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Growing Together: Assessing Equity and Effciency in an Early-Life Health Program in Chile

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  • Clarke, Damian
  • Cortés, Gustavo
  • Vergara, Diego

Abstract

We estimate the impact of participation in Chile Crece Contigo (ChCC), Chile’s flagship earlylife health and social welfare program, on neonatal health outcomes. We use administrative birth data matched to social benefits usage, and the staggered program roll-out, to identify the impact of participation. We find that this targeted social program had significant effects on birth weight (approximately 10 grams) and other early life human capital measures. These benefits are largest among the most socially vulnerable groups, however shift outcomes toward the middle of the distribution of health at birth. We show that program is efficient when compared to other successful neonatal health programs around the world, and find some evidence to suggest that maternal nutrition components and increased links to the social safety net are important mechanisms of action.

Suggested Citation

  • Clarke, Damian & Cortés, Gustavo & Vergara, Diego, 2017. "Growing Together: Assessing Equity and Effciency in an Early-Life Health Program in Chile," Research Department working papers 1139, CAF Development Bank Of Latinamerica.
    • Handle: RePEc:dbl:dblwop:1139
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    1. Heather Royer, 2009. "Separated at Girth: US Twin Estimates of the Effects of Birth Weight," American Economic Journal: Applied Economics, American Economic Association, vol. 1(1), pages 49-85, January.
    2. Anderson, Michael L, 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Department of Agricultural & Resource Economics, UC Berkeley, Working Paper Series qt15n8j26f, Department of Agricultural & Resource Economics, UC Berkeley.
    3. Joseph P. Romano & Michael Wolf, 2005. "Stepwise Multiple Testing as Formalized Data Snooping," Econometrica, Econometric Society, vol. 73(4), pages 1237-1282, July.
    4. Pedro Carneiro & Emanuela Galasso & Rita Ginja, 2019. "Tackling Social Exclusion: Evidence from Chile," The Economic Journal, Royal Economic Society, vol. 129(617), pages 172-208.
    5. Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2010. "Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 591-634.
    6. Jonah B. Gelbach, 2016. "When Do Covariates Matter? And Which Ones, and How Much?," Journal of Labor Economics, University of Chicago Press, vol. 34(2), pages 509-543.
    7. Sebastian Calonico & Matias D. Cattaneo & Rocio Titiunik, 2014. "Robust Nonparametric Confidence Intervals for Regression‐Discontinuity Designs," Econometrica, Econometric Society, vol. 82, pages 2295-2326, November.
    8. 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.
    9. Janet Currie & Tom Vogl, 2013. "Early-Life Health and Adult Circumstance in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 1-36, May.
    10. Flavio Cunha & James J. Heckman & Susanne M. Schennach, 2010. "Estimating the Technology of Cognitive and Noncognitive Skill Formation," Econometrica, Econometric Society, vol. 78(3), pages 883-931, May.
    11. Rosenzweig, Mark R. & Zhang, Junsen, 2013. "Economic growth, comparative advantage, and gender differences in schooling outcomes: Evidence from the birthweight differences of Chinese twins," Journal of Development Economics, Elsevier, vol. 104(C), pages 245-260.
    12. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    13. Rossin-Slater, Maya, 2013. "WIC in your neighborhood: New evidence on the impacts of geographic access to clinics," Journal of Public Economics, Elsevier, vol. 102(C), pages 51-69.
    14. Orazio P. Attanasio & Vincenzo Di Maro & Marcos Vera‐Hernández, 2013. "Community Nurseries and the Nutritional Status of Poor Children. Evidence from Colombia," Economic Journal, Royal Economic Society, vol. 123, pages 1025-1058, September.
    15. A. Colin Cameron & Douglas L. Miller, 2015. "A Practitioner’s Guide to Cluster-Robust Inference," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 317-372.
    16. Marianne P. Bitler & Lynn A. Karoly, 2015. "Intended And Unintended Effects Of The War On Poverty: What Research Tells Us And Implications For Policy," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 34(3), pages 639-696, June.
    17. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
    18. Andrea Bentancor & Damian Clarke, 2017. "Assessing Plan B: The Effect of the Morning After Pill on Children and Women," Economic Journal, Royal Economic Society, vol. 127(607), pages 2525-2552, December.
    19. Justin Cook, C. & Fletcher, Jason M., 2015. "Understanding heterogeneity in the effects of birth weight on adult cognition and wages," Journal of Health Economics, Elsevier, vol. 41(C), pages 107-116.
    20. Douglas Almond & Janet Currie, 2011. "Killing Me Softly: The Fetal Origins Hypothesis," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 153-172, Summer.
    21. Fletcher, Jason M., 2011. "The medium term schooling and health effects of low birth weight: Evidence from siblings," Economics of Education Review, Elsevier, vol. 30(3), pages 517-527, June.
    22. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    23. Johnson Rucker C & Schoeni Robert F, 2011. "The Influence of Early-Life Events on Human Capital, Health Status, and Labor Market Outcomes Over the Life Course," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(3), pages 1-57, September.
    24. Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March.
    25. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    26. Gerard J. van den Berg & Maarten Lindeboom & France Portrait, 2006. "Economic Conditions Early in Life and Individual Mortality," American Economic Review, American Economic Association, vol. 96(1), pages 290-302, March.
    27. Damian Clarke & Sonia Oreffice & Climent Quintana‐Domeque, 2021. "On the Value of Birth Weight," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 83(5), pages 1130-1159, October.
    28. 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.
    29. Orla Doyle, 2017. "The First 2,000 Days and Child Skills: Evidence from a Randomized Experiment of Home Visiting," Working Papers 201715, School of Economics, University College Dublin.
    30. 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.
    31. Barham, Tania, 2011. "A healthier start: The effect of conditional cash transfers on neonatal and infant mortality in rural Mexico," Journal of Development Economics, Elsevier, vol. 94(1), pages 74-85, January.
    32. McCrary, Justin, 2008. "Manipulation of the running variable in the regression discontinuity design: A density test," Journal of Econometrics, Elsevier, vol. 142(2), pages 698-714, February.
    33. repec:pri:rpdevs:currie_vogl_ar is not listed on IDEAS
    34. Romano, Joseph P. & Wolf, Michael, 2016. "Efficient computation of adjusted p-values for resampling-based stepdown multiple testing," Statistics & Probability Letters, Elsevier, vol. 113(C), pages 38-40.
    35. Douglas Almond & Bhashkar Mazumder, 2005. "The 1918 Influenza Pandemic and Subsequent Health Outcomes: An Analysis of SIPP Data," American Economic Review, American Economic Association, vol. 95(2), pages 258-262, May.
    36. Alejandra Marroig & Ivone Perazzo & Gonzalo Salas & Andrea Vigorito, 2017. "Evaluación de impacto del programa de acompañamiento familiar de Uruguay Crece Contigo," Documentos de Trabajo (working papers) 17-15, Instituto de Economía - IECON.
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    2. Sonia Bhalotra & Rudi Rocha & Rodrigo R. Soares, 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," Documentos de Trabajo 17122, The Latin American and Caribbean Economic Association (LACEA).
    3. Beltran-Silva, Francisco, 2023. "Fighting against hunger: A country-wide intervention and its impact on birth outcomes," World Development, Elsevier, vol. 165(C).

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    Keywords

    Evaluación de impacto;

    JEL classification:

    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • H43 - Public Economics - - Publicly Provided Goods - - - Project Evaluation; Social Discount Rate
    • O38 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Government Policy
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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