The effect of expansions in medicaid income eligibility on abortion

In this paper we examine the effect of expansions in Medicaid income eligibility on abortion, using individual-level data from South Carolina, Tennessee, and Virginia. The results suggest that for unmarried nonblack women with less than a high school degree, expansions of income eligibility lowered the probability of abortion by two to five percentage points. Most of the impact of the Medicaid expansions on abortion occurred in the first round of expansions from approximately 45% of the federal poverty level to 100%. For black unmarried women with less than a high school degree, we generally find no effect of expansions in Medicaid income eligibility on abortion.     

The effect of pregnancy intention on child development

In this paper, we use data from the National Longitudinal Survey of Youth to investigate the empirical link between unintended pregnancy and child health and development. An important contribution of our study is the use of information on siblings to control for unmeasured factors that may confound estimates of the effect of pregnancy intentions on infant and child outcomes. Results from our study indicate that unwanted pregnancy is associated with prenatal and postpartum maternal behaviors that adversely affect infant and child health, but that unwanted pregnancy has little association with birth weight and child cognitive outcomes. Estimates of the association between unwanted pregnancy and maternal behaviors were greatly reduced after controls for unmeasured family background were included in the model. Our results also indicate that there are no significant differences in maternal behaviors or child outcomes between mistimed and wanted pregnancies.     

Family cap provisions and changes in births and abortions

As part of welfare reform efforts in the 1990s, 23 states implemented family caps, provisions that deny or reduce cash assistance to welfare recipients who have additional births. We use birth and abortion records from 24 states to estimate effects of family caps on birth and abortion rates. We use age, marital status, and completed schooling to identify women at high risk for use of public assistance, and parity (number of previous live births) to identify those most directly affected by the family cap. In family cap states, birth rates fell more and abortion rates rose more among high-risk women with at least one previous live birth compared to similar childless women, consistent with an effect of the family cap. However, this parity-specific pattern of births and abortions also occurred in states that implemented welfare reform with no family cap. Thus, the effects of welfare reform may have differed between mothers and childless women, but there is little evidence of an independent effect of the family cap.     

DO SUPPLY‐SIDE FORCES EXPLAIN GEOGRAPHIC VARIATION IN HEALTH CARE USE?

Regional variation in health care utilization has been well‐documented, yet uncertainty persists about whether this variation is primarily the result of supply‐side or demand‐side forces. We provide new evidence on this issue by examining changes in health care use for the near‐elderly as they transition from being uninsured into Medicare. Results support a causal, supply‐side explanation of regional variation. Estimates indicate that gaining Medicare coverage in above‐median spending regions increases the probability of at least one hospital visit by 40% and the probability of having more than five doctor visits by 26% relative to similar individuals in below‐median spending regions. (JEL D43, H42, H51, I1, I11, I13)     

Child Care and Work Absences: Trade‐Offs by Type of Care

Parents face a trade‐off in the effect of child‐care problems on employment. Whereas large settings may increase problems because of child illness, small group care may relate to provider unavailability. Analyzing the NICHD Study of Early Child Care, we find that child‐care centers and large family day care lead to mothers’ greater work absences because of a sick child, but not to maternal job exits. Greater work absences because of unavailability of small home‐based providers are associated with mothers’ job exits, especially when mothers have low earnings and use nonrelative caregivers. Our findings accentuate the need for improved hygiene practices in child care, expanded personal leave coverage for parents, and greater backup care for sick and well children.     

The effects of child health on marital status and family structure

The purpose of this paper is to provide evidence on the effect of child health on marital stability and family structure in an economic framework. We use the 1988 National Health Interview Survey's Child Health Supplement, with a sample of about 9,000 families, to test whether having an unhealthy child decreases the mother's chance of being married and whether it increases her chance of living in an extended family. Using two different measures of child health, we find that having an unhealthy child decreases the mother's likelihood of being married. Our results imply that children in poor health are more likely to face obstacles beyond their illness because they also are more likely to suffer the consequences of poverty and the poor schooling outcomes that result from being raised in a female-headed household. The only mitigating factor is that unhealthy white children are more likely than their healthy counterparts to be living in an extended family.     

The effects of maternal employment on child injuries and infectious disease

This article presents estimates of effects of maternal paid work and nonmaternal child care on injuries and infectious disease for children aged 12 to 36 months. Mother-child fixed-effects estimates are obtained by using data from the NICHD Study of Early Child Care. Estimates indicate that maternal employment itself has no statistically significant adverse effects on the incidence of infectious disease and injury. However greater time spent by children in center-based care is associated with increased rates of respiratory problems for children aged 12 to 36 months and increased rates of ear infections for children aged 12 to 24 months.     

THE EFFECT OF MATERNAL DRUG USE ON BIRTH WEIGHT: MEASUREMENT ERROR IN BINARY VARIABLES

We develop a method to correct for non-random measurement error in a binary indicator of illicit drugs. Our results suggest that estimates of the effect of self-reported prenatal drug use on birth weight are biased upwards by measurement error—a finding contrary to predictions of a model of random measurement error. More accurate estimates of the true effect of drug use on birth weight can be obtained by using the predicted probability of falsely reporting drug use. Thus out-of-sample information on drug use may improve estimates of the effect of reported drug use in other settings.     

Family cap provisions and changes in births and abortions

As part of welfare reform efforts in the 1990s, 23 states implemented family caps, provisions that deny or reduce cash assistance to welfare recipients who have additional births. We use birth and abortion records from 24 states to estimate effects of family caps on birth and abortion rates. We use age, marital status, and completed schooling to identify women at high risk for use of public assistance, and parity (number of previous live births) to identify those most directly affected by the family cap. In family cap states, birth rates fell more and abortion rates rose more among high-risk women with at least one previous live birth compared to similar childless women, consistent with an effect of the family cap. However, this parity-specific pattern of births and abortions also occurred in states that implemented welfare reform with no family cap. Thus, the effects of welfare reform may have differed between mothers and childless women, but there is little evidence of an independent effect of the family cap.     

Stress, Allostatic Load and Health of Mexican Immigrants

OBJECTIVE: To assess whether the cumulative impact of exposure to repeated or chronic stressors as measured by allostatic load, contributes to the "unhealthy assimilation" effects often observed for immigrants with time in the United States. METHODS: We analyzed data from the National Health and Nutrition Examination Survey, 1988-1994, to estimate multivariate logistic regression models of the odds of having a high allostatic load score among Mexican immigrants, stratified by adult age group, according to length of residence in US, controlling for demographic, socioeconomic, and health input covariates. RESULTS: Estimates indicate that 45-60 year old Mexican immigrants have lower allostatic load scores upon arrival than US-born Mexican Americans, non-Hispanic whites, and non-Hispanic Blacks, and that this health advantage is attenuated with duration of residence in the US. CONCLUSIONS: The findings of our analysis are consistent with the hypothesis that repeated or chronic physiological adaptation to stressors is one contributor to the "unhealthy assimilation" effect observed for Mexican immigrants.