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Care-giver advice as a preventive measure for drinking during pregnancy: zeros, categorical outcome responses, and endogeneity

Listed author(s):
  • Joseph V. Terza

    (Department of Epidemiology and Health Policy Research, University of Florida, Gainesville, FL, USA)

  • Donald S. Kenkel

    (Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA)

  • Tsui-Fang Lin

    (Department of Public Finance, National Taipei University, Taipei, Taiwan)

  • Shinichi Sakata

    (Department of Economics, The University of British Columbia, Vancouver, BC, Canada)

We conduct an empirical investigation of the impact of prenatal care-giver advice on alcohol consumption by pregnant women. In the design of the model and estimator, we pay particular attention to three aspects of the data. First, a large proportion of pregnant women do not drink at all. To accommodate this aspect of the sample we base the essential formulation of the model on the modified version of the two-part approach of Duan et al. (Journal of Business and Economic Statistics 1983; 1 : 115-126.) suggested by Mullahy (Journal of Health Economics 1998; 17 : 247-281.). Second, in the survey that we analyze (the 1988 National Maternal and Infant Health Survey - NMIHS), respondents were only required to report their consumption up to a specified range of values (e.g. 1-2 drinks per week, 2-5 drinks per week, and so on). For this reason, the model is cast in the grouped regression framework of Stewart (Review of Economic Studies 1983; 50 : 141-149.). Third, the binary physician advice variable is likely to be endogenous and the econometric specification explicitly accounts for this possibility. To summarize the results, we find that failing to account for endogeneity leads to the counterintuitive conclusion that advice has a positive and statistically significant influence on drinking during pregnancy. When the model is extended to allow for potential endogeneity, we find that advice has a negative and statistically significant impact. Copyright © 2007 John Wiley & Sons, Ltd.

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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): 1 ()
Pages: 41-54

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Handle: RePEc:wly:hlthec:v:17:y:2008:i:1:p:41-54
DOI: 10.1002/hec.1232
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  1. Mark B. Stewart, 1983. "On Least Squares Estimation when the Dependent Variable is Grouped," Review of Economic Studies, Oxford University Press, vol. 50(4), pages 737-753.
  2. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
  3. Viscusi, W Kip, 1990. "Do Smokers Underestimate Risks?," Journal of Political Economy, University of Chicago Press, vol. 98(6), pages 1253-1269, December.
  4. Donald S. Kenkel & Joseph V. Terza, 2001. "The effect of physician advice on alcohol consumption: count regression with an endogenous treatment effect," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 16(2), pages 165-184.
  5. James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
  6. Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-126, April.
  7. Ippolito, Pauline M & Mathios, Alan D, 1995. "Information and Advertising: The Case of Fat Consumption in the United States," American Economic Review, American Economic Association, vol. 85(2), pages 91-95, May.
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