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Is prenatal care really ineffective? Or, is the 'devil' in the distribution?

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  • Conway, Karen Smith
  • Deb, Partha

Abstract

It is widely believed that expanding prenatal care should improve infant health; yet research typically finds weak effects of prenatal care on infant health. We argue that there are two kinds of pregnancies, 'complicated' and 'normal' ones, and that combining these pregnancies, as past research does, may lead prenatal care to appear ineffective. Data from the NMIHS offers compelling evidence supporting our view. The standard 2SLS approach yields residuals that are obviously bimodal and prenatal care coefficients that are frequently insignificant. In contrast, estimating birth weights with a finite mixture model yields estimates that are much more robust and that clearly suggest that prenatal care has a consistent, substantial effect on ?normal? pregnancies. Our Monte Carlo experiment confirms that ignoring even a small proportion of ?complicated? pregnancies can lead the onset of prenatal care to appear unimportant.
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  • Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
  • Handle: RePEc:eee:jhecon:v:24:y:2005:i:3:p:489-513
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    1. Morduch, Jonathan J. & Stern, Hal S., 1997. "Using mixture models to detect sex bias in health outcomes in Bangladesh," Journal of Econometrics, Elsevier, vol. 77(1), pages 259-276, March.
    2. Wang, Peiming & Cockburn, Iain M & Puterman, Martin L, 1998. "Analysis of Patent Data--A Mixed-Poisson-Regression-Model Approach," Journal of Business & Economic Statistics, American Statistical Association, vol. 16(1), pages 27-41, January.
    3. Warner, Geoffrey L, 1995. "Prenatal Care Demand and Birthweight Production of Black Mothers," American Economic Review, American Economic Association, vol. 85(2), pages 132-137, May.
    4. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    5. Theodore Joyce, 1994. "Self-Selection, Prenatal Care, and Birthweight among Blacks, Whites, and Hispanics in New York City," Journal of Human Resources, University of Wisconsin Press, vol. 29(3), pages 762-794.
    6. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
    7. 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.
    8. Gritz, R. Mark, 1993. "The impact of training on the frequency and duration of employment," Journal of Econometrics, Elsevier, vol. 57(1-3), pages 21-51.
    9. Karen Smith Conway & Lisa DeFelice Kennedy, 2004. "Maternal Depression and the Production of Infant Health," Southern Economic Journal, Southern Economic Association, vol. 71(2), pages 260-286, October.
    10. Wedel, M, et al, 1993. "A Latent Class Poisson Regression Model for Heterogeneous Count Data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 8(4), pages 397-411, Oct.-Dec..
    11. Joyce, Theodore, 1999. "Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City," Journal of Health Economics, Elsevier, vol. 18(1), pages 31-67, January.
    12. John F. Geweke & Michael P. Keane, 1997. "Mixture of normals probit models," Staff Report 237, Federal Reserve Bank of Minneapolis.
    13. Mark R. Rosenzweig & T. Paul Schultz, 1982. "The Behavior of Mothers as Inputs to Child Health: The Determinants of Birth Weight, Gestation, and Rate of Fetal Growth," NBER Chapters,in: Economic Aspects of Health, pages 53-92 National Bureau of Economic Research, Inc.
    14. 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.
    15. Jonathan Gruber, 1997. "Policy Watch: Medicaid and Uninsured Women and Children," Journal of Economic Perspectives, American Economic Association, vol. 11(4), pages 199-208, Fall.
    16. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, Southern Economic Association, vol. 65(1), pages 42-63, July.
    17. Rosenzweig, Mark R & Schultz, T Paul, 1983. "Estimating a Household Production Function: Heterogeneity, the Demand for Health Inputs, and Their Effects on Birth Weight," Journal of Political Economy, University of Chicago Press, vol. 91(5), pages 723-746, October.
    18. Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
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