Mother's Labor Supply and Child Health: Case of Asthma

Asthma is one of the most prevalent chronic conditions for children – affecting approximately 8% or 6 million children under the age of 18 in the United States (2013 National Health Interview Survey).   It is estimated that 12.8 million school days are missed annually due to complications of asthma (American Lung Association).  Currently there is no cure but, through close management and treatment, most children’s asthma can be controlled. However, such monitoring requires parental resources.  In addition to missed school days, there are likely to be a significant number of missed work days for parents of children who require monitoring.  Even if caregivers are not absent from work there is likely to be lost productivity on the job or presenteeism.  As such, a mother’s decision to enter the labor force and, if she chooses to participate, the number of hours she works per week is likely to be influenced by having a child with asthma.

Caring for a child with a serious condition, such as asthma, requires both financial resources and time as modeled by Gould (2004).  While there have been several studies to examine mothers’ labor supply and child health or disability (e.g., Salkever, 1980; Powers, 2001a; 2001b; Porterfield, 2002), few have given particular attention to the effect of child asthma (e.g., Feng, 2006; Baydar, 2007; Morrill, 2010).  Not all child health conditions require the same amount of time and money resources.  As such combining all conditions together may underestimate both the time and financial costs.  Financial resources including income and access to health insurance may provide reasons for a mother to maintain labor force attachment, particularly pre-Affordable Care Act.  The time component is unpredictable, sporadic, and may be relatively high depending on the severity and how well the condition is managed.  Close in-home monitoring and doctor visits may be required during asthma episodes such that caregiving time may influence reduced or no labor force attachment, particularly if no suitable market-based child care is available where medical knowledge and monitoring of the child is needed. 

This study contributes to the overall literature on mothers’ labor supply and child health along several dimensions.  Using data pooled from the 1999-2013 National Health Interview Surveys (NHIS), we analyze labor market outcomes for mothers who have a child with asthma compared to those who have an asthma free child.  We measure asthma as an indicator measures as well as multiple measures in order to capture differences in severity.  Furthermore, we are able to study employment decision at a more detailed level (e.g. full-time, part-time) as well as hours worked because of our large pooled sample.  We do this while controlling for child and mother health as well as source of health insurance for both.  Ultimately, our ability to assess the impact of child asthma on incremental work decisions may provide more information to policymakers who will be better informed in order to formulate a comprehensive child health/disability policy that effectively provides aid to families with sick children.