Journal Issue: Immigrant Children Volume 21 Number 1 Spring 2011
Health status is a vital aspect of human capital. Un- healthy workers are less productive, more costly for employers, and earn less over their lifetimes. A growing literature links adult ailments to childhood experiences. For example, childhood asthma and obesity rates are associated with a myriad of chronic illnesses in adulthood (such as diabetes, hypertension, and coronary disease). For the children of immigrants, poverty, the stresses of migration, and the challenges of acculturation can substantially increase their risk for the development of physical and mental health problems. This article documents the evidence about differences in the health status of immigrant youth, including systematic variation in health-compromising behavior and access to health services. It concludes with a discussion of policy implications and strategies to reverse the troubling trends.
Numerous studies document the human capital cost of poor health in adulthood. Obesity, psychiatric disorders, and substance use, for example, affect large numbers of Americans and have all been shown to reduce adult employment and earnings significantly.1 Largely because of technical challenges and data limitations, fewer studies have examined the human capital costs of poor health in childhood. Nevertheless, evidence that poor childhood health negatively influences adult education, employment, and socioeconomic status has begun to accumulate.
Early research into the human capital costs of poor childhood health evaluated the educational consequences of teenage childbearing and substance use, especially alcohol and illicit drug use. Results were mixed, with some analysts finding significant reductions in educational attainment—lower rates of high school graduation, college graduation, and years of schooling—related to illicit drug use. Other studies found small or insignificant reductions in educational attainment related to alcohol use or teenage childbearing.2
More recent studies have examined the consequences of childhood illnesses, nutrition, physical activity, excessive weight, and mental health for educational attainment, measured by grade completion and graduation, and for achievement, measured by grades and test scores. These analyses demonstrate that the negative consequences of poor childhood health are apparent as early as kindergarten and continue into adulthood.3 Childhood asthma and other illnesses result in frequent emergency room visits, hospitalizations, and school absenteeism, and consequently lower math and reading achievement.4 Childhood mental health or behavioral problems such as depression and hyperactivity negatively influence performance on standardized math and reading scores in elementary school. Mental health and behavioral problems also increase the likelihood of dropping out of high school and not attending college.5 In contrast, good nutrition and regular physical activity in elementary school can improve school attendance, engagement in school, and academic performance.6
Even when studies find that child health or health behaviors have only a small influence on educational outcomes, the economic costs of poor child health and health behaviors can be high. The negative effects of poor health in childhood can persist and accumulate over time. Therefore, adults with poor childhood physical or mental health or unhealthy behaviors can experience lower rates of labor force participation, employment, and, ultimately, earnings.7 Subsequently, the low socioeconomic status of these adults contributes to poor childhood health outcomes among their children. As a result, poor childhood health perpetuates socioeconomic inequalities across family generations.8 This cycle can be particularly pernicious for low-income minority populations such as the children of disadvantaged immigrants and, because of the rapid growth in the numbers of immigrant children, for the nation as a whole.