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The Costs of Low Birth Weight

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  • Douglas Almond
  • Kenneth Y. Chay
  • David S. Lee

Abstract

Birth weight has emerged as the leading indicator of infant health and welfare and the central focus of infant health policy. This is because low birth weight (LBW) infants experience severe health and developmental difficulties that can impose enormous costs on society. But would the prevention of LBW generate equally sizable cost savings and health improvements? Estimates of the return to LBW-prevention from cross-sectional associations may be biased by omitted variables that cannot be influenced by policy, such as genetic factors. To address this, we compare the hospital costs, health at birth, and infant mortality rates between heavier and lighter infants from all twin pairs born in the United States. We also examine the effect of maternal smoking during pregnancy the leading risk factor for LBW in the United States on health among singleton births after controlling for detailed background characteristics. Both analyses imply substantially smaller effects of LBW than previously thought, suggesting two possibilities: 1) existing estimates overstate the true costs and consequences of LBW by at least a factor of four and by as much as a factor of 20; or 2) different LBW-preventing interventions have different health and cost consequences, implying that policy efforts that presume a single return to reducing LBW will necessarily be suboptimal.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10552.

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Date of creation: Jun 2004
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Publication status: published as Almond, Douglas, Kenneth Y. Chay and David S. Lee. "The Costs Of Low Birth Weight," Quarterly Journal of Economics, 2005, v120(3,Aug), 1031-1083.
Handle: RePEc:nbr:nberwo:10552

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  1. Currie, J. & Cole, N., 1992. "Welfare and Child Health: the Link Between AFDC Participation and Birth Weight," Working papers 92-9, Massachusetts Institute of Technology (MIT), Department of Economics.
  2. Janet Currie & Rosemary Hyson, 1999. "Is the Impact of Health Shocks Cushioned by Socioeconomic Status? The Case of Low Birthweight," NBER Working Papers 6999, National Bureau of Economic Research, Inc.
  3. 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.
  4. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December.
  5. Hanratty, Maria J, 1996. "Canadian National Health Insurance and Infant Health," American Economic Review, American Economic Association, vol. 86(1), pages 276-84, March.
  6. Janet Currie & Enrico Moretti, 2003. "Mother'S Education And The Intergenerational Transmission Of Human Capital: Evidence From College Openings," The Quarterly Journal of Economics, MIT Press, vol. 118(4), pages 1495-1532, November.
  7. Rosenzweig, Mark R. & Wolpin, Kenneth I., 1991. "Inequality at birth : The scope for policy intervention," Journal of Econometrics, Elsevier, vol. 50(1-2), pages 205-228, October.
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