The health of children and the health of
the elderly: implications for economic
growth
Alberto Palloni
Institute for Policy Research
Northwestern University
Plan of presentation I: prospects for
healthy aging
• Demographics: unusual aging process
– Unprecedented speed: mortality and fertility
– Remarkable Origin: connection early childhood and adult
health
• Erosion of traditional family
• Fragile institutional context
The demand for care
Plan of presentation II: healthy children
and economic growth
• Early childhood health and acquisition of
individual traits
– Cognitive
– Non cognitive
HUMAN K
• Socioeconomic achievement
Human K
Economic growth
Plan of presentation I: prospects for
healthy aging
• Demographics: unusual aging process
– Unprecedented speed: mortality and fertility
– Remarkable Origin: connection early childhood and adult
health
• Erosion of traditional family
• Fragile institutional context
The demand for care
Origins of aging
• Proportion over 60 or 65:
– CURRENT in fertility
– PAST decreases older age mortality
• Rate of growth over 60 or 65:
– PAST fertility
– PAST mortality decline in early
childhood
– PAST decreases older age mortality
Aging is produced because
proportions at older ages are too
high
Compressed aging: the rule of 1/4
• How long does it take for the proportion
over 65 to go from 7 to 14 percent?
– France:
– China:
– Brazil:
– Thailand:
115 years
27 years
21 years
22 years
Aging occurs because rate of
growth of older population exceeds
rate of growth of younger
population
Consequence for composition of elderly
by health status:2000-2030
• Survival due to medical technology and public
health NOT better standards of living
• Higher average exposure to early childhood
illnesses and poverty during childhood
• Potential for worse health and disability
Rapid aging: the rule of 17
• How long does it take for the population
65 and over to double its size?
Peculiar aging: origin of elderly growth
(2000-2030)
• Growth of past birth cohorts: 10-15%
• Past mortality decline 0 to 60:40-60%
• Past motality decline 60+:15-20%
The rule of 2/3
• About 2/3 of the growth of population
over 65 between years 2000 and 2030 is
due to early childhood mortality decline in
the 1940-1970 period
Effects
• Higher prevalence of diabetes and CVD
– In Mexico odds are increased by 20 to 40%
• Higher levels of disability:
– In Mexico odds are increased by 30 to 50%
• Lower levels of healthy life expectancy
– In Mexico decreases from 14 to about 11
Plan of presentation I: prospects for
healthy aging
• Demographics: unusual aging process
– Unprecedented speed: mortality and fertility
– Remarkable Origin: connection early childhood and adult
health
• Erosion of traditional family
• Fragile institutional context
The demand for care
The family
• Demography of kin
• Ideological context: intergenerational
contract
The supply of kin
Ideological context
• Changes of values regarding children
• Is old age security motive waning?
• The demise of the intergenerational
contract
Plan of presentation I: prospects for
healthy aging
• Demographics: unusual aging process
– Unprecedented speed: mortality and fertility
– Remarkable Origin: connection early childhood and adult
health
• Erosion of traditional family
• Fragile institutional context
The demand for care
Institutional fragility
• Lackluster aggregate economic performance
• Diminished role of public sector or inexistent
• Poverty
• Inequality
Plan of presentation II: healthy children
and economic growth
• Early childhood health and acquisition of
individual traits
– Cognitive
– Non cognitive
• Socioeconomic achievement
Human K
Economic growth
The determinants of adult wages:
and Human capital
• Parental background (“wallets”)
• Educational attainment
• Cognitive (+non cognitive) traits
• Early health
Decomposition of effects of parental
social class on sons’ social class
Wallet 31%
Cognitive 51%
Health 9%
Decomposition of effects of parental
social class on sons’ social class
Education
9%
Wallet 31%
Cognitive 51%
Health 9%
Decomposition of effects of parental
social class on sons’ social class
Education
9%
Wallet 31%
Cognitive 51%
Health 9%
Decomposition of effects of parental
social class on sons’ social class
Education
9%
Wallet 31%
Wallet (Direct)
Health (LBW)
Health (Chronic)
Cognitive 51%
Health 9%
Cognitive
Education
Main inference
• The effects of early health on wages
are important but they also work
through cognitive skills and noncognitive traits. None are direct.
Plan of presentation II: healthy children
and economic growth
• Early childhood health and acquisition of
individual traits
– Cognitive
– Non cognitive
• Socioeconomic achievement
Human K
Economic growth
The dilemma: within family and in
society at large
• Old age related health expenditures:
healthy aging
• Future investments in child health: human
capital and future economic growth