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Author: Fang, Muriel Z.
Resulting in 6 citations.
1. Fang, Muriel Z.
Essays in Health Economics
Ph.D. Dissertation, Department of Economics, The Ohio State University, 2012
Cohort(s): Children of the NLSY79
Publisher: Department of Economics, The Ohio State University
Keyword(s): Body Mass Index (BMI); Child Health; Child Self-Administered Supplement (CSAS); Home Observation for Measurement of Environment (HOME); National Longitudinal Study of Adolescent Health (AddHealth); Parental Investments; Pre/post Natal Behavior; Pre/post Natal Health Care; Racial Differences; Siblings

Permission to reprint the abstract has not been received from the publisher.

My dissertation consists of three essays that use different types of variation across the life cycle to study health outcomes and behaviors in children and young adults. The first essay examines how child health is shaped by parental investments using data from Children of the National Longitudinal Survey of Youth 1979 (CNLSY79). Substantial empirical evidence suggests that early parental investments have long term consequences for physical health. The developmental plasticity theory suggests that children are most sensitive to inputs received during their early years. I estimate a value-added child health production function with time varying rates of return to investment in order to investigate whether the rates of return are highest during early stages of a child's life. I address measurement error using a multiple-indicator multiple-cause (MIMIC) model with a linear structural relationship in which concurrent measurements act as instrumental variables. The results indicate that the rate of return to investment is higher during the prenatal and infancy periods than during subsequent periods of childhood. I also explore racial differences in the production function and find that rates of return to investment are lower for black children than for whites. This finding, coupled with the fact that black children are more likely to be born premature and with low birthweight, contributes to an understanding of how racial disparity in health at birth persists through childhood.
Bibliography Citation
Fang, Muriel Z. Essays in Health Economics. Ph.D. Dissertation, Department of Economics, The Ohio State University, 2012.
2. Fang, Muriel Z.
Parental Investment, Child Health Formation and Racial Differences
Presented: Paris, France, EUCCONET/Society For Longitudinal And Life Course Studies International Conference, October 2012
Cohort(s): Children of the NLSY79
Publisher: Society for Longitudinal and Life Course Studies
Keyword(s): Birthweight; Body Mass Index (BMI); Child Health; Child Self-Administered Supplement (CSAS); Home Observation for Measurement of Environment (HOME); Parental Investments; Pre/post Natal Behavior; Racial Differences; Siblings

Permission to reprint the abstract has not been received from the publisher.

Recent researchers across social and medical sciences suggest early life circumstances have long term consequences for adult physical, cognitive and emotional health. This has given rise to the theory of developmental plasticity that children are most sensitive to inputs received during their early years. Evaluation of this hypothesis demands a study that accounts for the dynamic and cumulative nature of health formation process, which is lacking in the literature. I contribute to this investigation by empirically testing the hypothesis: I estimate a value-added child health production function with time varying rates of return to investment. Using the Children of U.S. National Longitudinal Survey of Youth 1979 (CNLSY79), I employed a multiple-indicator multiple-cause (MIMIC) model in which concurrent measurements act as instrumental variables. I find that investment rates of return during the prenatal and infancy periods are higher than those in subsequent periods of a child’s life. I also explore racial differences in the production function and find that rates of return to investment are lower for black children than for whites. This finding contributes to an understanding of how racial disparity in health at birth persists through childhood.
Bibliography Citation
Fang, Muriel Z. "Parental Investment, Child Health Formation and Racial Differences." Presented: Paris, France, EUCCONET/Society For Longitudinal And Life Course Studies International Conference, October 2012.
3. Reagan, Patricia Benton
Salsberry, Pamela J.
Fang, Muriel Z.
Gardner, William P.
Pajer, Kathleen
African-American/White Differences in the Age of Menarche: Accounting for the Difference
Social Science and Medicine 75,7 (October 2012): 1263-1270.
Also: http://www.sciencedirect.com/science/article/pii/S0277953612004327
Cohort(s): Children of the NLSY79, NLSY79
Publisher: Elsevier
Keyword(s): Birthweight; Body Mass Index (BMI); Menarche/First Menstruation; Poverty; Racial Differences; Smoking (see Cigarette Use); Weight

Lifetime health disparity between African-American and white females begins with lower birthweight and higher rates of childhood overweight. In adolescence, African-American girls experience earlier menarche. Understanding the origins of these health disparities is a national priority. There is growing literature suggesting that the life course health development model is a useful framework for studying disparities. The purpose of this study was to quantify the influence of explanatory factors from key developmental stages on the age of menarche and to determine how much of the overall race difference in age of menarche they could explain. The factors were maternal age of menarche, birthweight, poverty during early childhood (age 0 through 5 years), and child BMI z-scores at 6 years. The sample, drawn from the US National Longitudinal Surveys of Youth Child–Mother file, consisted of 2337 girls born between 1978 and 1998. Mean age of menarche in months was 144 for African-American girls and 150 for whites.

