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Mothers and Others: Who Invests in Children's Health?

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  • Anne Case
  • Christina Paxson

Abstract

We estimate the impact of family structure on investments made in children's health, using data from the 1988 National Health Interview Survey Child Health Supplement. Controlling for household size, income and characteristics, we find that children living with step mothers are significantly less likely to have routine doctor and dentist visits, or to have a place for usual medical care, or for sick care. If children living with step mothers have regular contact with their birth mothers, however, their health care does not suffer relative to that reported for children who reside with their birth mothers. In addition to health investments, we find a significant effect of step mothers on health-related behaviors: children living with step mothers are significantly less likely to wear seatbelts, and are significantly more likely to be living with a cigarette smoker. We cannot reject that investments for children living with birth fathers and step mothers are the same as those made by birth fathers living alone with their children. Who invests in children's health? It appears these investments are made, largely, by a child's mother, and that step mothers are not substitutes for birth mothers in this domain.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 7691.

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Date of creation: May 2000
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Publication status: published as Case, Anne & Paxson, Christina, 2001. "Mothers and others: who invests in children's health?," Journal of Health Economics, Elsevier, vol. 20(3), pages 301-328, May.
Handle: RePEc:nbr:nberwo:7691

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  1. Beller, Andrea H & Chung, Seung Sin, 1992. "Family Structure and Educational Attainment of Children: Effects of Remarriage," Journal of Population Economics, Springer, Springer, vol. 5(1), pages 39-59, February.
  2. Case, Anne & Paxson, Christina, 2001. "Mothers and others: who invests in children's health?," Journal of Health Economics, Elsevier, Elsevier, vol. 20(3), pages 301-328, May.
  3. I-Fen Lin & Anne Case & Sara McLanahan, 1999. "Household Resource Allocation in Stepfamilies: Darwin Reflects on the Plight of Cinderella," American Economic Review, American Economic Association, American Economic Association, vol. 89(2), pages 234-238, May.
  4. Jonathan Gruber, 2000. "Is Making Divorce Easier Bad for Children? The Long Run Implications of Unilateral Divorce," NBER Working Papers 7968, National Bureau of Economic Research, Inc.
  5. Anne Case & I-Fen Lin & Sara McLanahan, 2000. "Educational Attainment in Blended Families," NBER Working Papers 7874, National Bureau of Economic Research, Inc.
  6. Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, October.
  7. Anne Case & I-Fen Lin & Sara McLanahan, 1999. "How Hungry is the Selfish Gene?," NBER Working Papers 7401, National Bureau of Economic Research, Inc.
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