IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp11847.html
   My bibliography  Save this paper

Growing Together: Assessing Equity and Efficiency in an Early-Life Health Program in Chile

Author

Listed:
  • Clarke, Damian

    (University of Chile)

  • Cortés Méndez, Gustavo

    (Universidad de Santiago de Chile)

  • Vergara Sepúlveda, Diego

    (Universidad de Santiago de Chile)

Abstract

We study the mechanism of action of an early-life social safety net program, and quantify its impact on child health outcomes at birth. We consider both the equity and efficiency implications of program impacts, and provide a metric to compare various such programs around the world. In particular, we estimate the impact of participation in Chile Crece Contigo (ChCC), Chile's flagship early-life health and social welfare program, using administrative birth data matched to social benefits usage. We find that this targeted social program had significant effects on birth weight (approximately 10 grams) and other early life human capital measures. These benefits are largest among the most socially vulnerable groups, however shift outcomes toward the middle of the distribution of health at birth. We show that the program is efficient when compared to other successful neonatal health programs around the world, and find some evidence to suggest that maternal nutrition components and increased links to the social safety net are important mechanisms of action.

Suggested Citation

  • Clarke, Damian & Cortés Méndez, Gustavo & Vergara Sepúlveda, Diego, 2018. "Growing Together: Assessing Equity and Efficiency in an Early-Life Health Program in Chile," IZA Discussion Papers 11847, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp11847
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp11847.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Heather Royer, 2009. "Separated at Girth: US Twin Estimates of the Effects of Birth Weight," American Economic Journal: Applied Economics, American Economic Association, vol. 1(1), pages 49-85, January.
    2. Anderson, Michael L, 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Department of Agricultural & Resource Economics, UC Berkeley, Working Paper Series qt15n8j26f, Department of Agricultural & Resource Economics, UC Berkeley.
    3. Joseph P. Romano & Michael Wolf, 2005. "Stepwise Multiple Testing as Formalized Data Snooping," Econometrica, Econometric Society, vol. 73(4), pages 1237-1282, July.
    4. Pedro Carneiro & Emanuela Galasso & Rita Ginja, 2019. "Tackling Social Exclusion: Evidence from Chile," The Economic Journal, Royal Economic Society, vol. 129(617), pages 172-208.
    5. Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2010. "Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 591-634.
    6. Jonah B. Gelbach, 2016. "When Do Covariates Matter? And Which Ones, and How Much?," Journal of Labor Economics, University of Chicago Press, vol. 34(2), pages 509-543.
    7. Sebastian Calonico & Matias D. Cattaneo & Rocio Titiunik, 2014. "Robust Nonparametric Confidence Intervals for Regression‐Discontinuity Designs," Econometrica, Econometric Society, vol. 82, pages 2295-2326, November.
    8. Hoynes, Hilary & Page, Marianne & Stevens, Ann Huff, 2011. "Can targeted transfers improve birth outcomes?: Evidence from the introduction of the WIC program," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 813-827, August.
    9. Janet Currie & Tom Vogl, 2013. "Early-Life Health and Adult Circumstance in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 1-36, May.
    10. Flavio Cunha & James J. Heckman & Susanne M. Schennach, 2010. "Estimating the Technology of Cognitive and Noncognitive Skill Formation," Econometrica, Econometric Society, vol. 78(3), pages 883-931, May.
    11. Rosenzweig, Mark R. & Zhang, Junsen, 2013. "Economic growth, comparative advantage, and gender differences in schooling outcomes: Evidence from the birthweight differences of Chinese twins," Journal of Development Economics, Elsevier, vol. 104(C), pages 245-260.
    12. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    13. Rossin-Slater, Maya, 2013. "WIC in your neighborhood: New evidence on the impacts of geographic access to clinics," Journal of Public Economics, Elsevier, vol. 102(C), pages 51-69.
    14. Orazio P. Attanasio & Vincenzo Di Maro & Marcos Vera‐Hernández, 2013. "Community Nurseries and the Nutritional Status of Poor Children. Evidence from Colombia," Economic Journal, Royal Economic Society, vol. 123, pages 1025-1058, September.