An instrumental variable approach was used to estimate a causal effect of child BMI z-score on age of menarche. The instrumental variables were pre-pregnancy BMI, high gestational weight gain and smoking during pregnancy. We found strong effects of maternal age of menarche, birthweight, and child BMI z-score (−5.23, 95% CI [−7.35,−3.12]) for both African-Americans and whites. Age of menarche declined with increases in exposure to poverty during early childhood for whites. There was no effect of poverty for African-Americans. We used Oaxaca decomposition techniques to determine how much of the overall race difference in age of menarche was attributable to race differences in observable factors and how much was due to race dependent responses. The African-American/white difference in childhood BMI explained about 18% of the overall difference in age of menarche and birthweight differences explained another 11%.

Bibliography Citation
Reagan, Patricia Benton, Pamela J. Salsberry, Muriel Z. Fang, William P. Gardner and Kathleen Pajer. "African-American/White Differences in the Age of Menarche: Accounting for the Difference." Social Science and Medicine 75,7 (October 2012): 1263-1270.
4. Salsberry, Pamela J.
Reagan, Patricia Benton
Fang, Muriel Z.
Disparities in Women’s Health Across a Generation: A Mother–Daughter Comparison
Journal of Women's Health 22,7 (July 2013): 617-624
Cohort(s): Children of the NLSY79, NLSY79, NLSY79 Young Adult
Publisher: Mary Ann Liebert, Inc.
Keyword(s): Age at Menarche/First Menstruation; Body Mass Index (BMI); Health/Health Status/SF-12 Scale; Height; Height, Height-Weight Ratios; Intergenerational Patterns/Transmission; Obesity; Racial Differences; Weight

Permission to reprint the abstract has not been received from the publisher.

Background: The U.S. Centers for Disease Control and Prevention has set national goals to eliminate health disparities by race, sex, and socioeconomic status. Progress in meeting these goals has been mixed. This paper provides a different view on the evolving health of U.S. women by examining a sample of daughters and their mothers.

Methods: The aim was to determine if the health risk profiles of daughters (born 1975–1992) were different from their mothers (born 1957–1964) measured when both were between the ages of 17 and 24 years. The U.S.-based National Longitudinal Survey of Youth 1979 and associated Children and Young Adult Surveys were used. The sample was 2411 non-Hispanic white and African American girls born to 1701 mothers. Outcomes were height, weight, body mass index (BMI), age of menarche, and self-reported health.

Results: In both races, daughters were taller but entered adulthood at greater risk for the development of chronic illness than their mothers. Racial differences were greater in the daughters’ generation than in the mothers’. Whites in both generations experienced educational differences in health based upon the mother’s educational level, with fewer years of maternal education associated with poorer health. African Americans of both generations experienced differences by maternal education in self-reported health. However, when African American daughters were compared with their mothers, daughters born to college educated women gained more weight and had higher BMI and earlier menarche than did daughters born to high school dropouts.

Conclusion: Health deterioration across generations in both races suggests that much work is needed to meet Healthy People 2020 goals of health equity.

Bibliography Citation
Salsberry, Pamela J., Patricia Benton Reagan and Muriel Z. Fang. "Disparities in Women’s Health Across a Generation: A Mother–Daughter Comparison." Journal of Women's Health 22,7 (July 2013): 617-624.
5. Salsberry, Pamela J.
Reagan, Patricia Benton
Pajer, Kathleen
Gardner, William
Fang, Muriel Z.
Currie, Lisa
Choosing a Measure of Birth Size in Longitudinal Studies: How Do Various Measures Compare?
Presented: Dublin, Ireland, Society for Longitudinal and Life Course Studies (SLLS) International Conference, October 2015
Cohort(s): Children of the NLSY79, NLSY79, NLSY79 Young Adult
Publisher: Society for Longitudinal and Life Course Studies
Keyword(s): Adolescent Health; Age at Menarche/First Menstruation; Birthweight; Body Mass Index (BMI); Health Factors; Health/Health Status/SF-12 Scale; Methods/Methodology

Permission to reprint the abstract has not been received from the publisher.

