No CrossRef data available.
Article contents
Can adult children’s education prevent parental health decline in the short term and long term? Evidence from rural China
Published online by Cambridge University Press: 13 June 2023
Abstract
This paper presents the first evidence of the causal relationship between adult children’s schooling and changes in parental health in the short and long term. By using supply-side variation in schooling as an instrument for adult children’s education and a representative dataset for rural China, we find that adult children’ education has a positive influence on the long-term changes in parental health, with limited evidence of any short-term effect. Our results remain consistent after a variety of sensitivity tests. The heterogeneous analyses show differences in socio-economic status and gender, with low-educated parents and mothers being the primary beneficiaries of children’s schooling. Potential mechanisms for the long-term effects of adult children’s education on changes in parental health include better chronic disease management, improved access to health, sanitation, and clean fuel facilities, improved psychological well-being, and reduced smoking behaviours.
- Type
- Research Article
- Information
- Copyright
- © The Author(s), 2023. Published by Cambridge University Press
References
Amiri, S and Behnezhad, S (2020) Smoking as a risk factor for physical impairment: a systematic review and meta-analysis of 18 cohort studies. Journal of Addictive Disease 38(1), 19–32.CrossRefGoogle ScholarPubMed
Arendt, J (2005) Does education cause better health? A panel data analysis using school reforms for identification. Economics of Education Review 24(2), 149–160.CrossRefGoogle Scholar
Bairoliya, N and Miller, R (2021) Social insurance, demographics, and rural-urban migration in China. Regional Science and Urban Economics 91(103615). doi: 10.1016/j.regsciurbeco.2020.103615
CrossRefGoogle Scholar
Baum, C, Schaffer, M and Stillman, S (2003) Instrumental variables and GMM: estimation and testing. The Stata Journal 3(1), 1–31.CrossRefGoogle Scholar
Berkman, L, Glass, T, Brissette, I and Seeman, T (2000) From social integration to health: Durkheim in the new millennium. Social Science & Medicine 51, 843–857.CrossRefGoogle ScholarPubMed
Boehm, J and Kubzansky, L (2012) The heart’s content: the association between positive psychological well-being and cardiovascular health. Psychological Bulletin 138(4), 655–691.CrossRefGoogle ScholarPubMed
Cai, F, Giles, J, O’Keefe, P and Wang, D (2012) The elderly and old age support in rural China: challenges and prospects. In Directions in Development. Washington DC: World Bank, pp. 45–56. http://documents.worldbank.org/curated/en/769231468215685476/The-elderly-and-old-age-support-in-rural-China-challenges-and-prospects (accessed June 6, 2023).Google Scholar
Card, D (1995) Using geographic variation in college proximity to estimate the return to schooling. In Christophides, LN, Grant, EK and Swidinsky, R (eds.), Aspects of Labor Market Behavior: Essays in Honor of John Vanderkamp. Toronto: University of Toronto Press, pp. 201–222.Google Scholar
Chatterji, S, Byles, J, Cutler, D, Seeman, T and Verdes, E (2015) Health, functioning, and disability in older adults—present status and future implications. The Lancet 385(9967), 563–575.Google Scholar
Chen, J and Jordan, L (2019) Psychological well-being of coresiding elderly parents and adult children in China: do father–child and mother–child relationships make a difference? Journal of Family Issues 40(18), 2728–2750.CrossRefGoogle Scholar
Chen, X, Giles, J, Yao, Y, Yip, W, Meng, Q, Berkman, L, …, Zhao, Y (2022) The path to healthy ageing in China: a Peking University-Lancet Commission. Lancet 400(10367), 1967–2006.CrossRefGoogle Scholar
Cheng, L, Liu, H, Zhang, Y, Shen, K and Zeng, Y (2015) The impact of health insurance on health outcomes and spending of the elderly: evidence from China’s New Cooperative Medical Scheme. Health Economics 24(6), 672–691.CrossRefGoogle ScholarPubMed
Chida, Y and Steptoe, A (2008) Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosomatic Medicine 70(7), 741–756.CrossRefGoogle ScholarPubMed
Chou, C, Hwang, C and Wu, Y (2012) Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis. Archives of Physical Medicine and Rehabilitation 93(2), 237–244.CrossRefGoogle ScholarPubMed
Chou, S, Liu, J, Grossman, M and Joyce, T (2010) Parental education and child health: evidence from a natural experiment in Taiwan. American Economic Journal: Applied Economics 2(1), 33–61.Google ScholarPubMed
