American Economic Association

Family Health, Children's Own Health, and Test Score Gaps

Author(s): Rodney J. Andrews and Trevon D. Logan
Source: The American Economic Review, Vol. 100, No. 2, PAPERS AND PROCEEDINGS OF THE
One Hundred Twenty Second Annual Meeting OF THE AMERICAN ECONOMIC ASSOCIATION (May
2010), pp. 195-199
Published by: American Economic Association
Stable URL: http://www.jstor.org/stable/27804988
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100 (May 2010):

American Economic Review: Papers & Proceedings
100.2.195
h tip://www. aea web. org/articles.php ?doi=l0.1257/aer.

195-199

Family Health, Children's Own Health, and Test Score Gaps

By Rodney

J.Andrews

in educational performance between

Gaps
whites and racial minorities are not present at
early ages but do emerge early in the schooling
years and increase over time (Roland Fryer and
Steve Levitt 2006, forthcoming). JamesHeckman
(2007) assembles evidence from both the bio
logical and social sciences which highlights the
"dynamic complementarity" of the learning pro
cess?the notion that early learning is vital for
learning

later on. A

recent

literature

in econom

ics findsevidence that the returns to early invest

ments in children yield high returns to society
(Heckman and Dimitriy Masterov 2007). That
educational gaps exist and worsen over time is
troubling as educational attainment is associated
with a host of socioeconomic outcomes such as
health, earnings, and wealth (David Cutler and
Adriana Lleras-Muney 2008). At the same time,
gaps in educational performance and outcomes
are but one dimension of racial inequality. One
area of research has been with respect to racial
health disparities, which unlike educational dis
parities appear at very early ages and increase
over time (Linda Dynan (2009) provides a lit
erature review). Little work, however, directly
analyzes how health disparities in children may
impact other outcomes.1 The fact thathealth out
comes

may

lead

to socioeconomic

differences

which themselvesmay lead to furtherhealth and

and Trevon

D. Logan*

socioeconomic disparities requires a consider

ation of the nonhealth outcomes that could be
attributed to health disparities.
This paper aims to bring the relationship
between educational and health inequality into
sharper focus by considering their interac
tion.We concentrate in this paper on the initial
accounting

exercise

gaps

Hispanic-white

disclaimer applies.
1
One exception is Janet Currie (2005), who estimates
that racial differences in children's health conditions and in
maternal health and behaviors may account for as much as
25 percent of the racial gap in school readiness.

as motivation

on

assessments

of

read

ing and mathematics. When we add controls

for parental health, however, we find large and
significant reductions in themagnitude of both
black-white and Hispanic-white gaps for both
the reading and mathematics assessments. For
example, accounting for children's and paren
tal health reduces themagnitude of black-white
gaps on the reading assessment and mathematics
assessment forkindergarten students by approx
imately 23 percent and 17 percent, respectively.
For Hispanics, the reduction is nearly 13 percent
and

10 percent,

respectively.2

I. Health
*Andrews:
of Economics,
University of
Department
Road MS WT21,
800 West Campbell
Texas at Dallas,
Richardson, TX 75080 (e-mail: rodney.j.andrews@utdallas.
The Ohio State
of Economics,
edu); Logan: Department
University and NBER, 410 Arps Hall, 1945 N. High Street,
The
Columbus, OH 43210 (e-mail: logan.155@osu.edu).
views expressed in this paper are those of the authors and
do not necessarily represent those of the NBER. We thank
Rucker Johnson and other session participants of the 2010
annual meetings for help
American Economic Association
ful comments and discussions. We also thank the Robert
Wood Johnson Foundation for financial support. The usual

serves

which

for future analysis, which we argue should be

dynamic. Using a panel dataset thataccounts for
parental health, child health, and child educa
tional outcomes, we estimate the size of the edu
cational gaps that can be attributed to parental
and child health disparities.
We find that accounting for children's health
has very small effects on both black-white and

and Learning

We begin by considering a production func

tion for an educational outcome Y:

=
(1) Y, m,

AnT,(H?,TP(HP),IP(Hp),
X]

where subscripts i and P refer to the child and

parent, respectively.H is health, A, is the child's
ability, T{ refers to the amount of time the child
allocates toward studying (a function of //,),

2
We find similar patterns for the firstgrade, third grade,
and fifthgrade once parental health is controlled for.

195

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196 AEA PAPERSAND PROCEEDINGS MA Y 2010

Tp is the amount of time that parents allocate
towards the child (a function of HP), IP is the
parent's income (also a function ofHP), and X
represents other characteristics that affect the
outcome.

