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儿童期认知与行为障碍及成年期健康

Childhood Cognitive and Behavioral Impairments and Adult Health
NBER Working Papers · 2026 · Hope Corman、Kelly Noonan、Nancy Reichman

中文摘要

我们使用具有全美代表性的美国纵向数据,估计儿童期认知与行为障碍对成年期健康的影响。我们重点考察限制工作的健康状况以及自评健康状况一般或较差,同时也将睡眠是否充足、体重和健康行为(使用各类物质和预防性医疗服务)视为潜在作用路径。在家庭固定效应模型中,我们发现,两类障碍均与成年期存在限制工作的健康状况高度相关;具体而言,认知障碍使出现限制工作状况的概率提高70%,行为障碍使这一概率提高60%。与儿童期无认知障碍者相比,儿童期有认知障碍者在成年期报告自身健康状况一般或较差的可能性高43%。认知障碍对健康的影响似乎并非通过睡眠不足、肥胖或健康行为发挥作用。与无行为障碍者相比,儿童期有行为障碍者报告自身健康状况一般或较差的可能性并未更高,但更有可能睡眠不足和肥胖,这表明睡眠不足和肥胖可能位于从儿童期行为障碍到成年期限制工作的健康状况的作用路径上。

Abstract

We use U.S. nationally representative longitudinal data to estimate the effects of cognitive and behavioral impairments in childhood on health in adulthood. We focus on work-limiting health conditions and fair or poor self-rated health but also consider adequacy of sleep, body weight, and health behaviors (use of various substances and preventive health care) as potential pathways. In household fixed effects models, we find that both impairments are strongly associated with having a work-limiting health condition in adulthood; specifically, cognitive impairments increase the probability of a work-limiting condition by 70% and behavioral impairments increase the probability by 60%. Individuals with cognitive impairments in childhood are 43% more likely to report being in fair or poor health in adulthood compared to individuals without cognitive impairments. The effects of cognitive impairments on health do not appear to operate through insufficient sleep, obesity, or health behaviors. Individuals with childhood behavioral impairments are no more likely to report being in fair or poor health but are more likely to get insufficient sleep and to be obese, compared to individuals without behavioral impairments, suggesting that insufficient sleep and obesity could potentially lie on the pathway from behavioral impairments in childhood to work-limiting health conditions in adulthood.
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