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The Effects of Children’s Migration on Elderly Kin’s Health: A Counterfactual Approach

The Effects of Children’s Migration on Elderly Kin’s Health: A Counterfactual Approach

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Published by Randall Kuhn
Forthcoming in Demography, February 2011: Recent studies of migration and the left-behind have found that elders with migrant children actually experience better health outcomes than those with no migrant children, yet they raise many concerns about self-selection. Using three rounds of panel survey data from the Indonesian Family Life Survey, we employ the counterfactual framework developed by Rosenbaum and Rubin to examine the relationship between having a migrant child and the health of elders age 50+, as measured by activities of daily living (ADL), self-rated health (SRH), and mortality. As in earlier studies, we find a positive association between old-age health and children’s migration, an effect that is partly, though not fully, explained by an individual’s propensity to have migrant children. Positive impacts of migration are much greater among elders with a high propensity to have migrant children than those with low propensity. We note that migration is one of the single greatest sources of health disparity among the elders in our study population, and point to the need for research and policy aimed at broadening the benefits of migration to better improve health systems rather than individual health.
Forthcoming in Demography, February 2011: Recent studies of migration and the left-behind have found that elders with migrant children actually experience better health outcomes than those with no migrant children, yet they raise many concerns about self-selection. Using three rounds of panel survey data from the Indonesian Family Life Survey, we employ the counterfactual framework developed by Rosenbaum and Rubin to examine the relationship between having a migrant child and the health of elders age 50+, as measured by activities of daily living (ADL), self-rated health (SRH), and mortality. As in earlier studies, we find a positive association between old-age health and children’s migration, an effect that is partly, though not fully, explained by an individual’s propensity to have migrant children. Positive impacts of migration are much greater among elders with a high propensity to have migrant children than those with low propensity. We note that migration is one of the single greatest sources of health disparity among the elders in our study population, and point to the need for research and policy aimed at broadening the benefits of migration to better improve health systems rather than individual health.

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Published by: Randall Kuhn on Dec 18, 2010
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1
The Effects of Children’s Migration on Elderly Kin’s Health:
A Counterfactual Approach*
 Forthcoming in
 Demography
Randall S. KuhnJosef Korbel School of International Studies, University of DenverBethany EverettDepartment of Sociology, University of Colorado - BoulderRachel SilveyDepartment of Geography, University of Toronto* This research was supported by National Science Foundation grant #0422976
, ―
Migration andMarginalization: Social Networks, Inequality and Health in Indone
sia and Bangladesh‖.
Additional support came from National Institute on Aging grant R03AG19294-
01A1, ―Impact of Migration on Elderly Support in Bangladesh‖, and NIA grant 5P30AG017248
-
02 ―University of Colorado Population Aging Center‖. The authors thank R 
ichard Rogers, Francisca Antman, YingLu, and Steve Stillman for their helpful advice; Jarron Saint Onge, Kunga Lama, and YaffaTruelove for research assistance; Christine Peterson and the IFLS Support Team for dataassistance; and Graham Smith and Andrew Linke for editorial assistance. An earlier version of this paper was presented at the Annual Meeting of the Population Association of America inNew York in March 2007.August 31, 2009
 
2
Abstract:
 
Recent studies of migration and the left-behind have found that elders with migrant childrenactually experience better health outcomes than those with no migrant children, yet they raisemany concerns about self-selection. Using three rounds of panel survey data from the IndonesianFamily Life Survey, we employ the counterfactual framework developed by Rosenbaum andRubin to examine the relationship between having a migrant child and the health of elders age50+, as measured by activities of daily living (ADL), self-rated health (SRH), and mortality. Asin earlier studies, we find a positive association between old-age health and
children‘s migration,
an effect that is partly, though not fully,
explained by an individual‘s propensity to have migrant
children. Positive impacts of migration are much greater among elders with a high propensity tohave migrant children than those with low propensity. We note that migration is one of the singlegreatest sources of health disparity among the elders in our study population, and point to theneed for research and policy aimed at broadening the benefits of migration to better improvehealth systems rather than individual health.
 
1
INTRODUCTION
Population aging and migration pose a potential crisis of old-age support in Less DevelopedCountries (LDCs), particularly in rural areas that lack institutional support mechanisms such asnursing homes. Yet recent studies of the impact of 
children‘s migration on elders left behind by
migrant kin suggest an alternative conclusion. Rather than creating a healthcare vacuum in ruralareas, migration can actually be a valuable resource for improving health and development(Nyberg-Sørensen, Van Hear, and Engberg-Pederson 2002; Ozden and Schiff 2007). Anemerging literature has begun to address such effects, generally finding better health amongthose elders with migrant children than those without (Kuhn 2005; Nguyen, Yeoh and Toyota2006). This literature, however, has yet to address issues of self-selection bias, whereby thoseindividuals most likely to remain in good health are also most likely to have migrant children,
making it difficult to establish whether children‘s migration actually causes better health.
Social and demographic researchers have grown increasingly concerned with establishingcausal relationships between individual behaviors and health outcomes (Bhrolcháin 2001;Lieberson 1987, 1991; Link and Phelan 1995; McMichael 1999; Raftery 2001; Sobel 2000).Establishing causation is particularly challenging for a behavior like migration, which is bothembedded in, and determined by, a nexus of social and economic advantages and disadvantagesthat also directly or indirectly affect health (Curran 2002; Curran and Saguy 2001; Portes andSensenbrenner 1993). While demand for migrants is exogenously driven by labor markets,supply is determined by national and regional variations; observed micro-level factors such asgender, kinship, socioeconomic status, and health itself; and un-measurable latent factors thatcould include aggression, risk-seeking, and savvy (Curran and Rivero-Fuentes 2003; Knodel andSaengtienchai 2005; Massey 1988, 1990, 1999). While many studies have addressed causation

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