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Income Support Policy Packages and Birth Outcomes in U.S. States: An Ecological Analysis

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Listed:
  • Megan M. Reynolds

    (University of Utah)

  • Patricia A. Homan

    (Florida State University)

Abstract

Research suggests that generous social welfare programs play a role in maternal and child health. However, most studies examine a single policy in isolation. Drawing from research documenting low-income families ‘packaging’ of social policies, we create a novel measure summarizing the value of a collection of income support policies for the working poor. This collection includes: the Supplemental Nutrition Assistance Program (SNAP), the Earned Income Tax Credit (EITC), the minimum wage, and the unemployment insurance (UI) program. Using U.S. state-level administrative data from 1996 to 2014, we estimate fixed effects regression models to examine the relationship between birth outcomes and income support policies (individually and combined). We find that increases in the combined value of the four income supports are significantly associated with reductions in preterm births and low birthweight births, but not infant mortality rates. States with the highest observed levels of combined income support had 14% fewer PTBs and 7% fewer LBWs than states with the lowest levels of income support. Of the four individual income support policies, only unemployment insurance has no significant independent effects. SNAP benefits have the largest and most consistent effects, reducing poor birth outcomes across all three indicators. An annual increase of $1000 in SNAP benefits is associated with a 3% decline in infant deaths, 5% decline in preterm births, and 2% decline in low birthweight births. These results suggest that increasing the generosity of income support policies may be a promising strategy for improving birth outcomes in the United States.

