Urban fertility responses to local government programs: evidence from the 1923-1932 U.S
During the 1920s and early 1930s, fertility in American municipalities declined overall and with large variation between areas and across time. Using data for 1923-1932 on fertility and public spending for over 50 large cities, we show that the local government programs of health education and outdoor care of poor had the unintended effect of reducing fertility. Fixed effects regressions indicate a $4 increase in per capita public health education spending or a $37 increase in poor relief reduced the TFR by 0.1. This suggests that cities spending in the 75th percentile on health education experienced a 1.95% faster fertility decline than cities spending in the 25th percentile. For poor relief the difference was 1.45%. The mechanisms may be related to increased breastfeeding, social insurance incentives or the stressing of a two child home. The results help explain differing fertility trends, and highlight how policy may unintentionally reduce fertility.
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