Studying Health Within the NLSY(97, 79

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Studying Health Within the NLSY(97, 79
Child,Youth surveys)

• Pamela J. Salsberry
• College of Nursing
• Patricia B. Reagan
• Department of Economics

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Outline

• General comments about using the NLSY79 and
  related child files for health related research
• Specific data elements available for
  analysisadult, child, youth surveys
• Examples
• Questions/comments

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Why use the NLSY to study healththe positive
argument

• Interested in a life course perspective
• Interested in sibling models to control for
  unobserved heterogeneity
• Interested in the influence of family context on
  child health

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Why use the NLSY to study health, continued

• Interested in maternal influences on the health
  of her children
• Examine health of the childs impact on career
  trajectories of mothers
• Examine the intersection of multiple influences
  on health outcomes across time

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The negative argument or why the NLSY is not good
to examine health

• Many data sets are available that may be more
  appropriate to your research questions (NHIS,
  NHANES, MEPS, Medicares Current Beneficiary
  Survey)
• Limited data on health status early on in
  NLSY79related to ability to work

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The negative argument, continued

• Health data is self-reported
• No physiological measures to confirm diagnosis,
  no laboratory data (e.g., BPs, Cardiovascular
  indicators, EKGs)
• Population based sample which can only be used to
  study relatively common health conditions

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Adult Health Before Age 40

• Height
• Weight
• Does health limit amount or kind of work
  respondent can do?
• 1979, 1980 specific conditions causing limitation

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Health Module for those 40 years of age

• CESD7 items (92, 20-items 94-7 items)
• Parents health status (living/dead, age of death,
  cause of death)
• SF-12
• Health conditions- CVD, diabetes, asthma

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Risky Behaviors and HealthAdults (selected years)

• Smoking (could be important to track for any
  asthma study)
• Drug use
• Seat belt use, attitudes towards risk
• No diet or exercise histories

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Health Insurance--Adults

• Limited to 89, 90, 92-2004
• Determines coverage status and who pays for the
  plan (e.g., private, Medicaid)
• Same set of questions about the children and
  spouse

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Health Services Utilization- Adults Health at 40
Module

• Health services use (last saw a health provider)
• Important for ambulatory use sensitive
  conditions, like asthma

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Health Children of the NLSY

• Does health limit ability to attend school or
  play (for preschool children)?
• List of health disabling conditions (most
  frequent are asthma and learning disability)
• Injuries and accidents
• Height
• Weight
• Age of Menarche (females)

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Health Children of the NLSYContinued

• Birth weight
• Length of gestation
• Length
• Maternal behaviors
• Prepregnancy weight
• Smoking during pregnancy
• First trimester health care visit

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Risky Behaviors

• Asked only of those 10-14
• Drug, alcohol, sexual activity

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Health Insurance for the Child

• Is child covered by health insurance provided by
  an employer or an individual plan?
• Is child covered by Medicaid?

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Health services use

• Last time had routine health check
• Last dental visit
• Cautionquestion about required health
  carewording leaves open the possibility of
  needing, but not receiving
• Seen by psychiatrist, counselor, psychologist

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Health Module for Young Adults

• Health limitationswork and school
• List of health conditions
• Health status question (Poor to Excellent)
• Accidents or injuries
• Fertility modules
• Height
• Weight

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Risky behaviors and HealthYoung Adults

• Self report booklet
• Sex birth control
• Drugs alcohol
• Abortions

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Health Insurance for the Young Adults

• Source of coverageparent, employer, self
• Covered by Medicaid?

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Health services useYoung Adult

• Last time had routine health check
• Last time seen for treatment of an illness
• Cautionquestion about required health
  carewording leaves open the possibility of
  needing, but not receiving

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NLSY 97 Health

• General Health
• Height
• Weight
• Perceptions about weight
• Chronic conditions Rounds 1 6
• Age of menarche (females)

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NLSY97 Risky Behaviors

• Agegt14
• Cigarettes, alcohol, drugs
• Sexual behavior
• Birth control

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NLSY97- Health Insurance and Utilization of
Services

• Insurance coverage- Rounds 1 6
• Visit doctor in past 12 months- Round 6

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Research Applications

• Birth Outcomes
• Development of childhood overweight

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Birth Outcomes- Mothers are NLSY79 Respondents

• Issues to consider
• Children born to teens occurred in the earliest
  years of the surveyby mid-1980s all respondents
  were aged 20 --so that if you wish to ask
  questions about teen births then one must
  consider whether the time differences are
  important

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Studying Birth Outcomes

• Time trends in health care for example
  scheduled preterm deliveries have increased
  over the last 20 years
• Birth weights
• Gestational agepreterm deliveries
• SGA and LGA determination

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Variables of interest

• Individual
• Age of mother, parity
• Interval between pregnancies
• Previous preterm infant
• Maternal prepregnancy weight
• Risk behaviors of the mother (smoking, drinking,
  drug use)
• Individual SESfamily income, marital status,
  education

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Determining Prepregnancy BMI

• Recording of data slightly different
• Height asked at three time points(1981, 1982,
  1983(for women only) and 1985)
• 19814004 feet, 0 inches
• 1983feet and inches
• 1985inches
• There are some out of range values
• Only self-report measures

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Preterm Study Reagan/Salsberry Social Science
and Medicine 2005

• Research Aim To examine effect of social context
  on differences among blacks, whites, and
  Hispanics in rates of moderately preterm
  (gestation 33-36 weeks) and very preterm infants
  (lt33 weeks) relative to term births.

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Contextual Measure

• Lifetime exposure to income inequality
• fraction of mothers life since age 14 that she
  had spent in a state with a Gini coefficient
  above the yearly median

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Findings

• Blacks gt very preterm
• First births lt preterm/very preterm
• Short interval pregnancies gt preterm/very preterm
• Drug use during pregnancygt preterm/very preterm
• Cumulative exposure to income inequality
  Hispanics gt very preterm

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Studying Child Overweight

• Questions slightly different
• Need to convert to percentile rankings for age
  and sex
• Use of CDC program to standardize BMI
• Height in inches
• Weight in ounces
• Sex
• Age in months

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Studying Child Overweight

• Measured vs. reported data
• Question asked if child can be measuredif not,
  then measures are reported by the mother. There
  is a follow up question on how the data were
  obtained (except for 86question not asked).
  Generally 70 or more are measured. We have found
  that measured heights and weights result in less
  overweight than the self-report data,

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Development of overweight in Children
Salsberry/Reagan Pediatrics 2005

• Research aim To examine the timing and extent
  of early life influences on the development of
  overweight in children from birth through age 7.

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Sample

• Children of the NLSY
• NLSY79
• Merged mom information, prenatal information,
  with child information
• In this study we needed data at four time
  pointsneeded birth information, and interviews
  at 2/3, 4/5, 6/7

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Findings

• Prepregnancy obesity Smoking during pregnancy gt
  overweight 2/4
• Prepregnancy obesity Smoking during pregnancy gt
  overweight 4/6 and 6/8 conditional on prior
  overweight
• Race/ethnic differences

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Comments/Discussion