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« Back to Results

Determinants of Children's Health

Paper Session

Friday, Jan. 4, 2019 2:30 PM - 4:30 PM

Atlanta Marriott Marquis, M104
Hosted By: American Economic Association
  • Chair: Diane Whitmore Schanzenbach, Northwestern University

Do Better-Informed Individuals Make Healthier Choices? Evidence from Calorie Labeling and Weight Gain During Pregnancy

Koray Caglayan
,
Tulane University
Rodrigo Aranda Balcazar
,
Tulane University

Abstract

Does disclosure of dietary information lead to healthier choices and outcomes? We use calorie labeling laws (CLLs) to investigate the effect of information disclosure on people’s health behaviors and outcomes. CLLs mandate the disclosure of calorie content of fast food items to the public, exogenously raising the level of available information. Unlike previous studies that look at all adults; we focus on pregnant women, a subpopulation that is likely to be more sensitive to new dietary information. To measure the impact of information disclosure on maternal behaviors and outcomes, we use Natality Data and employ a difference-in-differences strategy where the 2008 New York City Labeling Mandate serves as the exogenous shock. In order to make sure our results are not unique to NYC, we do the same analysis for King County where a similar CLL took effect.

Our results show a statistically significant decline of 4.1 percent in maternal weight gain during pregnancy for NYC. This decline is higher for first pregnancies. Excessive weight gain (i.e. gaining more than 15 kg) during pregnancy also decreases, especially among minorities and relatively younger mothers. We find statistically significant and economically meaningful declines in the prevalence of pregnancy-associated hypertension, post-term pregnancies (gestation>=42 weeks) and fetal macrosomia (birth weight>4500 grams). Point estimates from King County agree with those from NYC and raise our confidence to state that the identified effects are not unique to NYC.

These results suggest that available information has a significant impact on maternal weight gain during pregnancy. This impact seems to translate into a decrease in the incidence of risk factors and complications during pregnancy and labor. Our findings imply that providing expecting mothers with necessary information and raising awareness about the consequences of their choices should be an integral part of policies towards maternal and child health.

Maternal employment, time use, and overweight children: A series of implications of legal marijuana sales

Rahi Abouk
,
William Paterson University
Scott Adams
,
University of Wisconsin-Milwaukee

Abstract

When states allow for recreational use and sale of marijuana legally, we find that parents with grade-school aged kids in the household have lower employment rates and lower labor force participation rates. As a plausible explanation, we offer evidence establishing a concurrent increase in older worker labor force participation and employment, which likely is attributable to the latter’s greater ability to manage work-limiting conditions. In a two-stage estimation, we also show that the grade-school aged children of women not in the labor force following legal marijuana sales have a lower prevalence of obesity. Finally, we show in time use data that parents are spending more times cooking food and less time dining out with their kids following marijuana legalization.

Early Life Medicaid Eligibility and Human Capital

Javaeria Qureshi
,
University of Illinois-Chicago
Anuj Gangopadhyaya
,
Urban Institute

Abstract

While past work has studied the effect of Medicaid expansions for children on access to healthcare, childhood health and, more recently, subsequent health in adulthood, only a handful of studies have investigated the spillover effects of Medicaid on children’s non-health outcomes such as their educational attainment and earnings. Human capital theory predicts that Medicaid can affect children’s education and academic performance because it may lead to significant improvements in children’s health and increased financial stability in their households.

This study evaluates the effect of early life Medicaid eligibility on short-term academic outcomes and health. We exploit a discontinuity in childhood Medicaid eligibility based on date of birth to study the effects of expanded Medicaid eligibility between the ages of 8 and 14. We use the National Health Insurance Survey to show that the Medicaid expansion we study is associated with significant expansions in health insurance and Medicaid coverage rates. We then use administrative school records from North Carolina to study the effect of the expanded Medicaid eligibility on children when they are 13 years old.

Our study finds that the Medicaid expansion significantly increases the grade that children are observed in and reduces the likelihood that a child is below grade. We also investigate the effect on reading and math proficiency, absences from school, the likelihood of having any disability and of having a learning disabilities, and find that there is no effect on any of these outcomes. Our finding that the Medicaid expansion has no significant effect on disabilities and absences, along with the significant heterogeneity we document in the effect on grade level by gender, suggests that Medicaid may benefit education through improving family resources rather than improving child health.

Deforestation, Malaria and Infant Mortality in Indonesia

Averi Chakrabarti
,
University of North Carolina-Chapel Hill

Abstract

Indonesia has experienced high levels of deforestation in recent years. In this paper, I investigate whether deforestation-induced malaria increases have led to higher infant mortality in the country. My empirical strategy exploits the pregnancy order-specific variation that exists in the risk of malaria—the disease is most likely to infect women during their first pregnancy and so adverse birth outcomes due to maternal malaria disproportionately affect firstborn children. I explore whether first born mortality changes differentially during deforestation relative to later born mortality. Results demonstrate that when mothers experience forest loss during pregnancy, firstborn children do indeed face a greater risk of infant mortality compared to other children. Apart from malaria, none of the factors that could change with declining forest cover (like air pollution) have such parity-specific effects. The findings thus point to malaria’s role in the resulting deaths.

Improving Child Health and Cognition: Evidence from a School-Based Nutrition Intervention in India

Santosh Kumar
,
Sam Houston State University
Sebastian Vollmer
,
University of Goettingen
Marion Kramer
,
University of Goettingen

Abstract

We present an experimental evidence on the impact of delivering double-fortified salt (DFS), salt fortified with iron and iodine, through the Indian school-feeding program called “midday meal” on anemia, cognition, and math and reading outcomes of primary school children. We conducted a field experiment that randomly provided one-year supply of DFS at a subsidized price to public primary schools in one of the poorest regions of India. The DFS treatment had significantly positive impacts on hemoglobin levels and reduced the prevalence of any form of anemia by 9.3 percentage points (or about 20 percent) but these health gains did not translate into statistically significant impacts on cognition and test scores. While exploring the heterogeneity in effects, we find that treatment had statistically significant gains in anemia and test scores among children with higher treatment compliance. We further estimate that the intervention was very cost effective and can potentially be scaled up rather easily.

Maternity Leave and Long-Term Health Outcomes of Children

Marc Fabel
,
Munich Graduate School of Economics & Ifo Institute
Natalia Danzer
,
Ifo Institute

Abstract

This paper assesses the impact of the length of maternity leave on children’s long-run health outcomes. Our quasi-experimental design evaluates an expansion in maternity leave coverage from two to six months, which occurred in the Federal Republic of Germany in 1979. The expansion came into effect after a sharp cutoff date and significantly increased the time working mothers stayed at home with their newborns during the first six months after childbirth. In our analysis, we exploit German hospital registry data, containing detailed information about the universe of inpatients' diagnoses for the years 1995 to 2014. By tracking the health of treated and control children from age 16 up to age 35, we provide new insights into the trajectory of health differentials over the life-cycle. We find a positive effect of the legislative change on several measures of long-term child health. Our intention-to-treat estimates suggest that children who were born shortly after the implementation of the reform experience fewer hospital admissions and are less likely to be diagnosed with mental and behavioral disorders.
JEL Classifications
  • I1 - Health