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The Costs of Low Birth Weight

Author

Listed:
  • Douglas Almond
  • Kenneth Y. Chay
  • David S. Lee

Abstract

Birth weight has emerged as the leading indicator of infant health and welfare and the central focus of infant health policy. This is because low birth weight (LBW) infants experience severe health and developmental difficulties that can impose enormous costs on society. But would the prevention of LBW generate equally sizable cost savings and health improvements? Estimates of the return to LBW-prevention from cross-sectional associations may be biased by omitted variables that cannot be influenced by policy, such as genetic factors. To address this, we compare the hospital costs, health at birth, and infant mortality rates between heavier and lighter infants from all twin pairs born in the United States. We also examine the effect of maternal smoking during pregnancy the leading risk factor for LBW in the United States on health among singleton births after controlling for detailed background characteristics. Both analyses imply substantially smaller effects of LBW than previously thought, suggesting two possibilities: 1) existing estimates overstate the true costs and consequences of LBW by at least a factor of four and by as much as a factor of 20; or 2) different LBW-preventing interventions have different health and cost consequences, implying that policy efforts that presume a single return to reducing LBW will necessarily be suboptimal.

Suggested Citation

  • Douglas Almond & Kenneth Y. Chay & David S. Lee, 2004. "The Costs of Low Birth Weight," NBER Working Papers 10552, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:10552
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    References listed on IDEAS

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    3. Rosemary Hyson & Janet Currie, 1999. "Is the Impact of Health Shocks Cushioned by Socioeconomic Status? The Case of Low Birthweight," American Economic Review, American Economic Association, vol. 89(2), pages 245-250, May.
    4. Currie, Janet & Cole, Nancy, 1993. "Welfare and Child Health: The Link between AFDC Participation and Birth Weight," American Economic Review, American Economic Association, vol. 83(4), pages 971-985, September.
    5. Grossman, Michael & Joyce, Theodore J, 1990. "Unobservables, Pregnancy Resolutions, and Birth Weight Production Functions in New York City," Journal of Political Economy, University of Chicago Press, vol. 98(5), pages 983-1007, October.
    6. Rosenzweig, Mark R. & Wolpin, Kenneth I., 1991. "Inequality at birth : The scope for policy intervention," Journal of Econometrics, Elsevier, vol. 50(1-2), pages 205-228, October.
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    Cited by:

    1. Tapia Granados, José A. & Rodriguez, Javier M., 2015. "Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland," Health Policy, Elsevier, vol. 119(7), pages 941-953.
    2. Kelly Noonan & Nancy E. Reichman & Hope Corman & Dhaval Dave, 2007. "Prenatal drug use and the production of infant health," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 361-384.
    3. Neelsen, Sven & Stratmann, Thomas, 2011. "Effects of prenatal and early life malnutrition: Evidence from the Greek famine," Journal of Health Economics, Elsevier, vol. 30(3), pages 479-488, May.
    4. Marianne Bitler, 2005. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes: Evidence from Health Insurance Mandates," PPIC Working Papers 2005.06, Public Policy Institute of California.
    5. Nastis, Stefanos A. & Crocker, Thomas D., 2012. "Valuing mother and child health: The intrauterine environment," Economics & Human Biology, Elsevier, vol. 10(3), pages 318-328.
    6. Marianne P. Bitler, 2006. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes Evidence from Health Insurance Mandates," Working Papers WR-330, RAND Corporation.
    7. David Loughran & Ashlesha Datar & M. Kilburn, 2008. "The response of household parental investment to child endowments," Review of Economics of the Household, Springer, vol. 6(3), pages 223-242, September.
    8. James Smith, 2009. "Reconstructing childhood health histories," Demography, Springer;Population Association of America (PAA), pages 387-403.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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