Clark, D and Royer, H (2013) The effect of education on adult mortality and health: evidence from Britain. American Economic Review 103(6), 2087–2120.CrossRefGoogle ScholarPubMed
Cong, Z and Silverstein, M (2011) Intergenerational exchange between parents and migrant and nonmigrant sons in rural China. Journal of Marriage and Family 73, 93–104.CrossRefGoogle Scholar
Crimmins, E and Beltrán-Sánchez, H (2011) Mortality and morbidity trends: is there compression of morbidity? The Journals of Gerontology: Series B, Psychological Sciences and Social Sciences 66(1), 75–86.CrossRefGoogle ScholarPubMed
Currie, J and Moretti, E (2003) Mother’s education and the intergenerational transmission of human capital: evidence from college openings. Quarterly Journal of Economics 118(4), 1495–1532.CrossRefGoogle Scholar
Cutler, DM and Lleras-Muney, A (2010) Understanding differences in health behaviors by education. Journal of Health Economics 29, 1–28.CrossRefGoogle ScholarPubMed
Davidson, K, Mostofsky, E and Whang, W (2010) Don’t worry, be happy: positive affect and reduced 10-year incident coronary heart disease: the Canadian Nova Scotia Health Survey. European Heart Journal 31(9), 1065–1070.CrossRefGoogle ScholarPubMed
de Meijer, C, Koopmanschap, M, D’ Uva, T and van Doorslaer, E (2011) Determinants of long-term care spending: age, time to death or disability? Journal of Health Economics 30(2), 425–438.CrossRefGoogle ScholarPubMed
De Neve, J-W and Fink, G (2018) Children’s education and parental old age survival – quasi-experimental evidence on the intergenerational effects of human capital investment. Journal of Health Economics 58, 76–89.CrossRefGoogle ScholarPubMed
De Neve, J-W and Kawachi, I (2017) Spillovers between siblings and from offspring to parents are understudied: a review and future directions for research. Social Science & Medicine 183, 56–61.CrossRefGoogle ScholarPubMed
de Walque, D (2007) Does education affect smoking behaviors? Evidence using the Vietnam draft as an instrument for college education. Journal of Health Economics 26, 877–895.CrossRefGoogle ScholarPubMed
Démurger, S, Gurgand, M, Li, S and Yue, X (2009) Migrants as second-class workers in urban China? A decomposition analysis. Journal of Comparative Economics 37(4), 610–628.CrossRefGoogle Scholar
Dong, X and Simon, M (2009) Health and aging in a Chinese population: Urban and rural disparities. Geriatrics & Gerontology International 10(1), 85–93.CrossRefGoogle Scholar
Fang, H and Feng, J (2018) The Chinese pension system. NBER Working Paper, No. 25088. https://www.nber.org/system/files/working_papers/w25088/w25088.pdf (accessed June 6 2023).Google Scholar
Feng, Z, Glinskaya, E, Chen, H, Gong, S, Qiu, Y, Xu, J and Yip, W (2020) Long-term care system for older adults in China: policy landscape, challenges, and future prospects. Lancet 396(10259), 1362–1372.CrossRefGoogle Scholar
Freedman, V, Martin, L and Schoeni, R (2002) Recent trends in disability and functioning among older adults in the United States: a systematic review. JAMA 288(24), 3137–3146.CrossRefGoogle ScholarPubMed
Fried, T, Bradley, E, Williams, C and Tinetti, M (2001) Functional disability and health care expenditures for older persons. The Archives of Internal Medicine 161(21), 2602–2607.CrossRefGoogle ScholarPubMed
Friedman, E and Mare, R (2014) The schooling of offspring and the survival of parents. Demography 51, 1271–1293.CrossRefGoogle ScholarPubMed
Fries, J (1980) Aging, natural death, and the compression of morbidity. New England Journal of Medicine 303, 1369–1370.CrossRefGoogle ScholarPubMed
Fries, J (2002) Reducing disability in older age. JAMA 288(24), 3164–3166.CrossRefGoogle ScholarPubMed
Fuligni, A and Zhang, W (2004) Attitudes toward family obligation among adolescents in contemporary urban and rural China. Child Development 75(1), 180–192.CrossRefGoogle ScholarPubMed
Gathmann, C, Jürges, H and Reinhold, S (2015) Compulsory schooling reforms, education and mortality in twentieth century Europe. Social Science & Medicine 127, 74–82.CrossRefGoogle ScholarPubMed
Giles, J, Lei, X, Wang, Y and Zhao, Y (2023) One country, two systems: evidence on retirement patterns in China. Journal of Pension Economics & Finance, 22(2), 188–210.CrossRefGoogle ScholarPubMed
Grepin, KA and Bharadwaj, P (2015) Maternal education and child mortality in Zimbabwe. Journal of Health Economics 44, 97–117.CrossRefGoogle ScholarPubMed
