression and chronic body pain, with data collected from service workers in two cities from two countries that have dramatically different approaches to health care: Canada and the U.S. The results demonstrates that high levels of change in family structure during childhood lower the odds of intending to use formal care, independent of a number of demographic attributes, mediating mechanisms, mental and physical health, and access to health care. Consistent with a life course perspective, our results indicate that distal factors, such as those that occur in early childhood, have long-term consequences for health care service use and thus for health.

Authors

• Ethan J. Evans, University of California-Davis

• Bill McCarthy, University of California-Davis

• Cecilia M. Benoit, University of Victoria

• Mikael Jansson, University of Victoria