Studying Health Within the NLSY

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Transcript Studying Health Within the NLSY

Studying Health Within
the NLSY(97, 79 &
Child,Youth surveys)
Pamela J. Salsberry
College of Nursing
Patricia B. Reagan
Department of Economics
 General comments about using the
NLSY79 and related child files for health
related research
 Specific data elements available for
analysis—adult, child, youth surveys
 Examples
 Questions/comments
Why use the NLSY to study
health—the 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
Why use the NLSY to study
health, continued
 Interested in maternal influences on the
health of her children
 Examine health of the child’s impact on
career trajectories of mothers
 Examine the intersection of multiple
influences on health outcomes across
The negative argument or why the
NLSY is not good to examine
 Many data sets are available that may
be more appropriate to your research
questions (NHIS, NHANES, MEPS,
Medicare’s Current Beneficiary Survey)
 Limited data on health status early on in
NLSY79—related to ability to work
The negative argument,
 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
Adult Health Before Age 40
 Height
 Weight
 Does health limit amount or kind of work
respondent can do?
 1979, 1980 specific conditions causing
Health Module for those 40
years of age
 CESD—7 items (92, 20-items; 94-7
 Parents health status (living/dead, age of
death, cause of death)
 SF-12
 Health conditions- CVD, diabetes,
Risky Behaviors and Health—
Adults (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
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
Health Services UtilizationAdults Health at 40 Module
 Health services use (last saw a health
 Important for ambulatory use sensitive
conditions, like asthma
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
 Injuries and accidents
 Height
 Weight
 Age of Menarche (females)
Health – Children of the NLSY
 Birth weight
 Length of gestation
 Length
 Maternal behaviors
Prepregnancy weight
Smoking during pregnancy
First trimester health care visit
Risky Behaviors
 Asked only of those 10-14
 Drug, alcohol, sexual activity
Health Insurance for the Child
 Is child covered by health insurance
provided by an employer or an individual
 Is child covered by Medicaid?
Health services use
 Last time had routine health check
 Last dental visit
 Caution—question about required health
care—wording leaves open the
possibility of needing, but not receiving
 Seen by psychiatrist, counselor,
Health Module for Young
 Health limitations—work and school
 List of health conditions
 Health status question (Poor to
 Accidents or injuries
 Fertility modules
 Height
 Weight
Risky behaviors and Health—
Young Adults
 Self report booklet—
Sex & birth control
Drugs & alcohol
Health Insurance for the
Young Adults
 Source of coverage—parent, employer,
 Covered by Medicaid?
Health services use—Young
 Last time had routine health check
 Last time seen for treatment of an illness
 Caution—question about required health
care—wording leaves open the
possibility of needing, but not receiving
NLSY 97 Health
 General Health
 Height
 Weight
 Perceptions about weight
 Chronic conditions Rounds 1 & 6
 Age of menarche (females)
NLSY97 Risky Behaviors
 Age>=14
 Cigarettes, alcohol, drugs
 Sexual behavior
 Birth control
NLSY97- Health Insurance
and Utilization of Services
 Insurance coverage- Rounds 1 & 6
 Visit doctor in past 12 months- Round 6
Research Applications
 Birth Outcomes
 Development of childhood
Birth Outcomes- Mothers are
NLSY79 Respondents
Issues to consider:
Children born to teens occurred in the
earliest years of the survey—by mid1980s 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
Studying Birth Outcomes
 Time trends in health care – for example
“scheduled” preterm deliveries have
increased over the last 20 years
 Birth weights
 Gestational age—preterm deliveries
 SGA and LGA determination
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 SES—family income, marital
status, education
Determining Prepregnancy
 Recording of data slightly different
 Height asked at three time points(1981,
1982, 1983(for women only) and 1985)
1981=400=4 feet, 0 inches
1983=feet and inches
 There are some out of range values
 Only self-report measures
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 (<33 weeks) relative
to term births.
Contextual Measure
Lifetime exposure to income
inequality :
fraction of mother’s life since age
14 that she had spent in a state
with a Gini coefficient above the
yearly median
 Blacks > very preterm
 First births < preterm/very preterm
 Short interval pregnancies >
preterm/very preterm
 Drug use during pregnancy>
preterm/very preterm
 Cumulative exposure to income
inequality Hispanics > very preterm
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
Age in months
Studying Child Overweight
 Measured vs. reported data
 Question asked if child can be
measured—if not, then measures are
reported by the mother. There is a
follow up question on how the data were
obtained (except for 86—question 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,
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.
 Children of the NLSY
 NLSY79
 Merged mom information, prenatal
information, with child information
 In this study we needed data at four time
points—needed birth information, and
interviews at 2/3, 4/5, 6/7
 Prepregnancy obesity & Smoking during
pregnancy > overweight 2/4
 Prepregnancy obesity & Smoking during
pregnancy > overweight 4/6 and 6/8
conditional on prior overweight
 Race/ethnic differences