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Rolling back the gains: Maternal stress undermines pregnancy health after Flint's water switch

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  • Shooshan Danagoulian
  • Derek Jenkins

Abstract

Environmental disasters impact disadvantaged communities disproportionately both through the epidemiological challenge of exposure, but also by undermining the progress of public health efforts. This paper studies changes to smoking cessation, breastfeeding, and weight gain during pregnancy in the period following the switch in water supply in Flint, Michigan, in April 2014. As the switch resulted in immediate and significant deterioration in water quality, eventually leading to its contamination with lead, we estimate a 10.5 percentage point increase in smoking and a 2.1 percentage point decrease in breastfeeding. We show evidence that these changes in maternal behavior are linked to increased stress due to changing water quality. We estimate that the increase in smoking alone is responsible for most of the increase in incidence of low birthweight among infants in Flint, resulting in $700 additional costs per birth. Increased smoking during pregnancy and lower breastfeeding rates in Flint roll back years of public health efforts, resulting in lifetime higher rates of cardiovascular disease, diabetes, and cancer for mothers in the community.

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  • Shooshan Danagoulian & Derek Jenkins, 2021. "Rolling back the gains: Maternal stress undermines pregnancy health after Flint's water switch," Health Economics, John Wiley & Sons, Ltd., vol. 30(3), pages 564-584, March.
    • Handle: RePEc:wly:hlthec:v:30:y:2021:i:3:p:564-584
    DOI: 10.1002/hec.4210
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    1. van Ewijk, Reyn, 2011. "Long-term health effects on the next generation of Ramadan fasting during pregnancy," Journal of Health Economics, Elsevier, vol. 30(6), pages 1246-1260.
    2. Currie, Janet & Rossin-Slater, Maya, 2013. "Weathering the storm: Hurricanes and birth outcomes," Journal of Health Economics, Elsevier, vol. 32(3), pages 487-503.
    3. Janet Currie & Joshua Graff Zivin & Katherine Meckel & Matthew Neidell & Wolfram Schlenker, 2013. "Something in the water: contaminated drinking water and infant health," Canadian Journal of Economics, Canadian Economics Association, vol. 46(3), pages 791-810, August.
    4. Bruno Ferman & Cristine Pinto, 2019. "Inference in Differences-in-Differences with Few Treated Groups and Heteroskedasticity," The Review of Economics and Statistics, MIT Press, vol. 101(3), pages 452-467, July.
    5. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    6. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    7. Hanna-Attisha, M. & LaChance, J. & Sadler, R.C. & Schnepp, A.C., 2016. "Elevated blood lead levels in children associated with the flint drinking water crisis: A spatial analysis of risk and public health response," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 283-290.
    8. Janet Currie & Stefano DellaVigna & Enrico Moretti & Vikram Pathania, 2010. "The Effect of Fast Food Restaurants on Obesity and Weight Gain," American Economic Journal: Economic Policy, American Economic Association, vol. 2(3), pages 32-63, August.
    9. Scott Cunningham & Manisha Shah, 2018. "Decriminalizing Indoor Prostitution: Implications for Sexual Violence and Public Health," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 85(3), pages 1683-1715.
    10. Agüero, Jorge M. & Beleche, Trinidad, 2017. "Health shocks and their long-lasting impact on health behaviors: Evidence from the 2009 H1N1 pandemic in Mexico," Journal of Health Economics, Elsevier, vol. 54(C), pages 40-55.
    11. Emilia Simeonova, 2011. "Out of Sight, Out of Mind? Natural Disasters and Pregnancy Outcomes in the USA," CESifo Economic Studies, CESifo Group, vol. 57(3), pages 403-431, September.
    12. E. Kathleen Adams & Vincent P. Miller & Carla Ernst & Brenda K. Nishimura & Cathy Melvin & Robert Merritt, 2002. "Neonatal health care costs related to smoking during pregnancy," Health Economics, John Wiley & Sons, Ltd., vol. 11(3), pages 193-206, April.
    13. Janet Currie & Michael Mueller-Smith & Maya Rossin-Slater, 2022. "Violence While in Utero: The Impact of Assaults during Pregnancy on Birth Outcomes," The Review of Economics and Statistics, MIT Press, vol. 104(3), pages 525-540, May.
    14. Miriam Wüst, 2015. "Maternal Employment During Pregnancy and Birth Outcomes: Evidence From Danish Siblings," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 711-725, June.
    15. Chalfin, Aaron & Danagoulian, Shooshan & Deza, Monica, 2019. "More sneezing, less crime? Health shocks and the market for offenses," Journal of Health Economics, Elsevier, vol. 68(C).
    16. Sarah Fuller, 2014. "The Effect of Prenatal Natural Disaster Exposure on School Outcomes," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1501-1525, August.
    17. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2016. "Does Grief Transfer across Generations? Bereavements during Pregnancy and Child Outcomes," American Economic Journal: Applied Economics, American Economic Association, vol. 8(1), pages 193-223, January.
    18. Daniel S. Grossman & David J.G. Slusky, 2019. "The Impact of the Flint Water Crisis on Fertility," Demography, Springer;Population Association of America (PAA), vol. 56(6), pages 2005-2031, December.
    19. Murphy, M.J. & Graziano, J.H. & Popovac, D. & Kline, J.K. & Mehmeti, A. & Factor-Litvak, P. & Ahmedi, G. & Shrout, P. & Rajovic, B. & Nenezic, D.U. & Stein, Z.A., 1990. "Past pregnancy outcomes among women living in the vicinity of a lead smelter in Kosovo, Yugoslavia," American Journal of Public Health, American Public Health Association, vol. 80(1), pages 33-35.
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    1. Chris Sampson’s journal round-up for 8th March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-08 12:00:01

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    Cited by:

    1. Dave, Dhaval M. & Yang, Muzhe, 2022. "Lead in drinking water and birth outcomes: A tale of two water treatment plants," Journal of Health Economics, Elsevier, vol. 84(C).
    2. Rui Wang & Xi Chen & Xun Li, 2022. "Something in the pipe: the Flint water crisis and health at birth," Journal of Population Economics, Springer;European Society for Population Economics, vol. 35(4), pages 1723-1749, October.
    3. Richard W. DiSalvo & Elaine L. Hill, 2024. "Drinking water contaminant concentrations and birth outcomes," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 43(2), pages 368-399, March.
    4. Shooshan Danagoulian & Thomas A. Wilk, 2022. "Locking out prevention: Dental care in the midst of a pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1973-1992, September.
    5. Shooshan Danagoulian & Daniel Grossman & David Slusky, 2022. "Health Care Following Environmental Disasters: Evidence from Flint," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 41(4), pages 1060-1089, September.

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