The Impact of Parental Drinking on Children's Use of Health Care

Abstract

While a significant body of literature documents the health problems of children caused by and/or associated with parental alcohol misuse, little research has been conducted on the relationship between parental problem drinking and children's use of health care. We should expect to see an increase in children's health care if alcohol-misusing parents were responsive to their children's higher physical and mental health needs. Contrarily, it would decrease (conditional on health status) if alcohol-misusing parents were irresponsive to those needs. Analyzing a nationally representative sample of parents and children, we find a positive and significant association between parental high intensity drinking and pediatric visits for their children. We also find evidence linking parental drinking to more emergency room use. These findings suggest that the impact of parental drinking on child well-being should be considered when assessing the full costs of alcohol misuse.

RÉSUMÉ

Impact de l'Abus d'Alcool Parental sur l'Utilisation Infantile des Services de Santé

Malgré l'existence d'un corpus de documentation sur les problèmes de santé infantile dus à la consommation excessive d'alcool des parents, il existe à ce jour peu d’études sur le rapport entre l'abus d'alcool parental et l'utilisation des services de santé des enfants. Nous conjecturons une hausse de l'utilisation infantile des services de santé si leurs parents, consommateurs excessifs d'alcool, réagissent à leurs besoins de santé physique et mentale. À l'inverse, l'utilisation des services de santé diminuerait (en fonction de l’état de santé) si les parents, abuseurs d'alcool, ignorent ces besoins. En analysant un échantillon national représentatif de parents et d'enfants, nous trouvons une association positive et significative entre l'abus d'alcool parental et les visites pédiatriques de leurs enfants. Nous observons également un lien entre l'abus d'alcool parental et la fréquentation des services d'urgences. Ces résultats indiquent que l'impact de l'abus d'alcool parental sur le bien-être de l'enfant doit être pris en compte dans l’évaluation des coûts de l'abus d'alcool.

RESUMEN

El Impacto del Uso de Alcohol en los Padres en la Utilización de Servicios de Salud de sus Hijos

Si bien numerosas investigaciones documentan los problemas de salud que genera en los niños el consumo problemático de alcohol por parte de sus padres, se ha investigado poco acerca de la relación entre este consumo y la demanda efectiva de servicios de salud de sus hijos. El uso de servicios de salud pediátricos debería aumentar si los padres responden adecuadamente a los cambios en la morbilidad física o psicológica de sus hijos. Por el contrario, la demanda podría disminuir si los padres no atienden estas necesidades en forma debida. Este trabajo analiza una muestra representativa de padres e hijos en los Estados Unidos y encuentra una asociación positiva y significativa entre el uso problemático de alcohol por parte de los padres y las visitas pediátricas de sus hijos. También encuentra que el consumo problemático de alcohol en los padres se vincula a un mayor uso de servicios de emergencia pediátricos. Estos hallazgos sugieren que cualquier medición del impacto social del consumo problemático de alcohol debería tomar en cuenta el costo que los padres imponen sobre el bienestar de sus hijos.

Keywords :

• alcohol misuse
• children's health care
• costs of alcohol use
• children of alcoholics

THE AUTHORS

Ana I. Balsa, Ph.D., is Professor in the Department of Economics, Universidad de Montevideo, Montevideo, Uruguay. Dr. Balsa has conducted research on the economics of health and education, covering topics such as statistical discrimination in health care, determinants and consequences of substance abuse, relative deprivation, and program evaluation. She has been principal investigator in projects funded by the National Institutes of Health (NIH) and the Inter-American Development Bank (IADB).

Michael T. French, Ph.D., is Professor of Health Economics in the Department of Sociology at the University of Miami, Florida, USA, and Director of the Health Economics Research Group (HERG) (www.miami.edu/herg) at the same university. His experience includes policy and program evaluation, substance abuse research, health economics, cost-and-benefit analysis, human resource economics, and the economics of crime. He has been principal investigator or project leader on numerous research grants with the NIH, the Robert Wood Johnson Foundation, and several state agencies.

Notes

1 Respondents in the survey were first asked about the number of days they drank alcohol in the past year and then the average number of drinks they consumed in a single episode on each day they drank. Our main explanatory variable is based on the response to the latter question.

2 Note that the estimated effects for the full sample are not necessarily the averages of the effects for the father and mother subsamples because we compute the ATT on the treated group only. Thus, the estimates we observe for each subsample capture changes in the effects per se as well as in the distribution of observed characteristics among the treated individuals.

3 We also analyzed a few additional outcomes: an indicator of a visit to a medical specialist, an indicator of a visit to a mental health professional, and an indicator of a visit to a dentist in the past year. None of these models showed statistically significant results.