    15. A. Colin Cameron & Douglas L. Miller, 2015. "A Practitioner’s Guide to Cluster-Robust Inference," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 317-372.
    16. Marianne P. Bitler & Lynn A. Karoly, 2015. "Intended And Unintended Effects Of The War On Poverty: What Research Tells Us And Implications For Policy," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 34(3), pages 639-696, June.
    17. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
    18. Andrea Bentancor & Damian Clarke, 2017. "Assessing Plan B: The Effect of the Morning After Pill on Children and Women," Economic Journal, Royal Economic Society, vol. 127(607), pages 2525-2552, December.
    19. Justin Cook, C. & Fletcher, Jason M., 2015. "Understanding heterogeneity in the effects of birth weight on adult cognition and wages," Journal of Health Economics, Elsevier, vol. 41(C), pages 107-116.
    20. Douglas Almond & Janet Currie, 2011. "Killing Me Softly: The Fetal Origins Hypothesis," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 153-172, Summer.
    21. Fletcher, Jason M., 2011. "The medium term schooling and health effects of low birth weight: Evidence from siblings," Economics of Education Review, Elsevier, vol. 30(3), pages 517-527, June.
    22. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    23. Johnson Rucker C & Schoeni Robert F, 2011. "The Influence of Early-Life Events on Human Capital, Health Status, and Labor Market Outcomes Over the Life Course," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(3), pages 1-57, September.
    24. Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March.
    25. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    26. Gerard J. van den Berg & Maarten Lindeboom & France Portrait, 2006. "Economic Conditions Early in Life and Individual Mortality," American Economic Review, American Economic Association, vol. 96(1), pages 290-302, March.
    27. Damian Clarke & Sonia Oreffice & Climent Quintana‐Domeque, 2021. "On the Value of Birth Weight," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 83(5), pages 1130-1159, October.
    28. Hoynes, Hilary & Page, Marianne & Stevens, Ann Huff, 2011. "Can targeted transfers improve birth outcomes?," Journal of Public Economics, Elsevier, vol. 95(7), pages 813-827.
    29. Orla Doyle, 2017. "The First 2,000 Days and Child Skills: Evidence from a Randomized Experiment of Home Visiting," Working Papers 201715, School of Economics, University College Dublin.
    30. Douglas Almond & Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2011. "Inside the War on Poverty: The Impact of Food Stamps on Birth Outcomes," The Review of Economics and Statistics, MIT Press, vol. 93(2), pages 387-403, May.
    31. Barham, Tania, 2011. "A healthier start: The effect of conditional cash transfers on neonatal and infant mortality in rural Mexico," Journal of Development Economics, Elsevier, vol. 94(1), pages 74-85, January.
    32. McCrary, Justin, 2008. "Manipulation of the running variable in the regression discontinuity design: A density test," Journal of Econometrics, Elsevier, vol. 142(2), pages 698-714, February.
    33. repec:pri:rpdevs:currie_vogl_ar is not listed on IDEAS
    34. Romano, Joseph P. & Wolf, Michael, 2016. "Efficient computation of adjusted p-values for resampling-based stepdown multiple testing," Statistics & Probability Letters, Elsevier, vol. 113(C), pages 38-40.
    35. Douglas Almond & Bhashkar Mazumder, 2005. "The 1918 Influenza Pandemic and Subsequent Health Outcomes: An Analysis of SIPP Data," American Economic Review, American Economic Association, vol. 95(2), pages 258-262, May.
    36. Alejandra Marroig & Ivone Perazzo & Gonzalo Salas & Andrea Vigorito, 2017. "Evaluación de impacto del programa de acompañamiento familiar de Uruguay Crece Contigo," Documentos de Trabajo (working papers) 17-15, Instituto de Economía - IECON.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    2. Sonia Bhalotra & Martin Karlsson & Therese Nilsson & Nina Schwarz, 2022. "Infant Health, Cognitive Performance, and Earnings: Evidence from Inception of the Welfare State in Sweden," The Review of Economics and Statistics, MIT Press, vol. 104(6), pages 1138-1156, November.