We

assume

that

in health,

increases

ability, time, and income positively influ

ence outcomes: (df/dH,) > 0, [df/dA^ > 0,

> CV
m/dTt) > 0,
W/dTp) > 0, and (dfi/dlp)
Since we assume that the health of children
has a direct effect and thathealthier children are
able to devote more time to studying, it is clear
that an increase (decrease) in the health of the
child leads to greater (fewer) educational out
comes?that is, (dYi/dHi) > 0.
Changes in parental health have direct and
indirect effects on child outcomes:

II. Methodology

A. Methodology
In most analyses of disparities, researchers
usually estimate:

F, - ?t? + ?^L + ?lB + e;

(3)

where Y( represents the test scores of the child.

Xt represent a series of controls and L and B are
dichotomous indicators for race if the child is
Hispanic or black, respectively.
Our conjecture is that the estimates of ?\ and
?*2

are

contaminated.5

dYj =
dHP

dft dTP
?Tp dHp

ft dip '
dip dHP

first term on the right side in equation

(2) represents the effect of parental health via
its effect on parental time. We assume that
is, healthier parents are
(dTp/dHp) > 0?that
able to devote more time towards children.
The second term to the right of the equality
sign represents the effect of parental health
via its effect on parental income. We assume
that dip jdHp is greater than zero, consistent
with the large literaturewhich finds a positive
correlation between self-reported health and
The

income.4

Given

our

assumptions,

we

conclude

that an increase (decrease) in parental health

positively (negatively) affects children's educa
tional

outcomes.

For simplicity we concentrate on the reduced

form relationships below. This framework can
be extended to test additional implications that
pertain specifically to time inputs and income
and a dynamic setting to account for temporary
and permanent shocks to parental and child
health,

parental

income,

and

other

factors.

we

Here,

estimate:

=
Yt ?tfi + ?lL + ?2B + ?3Hi

(4)
[}

and Data

+ ?4HP + ei
Our basic strategy is to compare the estimates
of ?\ and ?*2 from equation (3) and ?x and ?2
from equation (4). That is,we examine how the
racial

gap

in assessment

performance

changes

once child and/or parental health is accounted

for. If the additional health measures alter the
estimates, then this provides evidence that
health influences the unexplained gaps in edu
cational

performance.
B. Data

The data used in the analysis come from

the Early Childhood
Longitudinal
Study,
Kindergarten Class of 1998-1999 (ECLS-K).
The ECLS-K
followed a nationally representa
tive cohort of 21,260 children who were in kin
dergarten during the 1998-1999 academic year
intomiddle school. The base year data were col
lected during the spring of 1999.
The ECLS-K
collects information on chil
dren from a variety of sources, including
interviewswith the children, parents/guardians,
teachers,
include

and

school

anthropom?trie

administrators.

measurements

The

data

of

the

children, the children's family structure, infor

mation on the demographics of the schools that
they attend, and, most important to the analysis
3
For this analysis, we suppress the fact thatHt may be
a function of HP.
4
If we held that child health was a function of parental
health we would add idfJdH,) (dHjdHp)
to the derivative.

5
Note that there is no contamination if either the health
conditions have no effect on the outcome or there is no cor
relation between racial/ethnic status and the omitted health
conditions.

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FAMILY HEALTH,

100 NO. 2

VOL.

