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Health Econ. 2019 Aug;28(8):955-970. doi: 10.1002/hec.3885. Epub 2019 Jun 4.

How do economic downturns affect the mental health of children? Evidence from the National Health Interview Survey.

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Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
Department of Health Policy and the Center for Medicine, Health & Society, Vanderbilt University School of Medicine, Nashville, Tennessee.
The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College and NBER, Hanover, New Hampshire.


Research linking economic conditions and health often does not consider children's mental health problems, which are the most common and consequential health issues for children and adolescents. We examine the effects of unemployment rates and housing prices on well-validated child and adolescent mental health outcomes and use of special education services for emotional problems in the 2001-2013 National Health Interview Survey. We find that the effects of economic conditions on children's mental health are clinically and economically meaningful; children's mental health outcomes worsen as the economy weakens. The effects of economic conditions on child and adolescent mental health are pervasive, found in almost every subgroup that we examine. The use of special education services for emotional problems also rises when economic conditions worsen. Our analyses of possible mechanisms that link economic conditions to child mental health suggest that parental unemployment cannot fully explain the relationship between economic conditions and child mental health.


children; economic conditions; mental health; unemployment


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