Association for Public Policy Analysis & Management

A number of recent studies have examined how state spending choices on health care relative to social services influences health. Importantly, these studies look at a snapshot of spending at a given time to predict health in a population. In this study, we use the three waves of the National Survey of Children’s Health to examine how state spending on education, income support, library, park and other non-health sectors, as well as eligibility for public insurance programs, over the course of children’s lifetimes influences their health. We use data from the Census of Governments on state spending sources from 1985 through 2012 to create spending levels for each year of a child’s life. Given that over 80 percent of children live in the same state through childhood, we can broadly track the spending environment in which the child was raised. We use multi-variate methods to estimate the impact on health and assess whether spending patterns matter more at different points during the life course. We control for individual, family and state characteristics. We estimate overall impacts and separate impacts for children above and below 200 percent of the federal poverty line. Health outcomes examined include general health status, limited in activities children of same age do, days missed from school, flourishing, anxiety, depression, school engagement, repeated school years, and extra-curricular activities after school, among others.