CHILDREN'S

that follows, measures of both children's and

parental health. The children's health measures
include the child's body mass index and a ques
tion that indicates whether the child was born
at least two weeks prematurely. The parental
health

measures

include

self-assess

parent's

ment of his/her own health status, and a ques

tion thatasks if the parent has a disability that is
severe enough to limitwork activities.
For brevity,we elide the consideration of the
structure

panel

of data

and

instead

focus

on ana

lyzing the cross-sectional samples that examine

score

assessment

the

saturated

in reading

performance

for kindergarten. The

and mathematics

include

regressions

an

fully

exhaustive

set

of indicators for race/ethnicity, demographic

information, indicators for the family's annual
income category, the highest level of educa
tion of a parent in the household, region, the
percentage of the child's school that is on free
or reduced price lunch, the parent's rating of
the child's health, as well as a set of indicators
that delineate the parent's response to 12 ques
tions from theCenter forEpidemiologie Studies
Depression Scale (CES-D).
III.

Results

Table 1 contains the estimates of both the

black-white and Hispanic-white gaps in perfor

mance

on

the reading

and mathematics

assess

in
ments administered as a part of theECLS-K
the
estimates
contains
Each
panel
kindergarten.
for a particular

assessment.6

Panel A of Table 1 contains the estimates

for the kindergarten reading sample. Our basic
specification in column 1only includes the race/
ethnicity indicator variables as controls. Thus,
the estimates displayed in column 1 reproduce
the unadjusted black-white and Hispanic-white
gaps. Column 2 adds the child health measures
to themodel.7 The addition of the child health
measures to the specification leads to small
and statistically insignificant changes in the

6
We

indicator variables for the

include in all models
following race/ethnic categories, black, Hispanic, Asian.
and Mixed Race. Non
Pacific Island, Native American,
Hispanic whites are the omitted category.
7
include indicators variables for
Child health measures
disability, premature birth (at least two weeks), frequent
ear infections, as well as parental assessment of the child's
health status and the child's body mass index.

OWN HEALTH,

AND TEST SCORE

197

GAPS

magnitude of the performance gaps between

blacks and whites and Hispanic and whites.
Relative to themagnitude of the unadjusted gap
in performance, the addition of child's health
measures

decreases

of the black

the magnitude

white disparity in performance by 0.7 percent;

whereas the gap between Hispanics and whites
actually increases by 2 percent.
When we add measures of parental health
to themodel in column 3, however, we observe
sizable and statistically significant declines
in the magnitude of both the black-white and
Hispanic-white gaps in performance on the
reading

assessment

for kindergarten

students.8

The black-white gap in performance declines

by 23 percent, and the Hispanic-white gap in
performance declines by 13 percent. Column 4
adds the demographic controls to the specifica
tion,while column 5 adds the school character
istics to the specification. The addition of these
characteristics furtherreduces themagnitude of
the gaps.

Panel B of Table 1 contains the estimates for

the unexplained gaps in performance for the

mathematics

assessment

administered

as

a part

The unadjusted black-white and

Hispanic-white gaps, which are contained in
column 1,exceed the analogous gaps we observe
for the reading assessment. Column 2 adds the
children's health measures to the model. For
both the black-white and Hispanic-white gaps in
performance, we observe small and statistically
insignificant changes in the magnitude of the
of theECLS-K.

performance

gaps.

As with the reading assessment, when we

add the parental health measures to the speci
fication in column 3, we observe declines in
the magnitudes of both the black-white and
Hispanic-white gaps thatare both economically
and statistically significant. The magnitude of
theblack-white gap inperformance on themath
ematics assessment declines by 17 percent, and
we observe a 10 percent decline in themagni
tude of theHispanic-white gap in performance
on

the mathematics

assessment.

When

we

add

8
include the following: an
The parental health measures
indicator variable that assumes a value of one if the par
ent has a disability that impairs work, a parent's assessment
of his or her own health, and indicator variables for the
various categories offered as answers to 12 questions from
Scale
Studies Depression
the Center for Epidemiologie
(CES-D).

