The Impact of Childhood Obesity on Health and Health Service Use
利用英国儿童调查数据，采用回归、兄弟姐妹固定效应和工具变量等方法，发现肥胖对儿童自评健康有显著负面影响，并增加医疗服务使用。
OBJECTIVE: To test the impact of obesity on health and health care use in children, by the use of various methods to account for reverse causality and omitted variables. DATA SOURCES/STUDY SETTING: Fifteen rounds of the Health Survey for England (1998-2013), which is representative of children and adolescents in England. STUDY DESIGN: We use three methods to account for reverse causality and omitted variables in the relationship between BMI and health/health service use: regression with individual, parent, and household control variables; sibling fixed effects; and instrumental variables based on genetic variation in weight. DATA COLLECTION/EXTRACTION METHODS: We include all children and adolescents aged 4-18 years old. PRINCIPAL FINDINGS: We find that obesity has a statistically significant and negative impact on self-rated health and a positive impact on health service use in girls, boys, younger children (aged 4-12), and adolescents (aged 13-18). The findings are comparable in each model in both boys and girls. CONCLUSIONS: Using econometric methods, we have mitigated several confounding factors affecting the impact of obesity in childhood on health and health service use. Our findings suggest that obesity has severe consequences for health and health service use even among children.