Gruenberg, M (2005) The failures of success. The Milbank Quarterly 83(4), 779–800.CrossRefGoogle ScholarPubMed
Jiang, J and Wang, P (2018) Health status in a transitional society: Urban-rural disparities from a dynamic perspective in China. Population Health Metrics 16(1), 22.CrossRefGoogle Scholar
Jung, S, Ostbye, T and Park, K (2006) A longitudinal study of the relationship between health behavior risk factors and dependence in activities of daily living. Journal of Preventive Medicine and Public Health 39(3), 221–228.Google ScholarPubMed
Kahneman, D, Diener, E and Schwarz, N (2003) Well-Being: The Foundations of Hedonic Psychology. New York: Russell Sage Foundation.Google Scholar
Kane, T and Rouse, C (1995) Labor market returns to two-and four-year colleges: is credit a credit and do degrees matter. American Economic Review 85(3), 600–614.Google Scholar
Katz, S, Ford, A, Moskowitz, R, Jackson, B and Jaffe, M (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185, 914–919.CrossRefGoogle Scholar
Kung, J (2002) Choice of land tenure in China: the case of a county with quasi-private property rights. Economic Development and Cultural Change 50(4), 793–817.CrossRefGoogle Scholar
Lawton, M and Brody, E (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist 9(3), 179–186.CrossRefGoogle ScholarPubMed
Lee, C (2018) Adult children’s education and physiological dysregulation among older parents. The Journals of Gerontology: Series B, Psychological Science and Social Science 73(6), 1143–1154.CrossRefGoogle ScholarPubMed
Lee, Y (2018) Adult children’s educational attainment and the cognitive trajectories of older parents in South Korea. Social Science & Medicine 209, 76–85.CrossRefGoogle ScholarPubMed
León-Muñoz, L, Guallar-Castillón, P, García-Esquinas, E, Galán, I and Rodríguez-Artalejo, F (2017) Alcohol drinking patterns and risk of functional limitations in two cohorts of older adults. Clinical Nutrition 36(3), 831–838.CrossRefGoogle ScholarPubMed
Li, J, Shi, L, Liang, H, Ding, G and Xu, L (2018) Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011. BMC Health Service Research 18(102). doi: 10.1186/s12913-018-2905-4.CrossRefGoogle ScholarPubMed
Lindeboom, M, Llena-Nozal, A and van der Klaauw, B (2009) Parental education and child health: evidence from a schooling reform. Journal of Health Economics 28(1), 109–139.CrossRefGoogle ScholarPubMed
Liu, M, Zhang, Q, Lu, M, Kwon, C and Quan, H (2007) Rural and urban disparity in health services utilization in China. Medical Care 45(8), 767–774.CrossRefGoogle Scholar
Liu, Y, Hsiao, WC and Eggleston, K (1999) Equity in health and health care: the Chinese experience. Social Science Medicine 49(10), 1349–1356.CrossRefGoogle ScholarPubMed
Liu, Y, Ma, Y and Smith, J (2022) Adult children’s education and older parents’ chronic illnesses in aging China. Demography 59(2), 535–562.CrossRefGoogle ScholarPubMed
Liu, Z (2021) Children’s education and parental health: Evidence from China. American Journal of Health Economics 7(1), 95–130.CrossRefGoogle Scholar
Lleras-Muney, A (2005) The relationship between education and adult mortality in the United States. Review of Economic Studies 72(1), 189–221.CrossRefGoogle Scholar
Lundborg, P and Majlesi, K (2018) Intergenerational transmission of human capital: is it a one-way street. Journal of Health Economics 57, 206–220.CrossRefGoogle ScholarPubMed
Ma, M (2019) Does children’s education matter for parents’ health and cognition? Evidence from China. Journal of Health Economics 66, 222–240.CrossRefGoogle ScholarPubMed
Manton, K (1988) A longitudinal study of functional change and mortality in the United States. Journal of Gerontology 43(5), 153–161.CrossRefGoogle ScholarPubMed
McCrary, J and Royer, H (2011) The effect of female education on fertility and infant health: evidence from school entry policies using exact date of birth. American Economic Review 101(1), 158–195.CrossRefGoogle ScholarPubMed
Moore, A, Endo, J and Carter, M (2003) Is there a relationship between excessive drinking and functional impairment in older persons? Journal of the American Geriatrics Society 51(1), 44–49.CrossRefGoogle Scholar
Mullan, K, Grosjean, P and Kontoleon, A (2011) Land tenure arrangements and rural–urban migration in China. World Development 39(1), 123–133.CrossRefGoogle Scholar
Pampel, F, Krueger, P and Denney, J (2010) Socioeconomic disparities in health behaviors. Annual Review of Sociology 36, 349–370.CrossRefGoogle ScholarPubMed