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198 AEA PAPERSAND PROCEEDINGS MAY 2010

Table

in Kindergarten
Reading
by Race and Ethnicity

1?Differences

(1)

(2)

(3)

-4.26***

-4.23***

~~

Panel A. Reading
Black

Hispanic

Observations
R2
Panel B. Math
Black

(4)
(5)

-3.27***

-1.33***

(0.27)

(0.28)

(0.31)

(0.33)

-3.49***

-3.56***

-3.03***

-1.58***

-1.34***

(0.28)

(0.28)

(0.28)

(0.29)

(0.30)

9,330
0.05

9,330
0.07

9,330
0.10

9,330
0.21

9,330
0.21

-6.25***

-6.20***

-5.20***

-3.22***

-2.49***

(0.27)

(0.30)

(0.32)

-5.70***

-3.08***

-2.49***

(0.25)

(0.28)

-6.30***

(0.26)
-6.34***

(0.25)

(0.25)

Observations

9,742

9,742

9,742

Children's health
Parent's health

No
No
No
No

Yes
Yes
Yes
No
Yes Yes
NoNo
Yes
Yes
NoNo
No
Yes

Yes

0.10

R2

Scores

(0.27)

(0.26)
Hispanic

and Math

Demographics
School characteristics

0.12

-1.06***

(0.29)

9,742

0.15

9,742

0.24

0.24

Standard errors are in parentheses.

at the 1 percent level.

Note:

***Significant

demographic controls in column 4 and school

level controls in column 5, we observe signifi
cant declines in themagnitudes of both black
white and Hispanic-white gaps in performance
on

the mathematics

assessment.

The results contained in Table 1 establish

some patterns: 1) The inclusion of the child's
own health measures results in small changes
in themagnitudes of both the black-white and
Hispanic-white gaps in performance on the
assessments. 2) The inclusion of the parental
health measures lead to a larger decrease in
themagnitude of the gaps in performance. The
inclusion of the health measures lead to rela
tively larger reductions for black students.
It is somewhat intuitive to see how paren
tal health affects child academic achieve
ment.

Parents

contribute

material

resources,

such as income and shelter, that are important

determinants

also

of

academic

success.

Parents

seek to provide an environment that is

conducive

to learning.

This

is a

time

consum

ing endeavor, and perhaps it is the case that

parents whose health is limited are unable to
devote sufficient time and effort tomaintaining

an adequate learning environment as theymust

reallocate

their own

personal

resources

to deal

with their own health issues. This is certainly

a pathway that is suggested by the production
function approach outlined above, and it is con
sistent with research that finds that mothers
who are treated for depression are better able
tomanage chronic conditions in their children
(Cynthia Perry 2008).
IV.

Conclusion

This paper sought to add to the literature that

examines health as a potential explanation for
racial differences in educational performance.
The addition of our measures of health to stan
dard specifications reduced the gaps between
minorities and whites on mathematics and read
ing assessments.

We stress that these results are preliminary

but serve as useful benchmarks for a much
larger project looking at health's effect on the
racial

achievement

gap.

There

are

number

of limitations to the present study; for exam

ple,

the

analysis

was

cross-sectional,

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and

the

VOL.

100 NO.

FAMILY HEALTH,

CHILDREN'S

health conditions are not randomly assigned.

Our results could underestimate the impact of
adverse health on learning to the extent that
we have observed families after they have
responded optimally to health shock(s). The
results

could

overestimate

the effects,

however,

ifwe capture families at times when the health

shocks have recently occurred, and where they
may take the largest amount of time away from
labor market participation (on the part of par
ents) and studying (on the part of children).
Future work will take a number of different
directions. First, exploiting changes in health
status over timemay yield cleaner estimates of
the effects of parental and child health status and
could also aid in the identification of "critical
windows" where investments in child or parental
healthwould have the largestreturn.Additionally,
themodel and results presented here have not
captured the effects of parental health on child
health itself,and both could evolve togetherover
time. It is also highly likely that the effects of
health are nonlinear, and themean impact could
disguise significantheterogeneity across the edu
cational distribution,which itselfcould differby
the type of the assessment (reading or math) or
the racial group being considered. For example, if
disability rates differ across race and affect both
parental income and child health directly, then
the specifications presented here must be modi
fied to reflect such complicated structures.Even
with these caveats, the resultspresented here sug
gest thathealth, particularly parental health, is an
importantdeterminant in the racial achievement
gap, and we hope that these results will inspire
continued work on the topic.

AND

OWN HEALTH,

TEST SCORE

GAPS

199

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