Seminar by Lakshmi K. Raut (University of Chicago)

Developmental programming literature in microbiology emphasizes that much of the process of health development throughout life is determined at the early stage of life by the early childhood epigenetic factors comprising internal and external environments, health care use, and health related behavior, together with the genetic factors. This paper introduces and empirically estimates a statistical multi-state time-to-event life history model of incidence of chronic diseases, disability and death at mid-ages, incorporating childhood factors and health behaviors. Many of the factors at the cellular level are unobserved or imperfectly instrumented with observed data, which causes biased estimates of the coefficients of included regressors. This paper corrects for unobserved heterogeneity biases, extending statistical techniques from the generally studied two-state models to the multi-state model of this paper. The paper uses the HRS (Health and Retirement Studies) dataset and takes the definition of disability as a health status that qualifies for the Social Security’s DI (Disability Insurance) program or the SSI (Supplemental Security Income) program. The paper studies how various childhood factors and health behaviors are associated with probabilities of following various transition paths through the health states of normal health, illness with one-or-more chronic diseases, disability and death. The paper also carries out quantitative policy analysis of social policies, improving the childhood factors of various social groups on their probabilities of maintaining good health, encountering disability or death in mid-ages.