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Is prenatal care really ineffective? Or, is the 'devil' in the distribution?

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  • Conway, Karen Smith
  • Deb, Partha

Abstract

It is widely believed that expanding prenatal care should improve infant health; yet research typically finds weak effects of prenatal care on infant health. We argue that there are two kinds of pregnancies, 'complicated' and 'normal' ones, and that combining these pregnancies, as past research does, may lead prenatal care to appear ineffective. Data from the NMIHS offers compelling evidence supporting our view. The standard 2SLS approach yields residuals that are obviously bimodal and prenatal care coefficients that are frequently insignificant. In contrast, estimating birth weights with a finite mixture model yields estimates that are much more robust and that clearly suggest that prenatal care has a consistent, substantial effect on ?normal? pregnancies. Our Monte Carlo experiment confirms that ignoring even a small proportion of ?complicated? pregnancies can lead the onset of prenatal care to appear unimportant.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 24 (2005)
Issue (Month): 3 (May)
Pages: 489-513

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Handle: RePEc:eee:jhecon:v:24:y:2005:i:3:p:489-513

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Web page: http://www.elsevier.com/locate/inca/505560

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References

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  1. Jonathan Gruber, 1997. "Policy Watch: Medicaid and Uninsured Women and Children," Journal of Economic Perspectives, American Economic Association, vol. 11(4), pages 199-208, Fall.
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  14. Karen Smith Conway & Lisa DeFelice Kennedy, 2004. "Maternal Depression and the Production of Infant Health," Southern Economic Journal, Southern Economic Association, vol. 71(2), pages 260-286, October.
  15. Grossman, Michael & Joyce, Theodore J, 1990. "Unobservables, Pregnancy Resolutions, and Birth Weight Production Functions in New York City," Journal of Political Economy, University of Chicago Press, vol. 98(5), pages 983-1007, October.
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Citations

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Cited by:
  1. Olena Y. Nizalova & Maria Vyshnya, 2010. "Evaluation of the impact of the Mother and Infant Health Project in Ukraine," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 107-125, September.
  2. Nancy E. Reichman & Hope Corman & Kelly Noonan & Dhaval Dave, 2009. "Infant health production functions: what a difference the data make," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 761-782.
  3. Partha Deb & Pravin Trivedi, 2011. "Finite Mixture for Panels with Fixed Effects," Hunter College Department of Economics Working Papers 432, Hunter College: Department of Economics.
  4. Munkin M & Trivedi P. K, 2009. "Incentives and Selection Effects of Drug Coverage on Total Drug Expenditure: a Finite Mixture Approach," Health, Econometrics and Data Group (HEDG) Working Papers 09/22, HEDG, c/o Department of Economics, University of York.
  5. Victoria Ateca-Amestoy & Arantza Ugidos, 2013. "The Impact of Different Types of Resource Transfers on Individual Wellbeing: An Analysis of Quality of Life Using CASP-12," Social Indicators Research, Springer, vol. 110(3), pages 973-991, February.
  6. Lien, Hsien-Ming & Lu, Mingshan & Albert Ma, Ching-To & McGuire, Thomas G., 2010. "Progress and compliance in alcohol abuse treatment," Journal of Health Economics, Elsevier, vol. 29(2), pages 213-225, March.
  7. Fishman, Ezra & Kimhi, Ayal, 2013. "Is the Israeli Labor Market Segmented? Revisiting the Mixture Regression Model," Discussion Papers 164512, Hebrew University of Jerusalem, Department of Agricultural Economics and Management.
  8. Colchero, M.A. & Sosa-RubĂ­, S.G., 2012. "Heterogeneity of income and lifestyle determinants of body weight among adult women in Mexico, 2006," Social Science & Medicine, Elsevier, vol. 75(1), pages 120-128.
  9. Wehby, George L. & Castilla, Eduardo E. & Lopez-Camelo, Jorge, 2010. "The impact of altitude on infant health in South America," Economics & Human Biology, Elsevier, vol. 8(2), pages 197-211, July.
  10. Deb, Partha & Gallo, William T. & Ayyagari, Padmaja & Fletcher, Jason M. & Sindelar, Jody L., 2011. "The effect of job loss on overweight and drinking," Journal of Health Economics, Elsevier, vol. 30(2), pages 317-327, March.
  11. Wehby, George L. & Murray, Jeffrey C. & Castilla, Eduardo E. & Lopez-Camelo, Jorge S. & Ohsfeldt, Robert L., 2009. "Prenatal care demand and its effects on birth outcomes by birth defect status in Argentina," Economics & Human Biology, Elsevier, vol. 7(1), pages 84-95, March.
  12. Karen Smith Conway & Andrea Kutinova, 2006. "Maternal health: does prenatal care make a difference?," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 461-488.
  13. George L. Wehby & Jeffrey C. Murray & Eduardo E. Castilla & Jorge S. Lopez-Camelo & Robert L. Ohsfeldt, 2009. "Quantile effects of prenatal care utilization on birth weight in Argentina," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1307-1321.

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