Childhood health shocks and parental labor supply
Discussant: Marianne Simonsen
The fundamental problem in estimating the causal impact of poor health on outcomes is that poor health is not randomly assigned. Those who are in poor health are likely to suffer from other disadvantages which would cause their outcomes to be worse for reasons other than health. By utilizing very detailed registry data, we demonstrate that children (and their parents) who get diabetes are similar to their healthy peers along an array of observable characteristics
Type 1 diabetes has – from an identification viewpoint – a nice set of features: Heritability is low; the vast majority of individuals affected do not have any immediate relatives with the condition. The condition cannot go undiagnosed nor can it be prevented. Symptoms develop within a very short timeframe of weeks to a couple of months, and treatment with insulin injections is fundamental for survival.
Type 1 diabetes is a complex disease to manage because it is cognitively demanding to constantly monitor glucose and adjust insulin levels. Thus, parents will likely need to shift some of their resources to helping manage the disease. Applying detailed information on disease management from blood samples drawn from affected individuals, we find the level of disease management varies by the education of the mother (academic degree versus less educated). At the time of diagnosis, children have the same high level of glucose concentration as measured by the HbA1c. One year after diagnosis and beyond we see gaps in disease management (HbA1c levels) by maternal education. This has important implications for clinicians who are trying to help patients better manage the disease.