Children’s multidimensional health and medium-run cognitive skills in low- and middle-income countries

This paper engages in the debate on the effects of children’s health on their education in later life stages in low- and middle-income countries. Using three rounds from the rich panel data of the Young Lives study in Ethiopia, India, Peru and Vietnam, it endorses a multidimensional approach to health (and poverty in general). In detail, the paper has a fourfold objective: (1) to explore whether the positive relationship between children’s height and cognitive skills at pre-school and primary-school age found in previous studies holds in our sample of countries, too; (2) to assess whether additional health and nutrition indicators, rarely available or used in the existing literature, are significantly associated with later cognitive achievements; (3) to examine whether the whole contribution of children’s multidimensional health to mid-term cognitive attainments can be adequately summarised by a composite deprivation index; (4) to investigate a few possible channels through which early childhood health may affect cognitive skills. In line with the main literature, the estimates show a positive, highly significant effect of the height-for-age of children between 6 and 18 months on almost all the dependent variables at both pre-school and primary-school age. The expansion of the informational basis to a multidimensional perspective proved to be informative, too. In particular, weight-for-height, proxy for acute malnutrition, is an important predictor of children’s learning outcomes, especially in India, Peru and Vietnam. However, the final health variable, indicating whether the child had experienced a serious illness, helps to explain only Maths scores in Vietnam. We then constructed an aggregate health-deprivation index, based on a revised version of the Alkire-Foster method. While it is associated with a variety of outcomes in the various countries, the index proved to be substantially less informative than the 'suite of indicators'. Finally, the paper sheds some light on the factors mediating the relationship between early childhood health conditions and mid-run cognitive abilities. In particular, it suggests that the level of formal education attended/completed is an important channel. However, in most of the cases, the inclusion of variables related to schooling in the estimates does not overrule the association between early health and middle-run cognition, which points to the persistent effects of health and nutrition in infancy on life-course skills formation.