As the fetal origins hypothesis has gained support over the past two decades, an increasing number of studies have used birth size as a predictor for later life health. Birth size is thought to matter because it is a marker of adverse intrauterine conditions that results in various structural, physiological and metabolic changes in the fetus. Empirical tests of the fetal origins hypothesis have generally provided support, but not all studies have found a relationship. This may be related to methodological differences across studies, with wide variation in how birth size is measured. For example, birth size has been captured using birth weight as a continuous measure as well as in categories of low and high weight; others capture gestational age or birth length as part of the measure. Little justification is generally provided regarding the choice of measure. But are these measures the same? Clinical research in maternal-fetal medicine indicates that different birth size measures provide different information about fetal development, thus suggesting that these measures may not be interchangeable. The purpose of this study is: i) to investigate how different birth size indexes predict young adult health outcomes, including age at menarche and BMI, outcomes that are related to adult health; and ii) whether different indexes identify the same group of high risk infants. The US based NLSY79 mother, child and young adult files are used in these analyses. Sample inclusion requires birth data and young adult outcomes on the participants. Regression analyses will be completed. Results from these analyses will help inform researchers about how various measures of birth size compare, providing empirical results to inform decisions regarding the choice of birth size measure in future studies.
Bibliography Citation
Salsberry, Pamela J., Patricia Benton Reagan, Kathleen Pajer, William Gardner, Muriel Z. Fang and Lisa Currie. "Choosing a Measure of Birth Size in Longitudinal Studies: How Do Various Measures Compare?" Presented: Dublin, Ireland, Society for Longitudinal and Life Course Studies (SLLS) International Conference, October 2015.
6. Tanda, Rika
Salsberry, Pamela J.
Reagan, Patricia Benton
Fang, Muriel Z.
The Impact of Prepregnancy Obesity on Children’s Cognitive Test Scores
Maternal and Child Health Journal 17,2 (February 2013): 222-229.
Also: http://www.springerlink.com/content/800p605l320n7861/
Cohort(s): Children of the NLSY79, NLSY79
Publisher: Springer
Keyword(s): Birthweight; Body Mass Index (BMI); Home Observation for Measurement of Environment (HOME); Obesity; Peabody Individual Achievement Test (PIAT- Math); Peabody Individual Achievement Test (PIAT- Reading); Pre/post Natal Behavior; Pregnancy and Pregnancy Outcomes; Weight

Permission to reprint the abstract has not been received from the publisher.

To examine the association between maternal prepregnancy obesity and cognitive test scores of children at early primary school age. A descriptive observational design was used. Study subjects consist of 3,412 US children aged 60–83 months from the National Longitudinal Survey of Youth 1979 Mother and Child Survey. Cognitive test scores using the Peabody Individual Achievement Test reading recognition and mathematics tests were used as the outcomes of interest. Association with maternal prepregnancy obesity was examined using the ordinary least square regression controlling for intrauterine, family background, maternal and child factors. Children of obese women had 3 points (0.23 SD units) lower peabody individual achievement test (PIAT) reading recognition score (p = 0.007), and 2 points (0.16 SD units) lower PIAT mathematics scores (p < 0.0001), holding all other factors constant. As expected, cognitive test score was associated with stimulating home environment (reading: β = 0.15, p < 0.0001, and math: β = 0.15, p < 0.0001), household income (reading: β = 0.03, p = 0.02 and math: β = 0.04, p = 0.004), maternal education (reading: β = 0.42, p = 0.0005, and math: β = 0.32, p = 0.008), and maternal cognitive skills (reading: β = 0.11, p < 0.0001, and math: β = 0.09, p < 0.0001). There was a significant association between maternal prepregnancy obesity and child cognitive test scores that could not be explained by other intrauterine, family background, maternal, and child factors. Children who live in disadvantaged postnatal environments may be most affected by the effects of maternal prepregnancy obesity. Replications of the current study using different cohorts are warranted to confirm the association between maternal prepregnancy obesity and child cognitive test scores.
Bibliography Citation
Tanda, Rika, Pamela J. Salsberry, Patricia Benton Reagan and Muriel Z. Fang. "The Impact of Prepregnancy Obesity on Children’s Cognitive Test Scores ." Maternal and Child Health Journal 17,2 (February 2013): 222-229.