Review of Economics of the Household

, Volume 15, Issue 1, pp 175–197 | Cite as

Family structure and young adult health outcomes

  • Alexander N. SladeEmail author
  • Andrea H. Beller
  • Elizabeth T. Powers


Previous research finds adverse effects of nontraditional family structures on cognitive and educational outcomes, but less is known about potential impacts on health. We use the National Longitudinal Study of Adolescent Health to examine two health statuses (self-reported overall health and depression) and one health behavior (smoking), estimating both static logit models of point-in-time health and discrete-time hazard models of health transitions. Overall, we find adverse associations between nontraditional family structures and health statuses and behavior. There are long-lasting associations of family structure with outcomes well into adulthood, not all of which are evident in adolescence. Dynamic estimates often inform but also provide new information not seen in the static model. “Unpacking” the family structure variables by period of childhood provides insight into how the timing of family break-ups affects the life trajectories of health and health behavior. Our findings differ remarkably by gender. Girls’ health appears more sensitive to family structure than boys’. In combination with prior findings in the literature, our findings intriguingly suggest that family break-ups and changes affect boys mostly through cognitive, educational, and emotional channels, while girls are most affected in their health and health behaviors. A major methodological contribution of this study is better measurement of family structure. We find that many adverse associations are masked by cruder measures in typical use.


Family structure Adolescent health Discrete-time hazard models National Longitudinal Study of Adolescent Health 

JEL Classification

I12 J12 



The authors would like to thank Craig Gundersen and Paul McNamara for helpful comments and suggestions. Carl Nelson’s assistance with data manipulation and retrieval was invaluable. All responsibility for errors rests with the authors. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from Grant P01-HD31921 for this analysis.

Supplementary material

11150_2015_9313_MOESM1_ESM.xlsx (40 kb)
Supplementary material 1 (XLSX 41 kb)


