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Multi-generational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation’s Health

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Listed:
  • Chloe N. East
  • Sarah Miller
  • Marianne Page
  • Laura R. Wherry

Abstract

We examine multi-generational impacts of positive in utero health interventions using a new research design that exploits sharp increases in prenatal Medicaid eligibility that occurred in some states. Our analyses are based on U.S. Vital Statistics Natality files, which enables linkages between individuals' early life Medicaid exposure and the next generation's health at birth. We find evidence that the health benefits associated with treated generations' early life program exposure extend to later offspring. Our results suggest that the returns on early life health investments may be substantively underestimated.

Suggested Citation

  • Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2017. "Multi-generational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation’s Health," NBER Working Papers 23810, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23810
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    1. van Ewijk, Reyn, 2011. "Long-term health effects on the next generation of Ramadan fasting during pregnancy," Journal of Health Economics, Elsevier, vol. 30(6), pages 1246-1260.
    2. 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.
    3. van den Berg, Gerard J. & Pinger, Pia R., 2016. "Transgenerational effects of childhood conditions on third generation health and education outcomes," Economics & Human Biology, Elsevier, vol. 23(C), pages 103-120.
    4. David Deming, 2009. "Early Childhood Intervention and Life-Cycle Skill Development: Evidence from Head Start," American Economic Journal: Applied Economics, American Economic Association, vol. 1(3), pages 111-134, July.
    5. Dhaval M. Dave & Sandra Decker & Robert Kaestner & Kosali I. Simon, 2008. "Re-examining the Effects of Medicaid Expansions for Pregnant Women," NBER Working Papers 14591, National Bureau of Economic Research, Inc.
    6. Kleibergen, Frank & Paap, Richard, 2006. "Generalized reduced rank tests using the singular value decomposition," Journal of Econometrics, Elsevier, vol. 133(1), pages 97-126, July.
    7. Janet Currie & Hannes Schwandt, 2016. "Mortality Inequality: The Good News from a County-Level Approach," Journal of Economic Perspectives, American Economic Association, vol. 30(2), pages 29-52, Spring.
    8. 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, Oxford University Press, vol. 125(2), pages 591-634.
    9. Pedro Carneiro & Rita Ginja, 2014. "Long-Term Impacts of Compensatory Preschool on Health and Behavior: Evidence from Head Start," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 135-173, November.
    10. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    11. Hilary Hoynes & Doug Miller & David Simon, 2015. "Income, the Earned Income Tax Credit, and Infant Health," American Economic Journal: Economic Policy, American Economic Association, vol. 7(1), pages 172-211, February.
    12. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2014. "Public Health Insurance, Labor Supply, and Employment Lock," The Quarterly Journal of Economics, Oxford University Press, vol. 129(2), pages 653-696.
    13. Douglas Almond & Janet Currie & Valentina Duque, 2018. "Childhood Circumstances and Adult Outcomes: Act II," Journal of Economic Literature, American Economic Association, vol. 56(4), pages 1360-1446, December.
    14. Janet Currie, 2011. "Inequality at Birth: Some Causes and Consequences," American Economic Review, American Economic Association, vol. 101(3), pages 1-22, May.
    15. Barbara H. Kehrer & Charles M. Wolin, 1979. "Impact of Income Maintenance on Low Birth Weight: Evidence from the Gary Experiment," Journal of Human Resources, University of Wisconsin Press, vol. 14(4), pages 434-462.
    16. Jens Ludwig & Douglas L. Miller, 2007. "Does Head Start Improve Children's Life Chances? Evidence from a Regression Discontinuity Design," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 159-208.
    17. Emla Fitzsimons & Marcos Vera-Hernandez, 2013. "Food for Thought? Breastfeeding and Child Development," IFS Working Papers W13/31, Institute for Fiscal Studies.
    18. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, Oxford University Press, vol. 127(3), pages 1057-1106.
    19. Janet Currie & Jonathan Gruber, 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," NBER Working Papers 4644, National Bureau of Economic Research, Inc.
    20. Valente, C, 2011. "Children of the Revolution: Fetal and Child Health amidst Violent Civil Conflict," Health, Econometrics and Data Group (HEDG) Working Papers 11/12, HEDG, c/o Department of Economics, University of York.
    21. Nicholas J. Sanders, 2012. "What Doesn’t Kill You Makes You Weaker: Prenatal Pollution Exposure and Educational Outcomes," Journal of Human Resources, University of Wisconsin Press, vol. 47(3), pages 826-850.
    22. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    23. Gary Solon, 2018. "What Do We Know So Far about Multigenerational Mobility?," Economic Journal, Royal Economic Society, vol. 128(612), pages 340-352, July.
