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Does the Delivery of Primary Health Care Improve Birth Outcomes? Evidence from the Rollout of Community Health Centers

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Listed:
  • Esra Kose
  • Siobhan M. O'Keefe
  • Maria Rosales-Rueda

Abstract

Community Health Centers (CHCs) deliver primary care to underserved populations by locating sliding-scale clinics in economically disadvantaged areas. We investigate how this policy affected infant health using the rollout of CHCs and a flexible event study framework with Vital Statistics natality data. We find that maternal access to CHCs improves infant health outcomes within seven years after their introduction. Treatment-on-the-treated estimates show a 25 to 42 gram increase in birth weight and a 9% to 16% reduction in the likelihood of low birth weight. These improvements in infant health can be explained by increased access to early prenatal care and reductions in maternal smoking.

Suggested Citation

  • Esra Kose & Siobhan M. O'Keefe & Maria Rosales-Rueda, 2022. "Does the Delivery of Primary Health Care Improve Birth Outcomes? Evidence from the Rollout of Community Health Centers," NBER Working Papers 30047, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:30047
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    1. Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2009. "Consumption Responses to In-Kind Transfers: Evidence from the Introduction of the Food Stamp Program," American Economic Journal: Applied Economics, American Economic Association, vol. 1(4), pages 109-139, October.
    2. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    3. 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.
    4. Janet Currie, 2011. "Inequality at Birth: Some Causes and Consequences," American Economic Review, American Economic Association, vol. 101(3), pages 1-22, May.
    5. 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.
    6. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2007. "From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 409-439.
    7. Sox, C.M. & Swartz, K. & Burstin, H.R. & Brennan, T.A., 1998. "Insurance or a regular physician: Which is the most powerful predictor of health care?," American Journal of Public Health, American Public Health Association, vol. 88(3), pages 364-370.
    8. Jens Ludwig & Douglas L. Miller, 2007. "Does Head Start Improve Children's Life Chances? Evidence from a Regression Discontinuity Design," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 159-208.
    9. Abrevaya, Jason & Dahl, Christian M, 2008. "The Effects of Birth Inputs on Birthweight," Journal of Business & Economic Statistics, American Statistical Association, vol. 26, pages 379-397.
    10. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    11. Melissa S. Kearney & Phillip B. Levine, 2007. "Socioeconomic Disadvantage and Early Childbearing," NBER Chapters, in: The Problems of Disadvantaged Youth: An Economic Perspective, pages 181-209, National Bureau of Economic Research, Inc.
    12. Martha J. Bailey & Shuqiao Sun & Brenden Timpe, 2021. "Prep School for Poor Kids: The Long-Run Impacts of Head Start on Human Capital and Economic Self-Sufficiency," American Economic Review, American Economic Association, vol. 111(12), pages 3963-4001, December.
    13. Andrew Goodman-Bacon, 2018. "Public Insurance and Mortality: Evidence from Medicaid Implementation," Journal of Political Economy, University of Chicago Press, vol. 126(1), pages 216-262.
    14. 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 1263-1296, December.
    15. Martha J. Bailey, 2012. "Reexamining the Impact of Family Planning Programs on US Fertility: Evidence from the War on Poverty and the Early Years of Title X," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 62-97, April.
    16. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    17. Fred Goldman & Michael Grossman, 1988. "The Impact of Public Health Policy: The Case of Community Health Centers," Eastern Economic Journal, Eastern Economic Association, vol. 14(1), pages 63-72, Jan-Mar.
    18. Evans, William N. & Lien, Diana S., 2005. "The benefits of prenatal care: evidence from the PAT bus strike," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 207-239.
    19. Bound, John & Brown, Charles & Mathiowetz, Nancy, 2001. "Measurement error in survey data," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 59, pages 3705-3843, Elsevier.
    20. Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2023. "Multigenerational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation's Health," American Economic Review, American Economic Association, vol. 113(1), pages 98-135, January.
    21. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    22. 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.
    23. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    24. 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.
    25. Martha J. Bailey & Hilary W. Hoynes & Maya Rossin-Slater & Reed Walker, 2020. "Is the Social Safety Net a Long-Term Investment? Large-Scale Evidence from the Food Stamps Program," NBER Working Papers 26942, National Bureau of Economic Research, Inc.
    26. Ricketts, S.A. & Murray, E.K. & Schwalberg, R., 2005. "Reducing low birthweight by resolving risks: Results from Colorado's prenatal plus program," American Journal of Public Health, American Public Health Association, vol. 95(11), pages 1952-1957.
    27. repec:ucn:wpaper:10197/317 is not listed on IDEAS
    28. Andrew Goodman-Bacon, 2021. "The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes," American Economic Review, American Economic Association, vol. 111(8), pages 2550-2593, August.
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    Cited by:

    1. Mallory Avery & Jessica LaVoice, 2023. "The effect of “failed” community mental health centers on non‐white mortality," Health Economics, John Wiley & Sons, Ltd., vol. 32(6), pages 1362-1393, June.
    2. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, Maria Deni, 2023. "An Ounce of Prevention for a Pound of Cure: Efficiency of Community-Based Healthcare," IZA Discussion Papers 16350, Institute of Labor Economics (IZA).
    3. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, María Deni, 2024. "An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems," IDB Publications (Working Papers) 13433, Inter-American Development Bank.
    4. Samuel Cole & Duha T. Altindag, 2023. "Managerial turnover in primary care clinics," Economic Inquiry, Western Economic Association International, vol. 61(4), pages 942-964, October.

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    More about this item

    JEL classification:

    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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