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Typically Unobserved Variables (TUVs) and Selection into Prenatal Inputs: Implications for Estimating Infant Health Production Functions

  • Nancy E. Reichman
  • Hope Corman
  • Kelly Noonan
  • Dhaval Dave

We examine the extent to which infant health production functions are sensitive to model specification and measurement error. We focus on the importance of typically unobserved but theoretically important variables (TUVs), other non-standard covariates (NSCs), input reporting, and characterization of infant health. The TUVs represent wantedness, taste for risky behavior, and maternal health endowment. The NSCs include father and family structure characteristics. We estimate effects of prenatal drug use, prenatal cigarette smoking, and first trimester prenatal care on birth weight, low birth weight, and a measure of abnormal infant health conditions. We compare estimates using self-reported inputs versus input measures that combine information from medical records and self-reports. We find that TUVs and NSCs are significantly associated with both inputs and outcomes, but that excluding them from infant health production functions does not appreciably affect the input estimates. However, using self-reported inputs leads to overestimated effects of inputs, particularly prenatal care, on outcomes, and using a direct measure of infant health does not always yield input estimates similar to those when using birth weight outcomes. The findings have implications for research, data collection, and public health policy.

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File URL: http://www.nber.org/papers/w12004.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 12004.

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Date of creation: Feb 2006
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Publication status: published as Reichman, N., Corman, H., Noonan, D., Dave, D. 2009. Infant Health Production Functions: What a Difference the Data Make. Health Economics 18(7): 761–782.
Handle: RePEc:nbr:nberwo:12004
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  1. Hope Corman & Theodore J. Joyce & Michael Grossman, 1987. "Birth Outcome Production Function in the United States," Journal of Human Resources, University of Wisconsin Press, vol. 22(3), pages 339-360.
  2. Robert Moffitt, 2005. "Remarks on the analysis of causal relationships in population research," Demography, Springer, vol. 42(1), pages 91-108, February.
  3. Robert Kaestner & Theodore Joyce & Hassan Wehbeh, 1996. "The Effect of Maternal Drug Use on Birth Weight: Measurement Error in Binary Variables," NBER Working Papers 5434, National Bureau of Economic Research, Inc.
  4. Kelly Noonan & Nancy E. Reichman & Hope Corman & Dhaval Dave, 2005. "Prenatal Drug Use and the Production of Infant Health," NBER Working Papers 11433, National Bureau of Economic Research, Inc.
  5. Ted Joyce & Robert Kaestner & Sanders Korenman, 2002. "On the validity of retrospective assessments of pregnancy intention," Demography, Springer, vol. 39(1), pages 199-213, February.
  6. Teitler, Julien O., 2001. "Father involvement, child health and maternal health behavior," Children and Youth Services Review, Elsevier, vol. 23(4-5), pages 403-425.
  7. Theodore Joyce & Michael Grossman, 1990. "Pregnancy wantedness and the early initiation of prenatal care," Demography, Springer, vol. 27(1), pages 1-17, February.
  8. Joyce, Theodore, 1999. "Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City," Journal of Health Economics, Elsevier, vol. 18(1), pages 31-67, January.
  9. Evans, William N. & Lien, Diana S., 2005. "The benefits of prenatal care: evidence from the PAT bus strike," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 207-239.
  10. Karen Smith Conway & Lisa DeFelice Kennedy, 2004. "Maternal Depression and the Production of Infant Health," Southern Economic Journal, Southern Economic Association, vol. 71(2), pages 260-286, October.
  11. Geoffrey Warner, 2003. "The association between maternal depression and prenatal care adequacy," The Review of Black Political Economy, Springer, vol. 30(3), pages 39-53, December.
  12. 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.
  13. Diana S. Lien & William N. Evans, 2005. "Estimating the Impact of Large Cigarette Tax Hikes: The Case of Maternal Smoking and Infant Birth Weight," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
  14. Hope Corman & Theodore J. Joyce & Michael Grossman, 1985. "Birth Outcome Production Functions in the U.S," NBER Working Papers 1729, National Bureau of Economic Research, Inc.
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