  1. Akashi-Ronquest, N. (2009). The impact of biological preferences on parental investments in children and step-children. Review of Economics of the Household, 7(1), 59–81.CrossRefGoogle Scholar
  2. Angel, R., & Worobey, J. L. (1988). Single motherhood and children’s health. Journal of Health and Social Behavior, 29(1), 38–52.CrossRefGoogle Scholar
  3. Antecol, H., & Bedard, K. (2007). Does single parenthood increase the probability of teenage promiscuity, substance use, and crime? Journal of Population Economics, 20(1), 55–71.CrossRefGoogle Scholar
  4. Beller, A. H., & Chung, S. S. (1992). Family structure and educational attainment of children: Effects of remarriage. Journal of Population Economics, 5(1), 39–59.CrossRefGoogle Scholar
  5. Beller, A. H., & Graham, J. W. (2003). The economics of child support. In S. Grossbard-Shechtman (Ed.), Marriage and the economy: Theory and evidence from advanced industrial societies. Cambridge: Cambridge University Press.Google Scholar
  6. Bertrand, M., & Pan, J. (2013). The trouble with boys: Social influences and the gender gap in disruptive behavior. American Economic Journal: Applied Economics, 5(1), 32–64.Google Scholar
  7. Bloch, M., Peleg, I., Koren, D., Aner, H., & Klein, E. (2007). Long-term effects of early parental loss due to divorce on the HPA axis. Hormones and Behavior, 51(4), 516–523.CrossRefGoogle Scholar
  8. Bramlett, M. D., & Blumberg, S. J. (2007). Family Structure and children’s physical and mental health. Health Affairs, 26(2), 549–558.CrossRefGoogle Scholar
  9. Brown, S. L. (2006). Family structure transitions and adolescent well-being. Demography, 43(3), 447–461.CrossRefGoogle Scholar
  10. Bzostek, S. H., & Beck, A. N. (2011). Familial instability and young children’s physical health. Social Science and Medicine, 73(2), 282–292.CrossRefGoogle Scholar
  11. Case, A., Fertig, A., & Paxson, C. (2005). The lasting impact of childhood health and circumstance. Journal of Health Economics, 24(2), 365–389.CrossRefGoogle Scholar
  12. Case, A., Lin, I. F., & McLanahan, S. (2001). Educational attainment of siblings in stepfamilies. Evolution and Human Behavior, 22(4), 269–289.CrossRefGoogle Scholar
  13. Case, A., & Paxson, C. (2001). Mothers and others: Who invests in children’s health? Journal of Health Economics, 20(3), 301–328.CrossRefGoogle Scholar
  14. Contoyannis, P., & Li, J. (2011). The evolution of health outcomes from childhood to adolescence. Journal of Health Economics, 30(1), 11–32.CrossRefGoogle Scholar
  15. Conway, K., & Li, M. (2012). Family structure and child outcomes: A high definition, wide angle “snapshot”. Review of Economics of the Household, 10(3), 345–375.CrossRefGoogle Scholar
  16. Dawson, D. A. (1991). Family structure and children’s health and well-being: Data from the 1988 national health interview survey on child health. Journal of Marriage and Family, 53(3), 573–584.CrossRefGoogle Scholar
  17. Eisenberg, D., & Druss, B. G. (2015). Time preferences, mental health and treatment utilization. Journal of Mental Health Policy and Economics, 18(1), 125–136.Google Scholar
  18. Elzinga, B. M., Roelofs, K., Tollenaar, M. S., Bakvis, P., van Pelt, J., & Spinhoven, P. (2008). Diminished cortisol responses to psychosocial stress associated with lifetime adverse events: A study among healthy young subjects. Psychoneuroendocrinology, 33(2), 227–237.CrossRefGoogle Scholar
  19. Evenhouse, E., & Reilly, S. (2004). A sibling study of stepchild well-being. Journal of Human Resources, 39(1), 248–276.CrossRefGoogle Scholar
  20. Fletcher, J. M., Green, J. C., & Neidell, M. J. (2010). Long term effects of childhood asthma on adult health. Journal of Health Economics, 29(3), 377–387.CrossRefGoogle Scholar
  21. Fletcher, J., & Sindelar, J. (2012). The effects of family stressors on substance use initiation in adolescence. Review of Economics of the Household, 10(1), 99–114.CrossRefGoogle Scholar
  22. Francesconi, M., Jenkins, S. P., & Siedler, T. (2010). The effect of lone motherhood on the smoking behavior of young adults. Health Economics, 19(11), 1377–1384.CrossRefGoogle Scholar
  23. Fuller-Thomson, E., & Dalton, A. D. (2012). Gender differences in the association between parental divorce during childhood and stroke in adulthood: Findings from a population-based survey. International Journal of Stroke, 10(6), 868–875.CrossRefGoogle Scholar
  24. Gennetian, L. (2005). One or two parents? Half or step siblings? The effect of family structure on young children’s achievement. Journal of Population Economics, 18(3), 415–436.CrossRefGoogle Scholar
  25. Ginther, D., & Pollak, R. (2004). Family structure and children’s educational outcomes: Blended families, stylized facts, and descriptive regressions. Demography, 41(4), 671–696.CrossRefGoogle Scholar
  26. Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80(2), 223–255.CrossRefGoogle Scholar
  27. Hamil-Luker, J., & O’Rand, A. M. (2007). Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood. Demography, 44(1), 137–158.CrossRefGoogle Scholar
  28. Harknett, K. (2009). Why are children with married parents healthier? The case of pediatric asthma. Population Research and Policy Review, 28(3), 347–365.CrossRefGoogle Scholar
  29. Heard, H., Gorman, B., & Kapinus, C. (2008). Family structure and self-rated health in adolescence and young adulthood. Population Research and Policy Review, 27(6), 773–797.CrossRefGoogle Scholar
  30. Heckman, J. J. (2007). The economics, technology, and neuroscience of human capability formation. Proceedings of the National Academy of Sciences, 104(33), 13250–13255.CrossRefGoogle Scholar
  31. Hill, M. S., Yeung, W. J., & Duncan, G. J. (2001). Childhood family structure and young adult behaviors. Journal of Population Economics, 14(2), 271–299.CrossRefGoogle Scholar
  32. Hoch, S. J., & Loewenstein, G. F. (1991). Time-inconsistent preferences and consumer self-control. Journal of Consumer Research, 17(4), 492–507.CrossRefGoogle Scholar
  33. Irwin, M., Artin, K., & Oxman, M. N. (1999). Screening for depression in the older adult: Criterion validity of the 10-item center for epidemiological studies depression scale (ces-d). Archives of Internal Medicine, 159(15), 1701–1704.CrossRefGoogle Scholar
  34. Kreider, R. M. (2008). Living arrangements of children: 2004. Current Population Reports (pp. P70–114). Washington, DC: U.S. Census Bureau.Google Scholar
  35. Krein, S. F., & Beller, A. H. (1988). Educational attainment of children from single-parent families: Differences by exposure, gender, and race. Demography, 25(2), 221–234.CrossRefGoogle Scholar
  36. Langton, C. E., & Berger, L. M. (2011). Family structure and adolescent physical health, behavior, and emotional well-being. Social Service Review, 85(3), 323–357.CrossRefGoogle Scholar
  37. Lundberg, S., McLanahan, S., & Rose, E. (2007). Child gender and father involvement in fragile families. Demography, 44(1), 79–92.CrossRefGoogle Scholar
  38. Lundberg, S., & Rose, E. (2002). The effects of sons and daughters on men’s labor supply and wages. Review of Economics and Statistics, 84(2), 251–268.CrossRefGoogle Scholar
  39. Lundberg, S., & Rose, E. (2003). Child gender and the transition to marriage. Demography, 40(2), 333.CrossRefGoogle Scholar
  40. Mauldon, J. (1990). The effect of marital disruption on children’s health. Demography, 27(3), 431–446.CrossRefGoogle Scholar
  41. McLanahan, S. S., & Sandefur, G. D. (1994). Growing up with a single parent: What hurts, what helps. Cambridge, MA: Harvard University Press.Google Scholar
  42. Mitchell, C., McLanahan, S., Hobcraft, J., Brooks-Gunn, J., Garfinkel, I., & Notterman, D. (2015). Family structure instability, genetic sensitivity, and child well-being. American Journal of Sociology, 120(4), 1195–1225.CrossRefGoogle Scholar
  43. Montgomery, L. E., Kiely, J. L., & Pappas, G. (1996). The effects of poverty, race, and family structure on US children’s health: Data from the NHIS, 1978 through 1980 and 1989 through 1991. American Journal of Public Health, 86(10), 1401–1405.CrossRefGoogle Scholar
  44. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.CrossRefGoogle Scholar
  45. Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of the American Academy of Child and Adolescent Psychiatry, 30(1), 58–66.CrossRefGoogle Scholar
  46. Spruijt, E., & de Goede, M. (1997). Transitions in family structure and adolescent well-being. Adolescence, 32(128), 897–911.Google Scholar
  47. Stewart, S. D., & Menning, C. L. (2009). Family structure, nonresident father involvement, and adolescent eating patterns. Journal of Adolescent Health, 45(2), 193–201.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Alexander N. Slade
    • 1
    Email author
  • Andrea H. Beller
    • 1
  • Elizabeth T. Powers
    • 2
  1. 1.Department of Agricultural and Consumer EconomicsUniversity of Illinois at Urbana-ChampaignUrbanaUSA
  2. 2.Department of Economics and Institute of Government and Public AffairsUniversity of Illinois at Urbana-ChampaignUrbanaUSA

Personalised recommendations