The effect of childhood environments on adult health and mortality

Project Abstract Early life conditions shape later life health outcomes such as mortality. However, it is not known which early conditions really matter and why. And are these conditions modifiable by policy? The absence of data that inform both where individuals lived during childhood and adult health outcomes substantially limits studies on

this topic. To fill this significant gap, we propose constructing a new dataset to investigate the causal impacts of two environmental conditions that can be modified by local authorities and that likely affect lifetime health: the quality of school that children attend and the infectious disease environment in which they grow up.

Previous literature typically relies on state-level measures of school quality and uses all-cause early life mortality in large areas (such as countries or states) as proxies for infectious disease environment. However, both of these conditions vary enormously within states. In this proposed study, we will construct a new

dataset linking individual childhood environment determinants at a granular level to longevity for large representative samples of Blacks and Whites (Aim 1). To our knowledge, it will be the largest individual dataset that follows U.S. residents from birth to death among individuals that survive to middle age. Despite

abundant association studies on how these two conditions affect lifetime health and other outcomes, causal evidence is rare. We will investigate the causal effects of school quality on adult health and longevity (Aim 2). We will examine the extent to which individuals who attended high-quality schools in their city of birth

obtained more schooling, had greater returns to the same level of schooling, and lived longer than those who attended low-quality schools, separately by race. We will follow the approaches of previous work (e.g., leveraging state minimum teacher wages) estimating the effects of school quality on economic outcomes but

apply them to investigate effects of substate-level school quality (e.g., average teacher salaries) on longevity. We will estimate the causal effects of childhood infectious disease exposure on adult health and longevity (Aim 3). To estimate causal effects of childhood infections (measured by city-level infectious

disease mortality), we will build on existing evidence that there was an important reduction in infectious disease mortality in cities in the 1920s due to a reduction in immigration and the associated improvement in living conditions that prevailed in cities. We will also conduct the analysis separately by race. Lastly, we will

examine the interaction of childhood education environment and infectious disease environment on longevity and their joint effects on racial disparities (Aim 4). We will empirically test if these two environments complement each other separately by race. We will assess the extent to which these two key

childhood environments explain inequality and racial disparities in longevity.