Parker, M and Thorslund, M (2007) Health trends in the elderly population: getting better and getting worse. The Gerontologist 47(2), 150–158.CrossRefGoogle ScholarPubMed
Pei, Y and Cong, Z (2020) Children’s education and their financial transfers to ageing parents in rural China: mothers and fathers’ strategic advantages in enforcing reciprocity. Ageing & Society 40(4), 896–920.CrossRefGoogle Scholar
Pei, Y, Cong, Z and Wu, B (2020) Education, adult children’s education, and depressive symptoms among older adults in rural China. Social Science & Medicine 253, 112966. doi: 10.1016/j.socscimed.2020.112966
CrossRefGoogle ScholarPubMed
Ram, A, Dave, S, Lancki, N, Moran, M, Puri-Taneja, A, Mammen, S, …, Kandula, N (2022) Social influence of adult children on parental health behavior among South Asian immigrants: findings from the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. Ethnicity & Health 27(3), 639–657.CrossRefGoogle ScholarPubMed
Roberts, C, Phillips, L, Cooper, C, Gray, S and Allan, J (2017) Effect of different types of physical activity on activities of daily living in older adults: systematic review and meta-analysis. Journal of Aging and Physical Activity 25(4), 653–670.CrossRefGoogle ScholarPubMed
Ryff, C (1995) Psychological well-being in adult life. Current Directions in Psychological Sciences 4(4), 99–104.CrossRefGoogle Scholar
Silles, MA (2009) The causal effect of education on health: evidence from the United Kingdom. Economics of Education Review 28(1), 122–128.CrossRefGoogle Scholar
Singer, B and Manton, K (1998) The effects of health changes on projections of health service needs for the elderly population of the United States. Proceedings of the National Academy of Sciences of the United States of America 95(26), 15618–15622.CrossRefGoogle Scholar
Smith, J, Shen, Y, Strauss, J, Zhe, Y and Zhao, Y (2012) The effects of childhood health on adult health and SES in China. Economic Development and Cultural Change 61(1), 127–156.CrossRefGoogle ScholarPubMed
Steptoe, A, Deaton, A and Stone, A (2015) Subjective wellbeing, health, and ageing. Lancet 385, 640–648.CrossRefGoogle ScholarPubMed
Tak, E, Kuiper, R, Chorus, A and Hopman-Rock, M (2013) Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a meta-analysis. Ageing Research Reviews 12(1), 329–338.CrossRefGoogle ScholarPubMed
Takashima, N, Miura, K, Hozawa, A, Okamura, T, Hayakawa, T, Okuda, N, …, Ueshima, H (2010) Cigarette smoking in middle age and a long-term risk of impaired activities of daily living: NIPPON DATA80. Nicotine & Tobacco Research 12(9), 944–949.CrossRefGoogle Scholar
Torssander, J (2013) From child to parent? The significance of children’s education for their parents’ longevity. Demography 50(2), 637–659.CrossRefGoogle ScholarPubMed
van der Heide, I, Wang, J, Droomers, M, Spreeuwenberg, P, Rademakers, J and Uiters, E (2013) The relationship between health, education, and health literacy: results from the Dutch Adult Literacy and Life Skills Survey. Journal of Health Communication 18(Suppl 1), 172–184.CrossRefGoogle ScholarPubMed
Wang, H, Han, S, Kim, K and Burr, J (2022) Adult children’s achievements and ageing parents’ depressive symptoms in China. Ageing and Society, 42(4), 896–917.CrossRefGoogle Scholar
World Health Organization & World Bank (2011) World report on disability. https://www.who.int/publications/i/item/9789241564182 (accessed June 6, 2023).Google Scholar
Xie, Y and Zhu, H (2009) Do sons or daughters give more money to parents in urban China? Journal of Marriage and Family 71, 174–186.CrossRefGoogle ScholarPubMed
Yahirun, J, Sheehan, C and Hayward, M (2017) Adult children’s education and changes to parents’ physical health in Mexico. Social Science & Medicine 181, 93–101.CrossRefGoogle ScholarPubMed
Yang, T (1997) China’s land arrangements and rural labor mobility. China Economic Review 8(2), 101–115.CrossRefGoogle Scholar
Zhu, H (2016) Adult children’s characteristics and intergenerational financial transfers in urban China. Chinese Journal of Sociology 2, 75–94.CrossRefGoogle Scholar
Zimmer, Z, Kaneda, T and Spess, L (2007) An examination of urban versus rural mortality in China using community and individual data. The Journals of Gerontology: Series B, Psychological Science and Social Science 62(5), 349–357.CrossRefGoogle Scholar
Zimmer, Z, Martin, L, Ofstedal, M and Chuang, Y-L (2007) Education of adult children and mortality of their elderly parents in Taiwan. Demography 44, 289–305.CrossRefGoogle ScholarPubMed