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The Effect of Brazil's Family Health Program on Cognitive Skills

Author

Listed:
  • Gunes, Pinar Mine

    (University of Alberta)

  • Tsaneva, Magda

    (Clark University)

Abstract

This paper examines the effect of Brazil's Family Health Program (Programa Saude da Familia, FHP) on cognitive skills of fifth-grade students. We use biennial data from national exams between 2007 and 2015, and variation in the FHP implementation date across municipalities, birth cohort, and test year to identify the effect of the program on language and mathematics test scores. We find that, in northern municipalities, students exposed to FHP at or prior to birth have 0.88 points higher language and 1.30 points higher mathematics test scores compared to those exposed to FHP in childhood. The estimated effects are intent-to-treat effects and correspond to increases of 0.021sd and 0.030sd in language and mathematics test scores. We use an event-study analysis demonstrating that the largest effects of FHP on cognitive skills are for those students exposed at or prior to birth, with trivial effects if exposed after birth. We do not find evidence for changes in parental investment behavior or child school attendance, which suggests that the effects are likely due to the direct impact of the program on child cognitive development.

Suggested Citation

  • Gunes, Pinar Mine & Tsaneva, Magda, 2022. "The Effect of Brazil's Family Health Program on Cognitive Skills," IZA Discussion Papers 15784, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp15784
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    1. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    2. Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
    3. Hongmei Yi & Linxiu Zhang & Kim Singer & Scott Rozelle & Scott Atlas, 2009. "Health insurance and catastrophic illness: a report on the New Cooperative Medical System in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 119-127, July.
    4. Francesconi, Marco & Heckman, James J., 2016. "Symposium on Child Development and Parental Investment: Introduction," IZA Discussion Papers 9977, Institute of Labor Economics (IZA).
    5. Jonathan Gruber & Nathaniel Hendren & Robert M. Townsend, 2014. "The Great Equalizer: Health Care Access and Infant Mortality in Thailand," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 91-107, January.
    6. Claudio Ferraz & Frederico Finan & Diana Belo Moreira, 2009. "Corrupting Learning: Evidence from Missing Federal Education Funds in Brazil," Textos para discussão 562, Department of Economics PUC-Rio (Brazil).
    7. Huang, Wei & Liu, Hong, 2023. "Early childhood exposure to health insurance and adolescent outcomes: Evidence from rural China," Journal of Development Economics, Elsevier, vol. 160(C).
    8. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    9. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
    10. Bütikofer, Aline & Løken, Katrine V. & Salvanes, Kjell G., 2015. "Long-term consequences of access to well-child visits," Working Papers in Economics 09/15, University of Bergen, Department of Economics.
    11. Emilia Del Bono & Marco Francesconi & Yvonne Kelly & Amanda Sacker, 2016. "Early Maternal Time Investment and Early Child Outcomes," Economic Journal, Royal Economic Society, vol. 126(596), pages 96-135, October.
    12. Mônica A. Haddad & Ricardo Freguglia & Cláudia Gomes, 2017. "Public Spending and Quality of Education in Brazil," Journal of Development Studies, Taylor & Francis Journals, vol. 53(10), pages 1679-1696, October.
    13. John A. Maluccio & John Hoddinott & Jere R. Behrman & Reynaldo Martorell & Agnes R. Quisumbing & Aryeh D. Stein, 2009. "The Impact of Improving Nutrition During Early Childhood on Education among Guatemalan Adults," Economic Journal, Royal Economic Society, vol. 119(537), pages 734-763, April.
    14. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    15. Jonas Hjort & Mikkel Sølvsten & Miriam Wüst, 2017. "Universal Investment in Infants and Long-Run Health: Evidence from Denmark's 1937 Home Visiting Program," American Economic Journal: Applied Economics, American Economic Association, vol. 9(4), pages 78-104, October.
    16. Emilia Del Bono & Marco Francesconi & Yvonne Kelly & Amanda Sacker, 2016. "Early Maternal Time Investment and Early Child Outcomes," Economic Journal, Royal Economic Society, vol. 126(596), pages 96-135, October.
    17. World Bank, 2001. "Brazil : Assessment of the Bolsa Escola Programs," World Bank Publications - Reports 15705, The World Bank Group.
    18. Marco Francesconi & James J. Heckman, 2016. "Child Development and Parental Investment: Introduction," Economic Journal, Royal Economic Society, vol. 126(596), pages 1-27, October.
    19. Hilary Hoynes & Diane Whitmore Schanzenbach & Douglas Almond, 2016. "Long-Run Impacts of Childhood Access to the Safety Net," American Economic Review, American Economic Association, vol. 106(4), pages 903-934, April.
    20. Rebecca Grossman‐Kahn & Julia Schoen & John William Mallett & Alexandra Brentani & Elizabeth Kaselitz & Michele Heisler, 2018. "Challenges facing community health workers in Brazil's Family Health Strategy: A qualitative study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(2), pages 309-320, April.
    21. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    22. Cruz, Tassia, 2018. "Teacher hiring decisions: How do governments react to an exogenous redistribution of education funds?," Economics of Education Review, Elsevier, vol. 67(C), pages 58-81.
    23. Prashant Bharadwaj & Katrine Vellesen L?ken & Christopher Neilson, 2013. "Early Life Health Interventions and Academic Achievement," American Economic Review, American Economic Association, vol. 103(5), pages 1862-1891, August.
    24. Tania Barham, 2012. "Enhancing Cognitive Functioning: Medium-Term Effects of a Health and Family Planning Program in Matlab," American Economic Journal: Applied Economics, American Economic Association, vol. 4(1), pages 245-273, January.
    25. Glewwe, Paul & Jacoby, Hanan G. & King, Elizabeth M., 2001. "Early childhood nutrition and academic achievement: a longitudinal analysis," Journal of Public Economics, Elsevier, vol. 81(3), pages 345-368, September.
    26. Boudreaux, Michel H. & Golberstein, Ezra & McAlpine, Donna D., 2016. "The long-term impacts of Medicaid exposure in early childhood: Evidence from the program's origin," Journal of Health Economics, Elsevier, vol. 45(C), pages 161-175.
    27. Ryu, Hanbyul & Helfand, Steven M. & Moreira, Roni Barbosa, 2020. "Starting early and staying longer: The effects of a Brazilian primary schooling reform on student performance," World Development, Elsevier, vol. 130(C).
    28. Marco Francesconi & James J. Heckman, 2016. "Child Development and Parental Investment: Introduction," Economic Journal, Royal Economic Society, vol. 126(596), pages 1-27, October.
    29. Aquino, R. & De Oliveira, N.F. & Barreto, M.L., 2009. "Impact of the Family Health Program on infant mortality in brazilian municipalities," American Journal of Public Health, American Public Health Association, vol. 99(1), pages 87-93.
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    More about this item

    Keywords

    early life interventions; cognitive skills; community healthcare; Brazil;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I21 - Health, Education, and Welfare - - Education - - - Analysis of Education

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