    3. Beltran-Silva, Francisco, 2023. "Fighting against hunger: A country-wide intervention and its impact on birth outcomes," World Development, Elsevier, vol. 165(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Damian Clarke & Gustavo Cortés Méndez & Diego Vergara Sepúlveda, 2020. "Growing together: assessing equity and efficiency in a prenatal health program," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(3), pages 883-956, July.
    2. Damian Clarke & Sonia Oreffice & Climent Quintana‐Domeque, 2021. "On the Value of Birth Weight," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 83(5), pages 1130-1159, October.
    3. Almond, Douglas & Currie, Janet, 2011. "Human Capital Development before Age Five," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 15, pages 1315-1486, Elsevier.
    4. Cygan-Rehm, Kamila & Karbownik, Krzysztof, 2022. "The effects of incentivizing early prenatal care on infant health," Journal of Health Economics, Elsevier, vol. 83(C).
    5. Douglas Almond & Janet Currie & Valentina Duque, 2018. "Childhood Circumstances and Adult Outcomes: Act II," Journal of Economic Literature, American Economic Association, vol. 56(4), pages 1360-1446, December.
    6. González, Libertad & Trommlerová, Sofia, 2022. "Cash transfers before pregnancy and infant health," Journal of Health Economics, Elsevier, vol. 83(C).
    7. Libertad González & Sofia Trommlerová, 2021. "Prenatal Transfers and Infant Health: Evidence from Spain," Working Papers 1261, Barcelona School of Economics.
    8. Libertad González Luna & Sofia Trommlerová, 2021. "Prenatal transfers and infant health: Evidence from Spain," Economics Working Papers 1783, Department of Economics and Business, Universitat Pompeu Fabra.
    9. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    10. Haeck, Catherine & Lefebvre, Pierre, 2016. "A simple recipe: The effect of a prenatal nutrition program on child health at birth," Labour Economics, Elsevier, vol. 41(C), pages 77-89.
    11. Da Mata, Daniel & Emanuel, Lucas & Pereira, Vitor & Sampaio, Breno, 2023. "Climate adaptation policies and infant health: Evidence from a water policy in Brazil," Journal of Public Economics, Elsevier, vol. 220(C).
    12. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    13. Chyn, Eric & Gold, Samantha & Hastings, Justine, 2021. "The returns to early-life interventions for very low birth weight children," Journal of Health Economics, Elsevier, vol. 75(C).
    14. Di Giacomo, Marina & Piacenza, Massimiliano & Siciliani, Luigi & Turati, Gilberto, 2022. "The effect of co-payments on the take-up of prenatal tests," Journal of Health Economics, Elsevier, vol. 81(C).
    15. Hilary Hoynes & Diane Whitmore Schanzenbach & Douglas Almond, 2016. "Long-Run Impacts of Childhood Access to the Safety Net," American Economic Review, American Economic Association, vol. 106(4), pages 903-934, April.
    16. Lina Cardona-Sosa & Carlos Medina, 2016. "The Effects of In utero Programs on Birth Outcomes: The Case of “Buen Comienzo” *** El Efecto de Programas dirigidos a Madres Gestantes en Indicadores al Nacer: El caso de “Buen Comienzo”," Borradores de Economia 955, Banco de la Republica de Colombia.
    17. Duque, Valentina & Rosales-Rueda, Maria & Sanchez, Fabio, 2019. "How Do Early-Life Shocks Interact with Subsequent Human Capital Investments? Evidence from Administrative Data," Working Papers 2019-17, University of Sydney, School of Economics.
    18. Clarke, Damian & Bustos, Nicolás Lillo & Tapia-­Schythe, Kathya, 2022. "Estimating Inter-Generational Returns to Medical Care: New Evidence from At­-Risk Newborns," IZA Discussion Papers 15593, Institute of Labor Economics (IZA).
    19. Lin, Ming-Jen & Liu, Elaine M., 2014. "Does in utero exposure to Illness matter? The 1918 influenza epidemic in Taiwan as a natural experiment," Journal of Health Economics, Elsevier, vol. 37(C), pages 152-163.
    20. Noghanibehambari, Hamid, 2022. "Intergenerational health effects of Medicaid," Economics & Human Biology, Elsevier, vol. 45(C).

    More about this item

    Keywords

    efficiency; social security; neonatal health; public health; early life investments;
    All these keywords.

    JEL classification:

    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • H43 - Public Economics - - Publicly Provided Goods - - - Project Evaluation; Social Discount Rate
    • O38 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Government Policy
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp11847. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.