Suggested Citation

  • Megan M. Reynolds & Patricia A. Homan, 2023. "Income Support Policy Packages and Birth Outcomes in U.S. States: An Ecological Analysis," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-24, August.
    • Handle: RePEc:kap:poprpr:v:42:y:2023:i:4:d:10.1007_s11113-023-09797-9
    DOI: 10.1007/s11113-023-09797-9
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    1. Peter Gottschalk & Robert Moffitt, 2009. "The Rising Instability of U.S. Earnings," Journal of Economic Perspectives, American Economic Association, vol. 23(4), pages 3-24, Fall.
    2. Craig Gundersen & Brent Kreider & John Pepper, 2011. "The Economics of Food Insecurity in the United States," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 33(3), pages 281-303.
    3. 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.
    4. Gundersen, Craig & Waxman, Elaine & Crumbaugh, Amy S., 2019. "An Examination of the Adequacy of Supplemental Nutrition Assistance Program (SNAP) Benefit Levels: Impacts on Food Insecurity," Agricultural and Resource Economics Review, Cambridge University Press, vol. 48(3), pages 433-447, December.
    5. Ann H. Stevens & Douglas L. Miller & Marianne E. Page & Mateusz Filipski, 2015. "The Best of Times, the Worst of Times: Understanding Pro-cyclical Mortality," American Economic Journal: Economic Policy, American Economic Association, vol. 7(4), pages 279-311, November.
    6. Nelson, Kenneth & Fritzell, Johan, 2014. "Welfare states and population health: The role of minimum income benefits for mortality," Social Science & Medicine, Elsevier, vol. 112(C), pages 63-71.
    7. Avendano, Mauricio & Berkman, Lisa F. & Brugiavini, Agar & Pasini, Giacomo, 2015. "The long-run effect of maternity leave benefits on mental health: Evidence from European countries," Social Science & Medicine, Elsevier, vol. 132(C), pages 45-53.
    8. Kuhn, Andreas & Staubli, Stefan & Wuellrich, Jean-Philippe & Zweimüller, Josef, 2020. "Fatal attraction? Extended unemployment benefits, labor force exits, and mortality," Journal of Public Economics, Elsevier, vol. 191(C).
    9. De Moortel, Deborah & Palència, Laia & Artazcoz, Lucía & Borrell, Carme & Vanroelen, Christophe, 2015. "Neo-Marxian social class inequalities in the mental well-being of employed men and women: The role of European welfare regimes," Social Science & Medicine, Elsevier, vol. 128(C), pages 188-200.
    10. Helen H. Jensen & Brent Kreider & Oleksandr Zhylyevskyy, 2019. "Investigating Treatment Effects of Participating Jointly in SNAP and WIC when the Treatment Is Validated Only for SNAP," Southern Economic Journal, John Wiley & Sons, vol. 86(1), pages 124-155, July.
    11. Cylus, J. & Glymour, M.M. & Avendano, M., 2015. "Health effects of unemployment benefit program generosity," American Journal of Public Health, American Public Health Association, vol. 105(2), pages 317-323.
    12. Halliday, Timothy J., 2014. "Unemployment and mortality: Evidence from the PSID," Social Science & Medicine, Elsevier, vol. 113(C), pages 15-22.
    13. Slack, Kristen S. & Kim, Bomi & Yang, Mi-Youn & Berger, Lawrence M., 2014. "The economic safety net for low-income families with children," Children and Youth Services Review, Elsevier, vol. 46(C), pages 213-219.
    14. repec:aph:ajpbhl:10.2105/ajph.2017.303768_5 is not listed on IDEAS
    15. Bhattacharya, Jayanta & Currie, Janet & Haider, Steven, 2004. "Poverty, food insecurity, and nutritional outcomes in children and adults," Journal of Health Economics, Elsevier, vol. 23(4), pages 839-862, July.
    16. George L. Wehby & Dhaval M. Dave & Robert Kaestner, 2020. "Effects of the Minimum Wage on Infant Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(2), pages 411-443, March.
    17. Lee, Bethany C. & Modrek, Sepideh & White, Justin S. & Batra, Akansha & Collin, Daniel F. & Hamad, Rita, 2020. "The effect of California's paid family leave policy on parent health: A quasi-experimental study," Social Science & Medicine, Elsevier, vol. 251(C).
    18. Hilary Hoynes & Doug Miller & David Simon, 2015. "Income, the Earned Income Tax Credit, and Infant Health," American Economic Journal: Economic Policy, American Economic Association, vol. 7(1), pages 172-211, February.
    19. Averett, Susan L. & Wang, Yang, 2012. "The Effects of EITC Payment Expansion on Maternal Smoking," IZA Discussion Papers 6680, Institute of Labor Economics (IZA).
    20. Elira Kuka, 2020. "Quantifying the Benefits of Social Insurance: Unemployment Insurance and Health," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 490-505, July.
    21. McDonough, Peggy & Worts, Diana & Sacker, Amanda, 2010. "Socioeconomic inequalities in health dynamics: A comparison of Britain and the United States," Social Science & Medicine, Elsevier, vol. 70(2), pages 251-260, January.
    22. Montez, J.K. & Zajacova, A. & Hayward, M.D., 2017. "Disparities in disability by educational attainment across US states," American Journal of Public Health, American Public Health Association, vol. 107(7), pages 1101-1108.
    23. Fu, Wei & Liu, Feng, 2019. "Unemployment insurance and cigarette smoking," Journal of Health Economics, Elsevier, vol. 63(C), pages 34-51.
    24. Marcia K. Meyers & Janet C. Gornick & Laura R. Peck, 2001. "Packaging Support for Low-Income Families: Policy Variation across the United States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(3), pages 457-483.
    25. Gordon F. De Jong & Deborah Roempke Graefe & Shelley K. Irving & Tanja St. Pierre, 2006. "Measuring State TANF Policy Variations and Change After Reform," Social Science Quarterly, Southwestern Social Science Association, vol. 87(4), pages 755-781, December.
    26. Rambotti, Simone, 2020. "Is there a relationship between welfare-state policies and suicide rates? Evidence from the U.S. states, 2000–2015," Social Science & Medicine, Elsevier, vol. 246(C).
    27. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 617-650.
    28. Cowan Benjamin & Tefft Nathan, 2012. "Education, Maternal Smoking, and the Earned Income Tax Credit," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 12(1), pages 1-39, October.
    29. Jennifer Karas Montez & Anna Zajacova & Mark D. Hayward & Steven H. Woolf & Derek Chapman & Jason Beckfield, 2019. "Educational Disparities in Adult Mortality Across U.S. States: How Do They Differ, and Have They Changed Since the Mid-1980s?," Demography, Springer;Population Association of America (PAA), vol. 56(2), pages 621-644, April.
    30. O'Campo, Patricia & Molnar, Agnes & Ng, Edwin & Renahy, Emilie & Mitchell, Christiane & Shankardass, Ketan & St. John, Alexander & Bambra, Clare & Muntaner, Carles, 2015. "Social welfare matters: A realist review of when, how, and why unemployment insurance impacts poverty and health," Social Science & Medicine, Elsevier, vol. 132(C), pages 88-94.
    31. Komro, K.A. & Livingston, M.D. & Markowitz, S. & Wagenaar, A.C., 2016. "The effect of an increased minimum wage on infant mortality and birth weight," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1514-1516.
    32. Dahl, Espen & van der Wel, Kjetil A., 2013. "Educational inequalities in health in European welfare states: A social expenditure approach," Social Science & Medicine, Elsevier, vol. 81(C), pages 60-69.
    33. Macinko, J. & Silver, D., 2012. "Improving state health policy assessment: An agenda for measurement and analysis," American Journal of Public Health, American Public Health Association, vol. 102(9), pages 1697-1705.
    34. Hanson, Kenneth & Andrews, Margaret S., 2009. "State Variations in the Food Stamp Benefit Reduction Rate for Earnings: Cross-Program Effects from TANF and SSI Cash Assistance," Economic Information Bulletin 58315, United States Department of Agriculture, Economic Research Service.
    35. Nguyen, B.T. & Shuval, K. & Bertmann, F. & Yaroch, A.L., 2015. "The supplemental nutrition assistance program, food insecurity, dietary quality, and obesity among US adults," American Journal of Public Health, American Public Health Association, vol. 105(7), pages 1453-1459.
    36. Tefft, Nathan, 2011. "Insights on unemployment, unemployment insurance, and mental health," Journal of Health Economics, Elsevier, vol. 30(2), pages 258-264, March.
    37. Homan, Patricia, 2017. "Political gender inequality and infant mortality in the United States, 1990–2012," Social Science & Medicine, Elsevier, vol. 182(C), pages 127-135.
    38. Jacob Bastian & Katherine Michelmore, 2018. "The Long-Term Impact of the Earned Income Tax Credit on Children’s Education and Employment Outcomes," Journal of Labor Economics, University of Chicago Press, vol. 36(4), pages 1127-1163.
    39. Beckfield, Jason & Bambra, Clare, 2016. "Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage," Social Science & Medicine, Elsevier, vol. 171(C), pages 30-38.
    40. Zheng, Hui & George, Linda K., 2012. "Rising U.S. income inequality and the changing gradient of socioeconomic status on physical functioning and activity limitations, 1984–2007," Social Science & Medicine, Elsevier, vol. 75(12), pages 2170-2182.
    41. Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2016. "The Effect of Safety-Net Programs on Food Insecurity," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 589-614.
    42. Hamid Noghanibehambari & Mahmoud Salari, 2020. "Health benefits of social insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1813-1822, December.
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