    24. Mansour, Hani & Rees, Daniel I., 2012. "Armed conflict and birth weight: Evidence from the al-Aqsa Intifada," Journal of Development Economics, Elsevier, vol. 99(1), pages 190-199.
    25. Almond, Douglas & Currie, Janet & Herrmann, Mariesa, 2012. "From infant to mother: Early disease environment and future maternal health," Labour Economics, Elsevier, vol. 19(4), pages 475-483.
    26. Alan I. Barreca, 2010. "The Long-Term Economic Impact of In Utero and Postnatal Exposure to Malaria," Journal of Human Resources, University of Wisconsin Press, vol. 45(4), pages 865-892.
    27. Jonathan Meer & Jeremy West, 2016. "Effects of the Minimum Wage on Employment Dynamics," Journal of Human Resources, University of Wisconsin Press, vol. 51(2), pages 500-522.
    28. William N. Evans & Craig L. Garthwaite, 2014. "Giving Mom a Break: The Impact of Higher EITC Payments on Maternal Health," American Economic Journal: Economic Policy, American Economic Association, vol. 6(2), pages 258-290, May.
    29. Anna Aizer & Laura Stroud & Stephen Buka, 2016. "Maternal Stress and Child Outcomes: Evidence from Siblings," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 523-555.
    30. Anna, Petrenko, 2016. "Мaркування готової продукції як складова частина інформаційного забезпечення маркетингової діяльності підприємств овочепродуктового підкомплексу," Agricultural and Resource Economics: International Scientific E-Journal, Agricultural and Resource Economics: International Scientific E-Journal, vol. 2(1), March.
    31. Scholte, Robert S. & van den Berg, Gerard J. & Lindeboom, Maarten, 2015. "Long-run effects of gestation during the Dutch Hunger Winter famine on labor market and hospitalization outcomes," Journal of Health Economics, Elsevier, vol. 39(C), pages 17-30.
    32. 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.
    33. Thomas DeLeire & Leonard Lopoo & Kosali Simon, 2011. "Medicaid Expansions and Fertility in the United States," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 725-747, May.
    34. Black, Sandra & Bütikofer, Aline & Devereux, Paul J. & Salvanes, Kjell G, 2013. "This Is Only a Test? Long-Run Impacts of Prenatal Exposure to Radioactive Fallout," CEPR Discussion Papers 9443, C.E.P.R. Discussion Papers.
    35. Adam Isen & Maya Rossin-Slater & W. Reed Walker, 2017. "Every Breath You Take—Every Dollar You’ll Make: The Long-Term Consequences of the Clean Air Act of 1970," Journal of Political Economy, University of Chicago Press, vol. 125(3), pages 848-902.
    36. Neelsen, Sven & Stratmann, Thomas, 2012. "Long-run effects of fetal influenza exposure: Evidence from Switzerland," Social Science & Medicine, Elsevier, vol. 74(1), pages 58-66.
    37. Petra Persson & Maya Rossin-Slater, 2018. "Family Ruptures, Stress, and the Mental Health of the Next Generation," American Economic Review, American Economic Association, vol. 108(4-5), pages 1214-1252, April.
    38. Laura R. Wherry & Bruce D. Meyer, 2016. "Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 556-588.
    39. Gregory Clark, 2015. "The Son Also Rises: Surnames and the History of Social Mobility," Economics Books, Princeton University Press, edition 1, number 10181-2.
    40. Sarah R. Cohodes & Daniel S. Grossman & Samuel A. Kleiner & Michael F. Lovenheim, 2016. "The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 727-759.
    41. Richter, André & Robling, Per Olof, 2013. "Multigenerational e ffects of the 1918-19 influenza pandemic in Sweden," Working Paper Series 5/2013, Stockholm University, Swedish Institute for Social Research.
    42. Melissa Schettini Kearney & Phillip B. Levine, 2012. "Explaining Recent Trends in the U.S. Teen Birth Rate," NBER Working Papers 17964, National Bureau of Economic Research, Inc.
    43. Thompson, Owen, 2017. "The long-term health impacts of Medicaid and CHIP," Journal of Health Economics, Elsevier, vol. 51(C), pages 26-40.
    44. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    45. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    46. Laura R. Wherry & Sarah Miller & Robert Kaestner & Bruce D. Meyer, 2018. "Childhood Medicaid Coverage and Later-Life Health Care Utilization," The Review of Economics and Statistics, MIT Press, vol. 100(2), pages 287-302, May.
    47. Zavodny, Madeline & Bitler, Marianne P., 2010. "The effect of Medicaid eligibility expansions on fertility," Social Science & Medicine, Elsevier, vol. 71(5), pages 918-924, September.
    48. Adriana Camacho, 2008. "Stress and Birth Weight: Evidence from Terrorist Attacks," American Economic Review, American Economic Association, vol. 98(2), pages 511-515, May.
    49. Takatoshi Ito & Andrew Rose, 2010. "The Economic Consequences of Demographic Change in East Asia," NBER Books, National Bureau of Economic Research, Inc, number ito_08-2.
    50. 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.
    51. repec:mpr:mprres:6774 is not listed on IDEAS
    52. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, vol. 82(1), pages 63-89, October.
    53. Elaine Kelly, 2011. "The Scourge of Asian Flu: In utero Exposure to Pandemic Influenza and the Development of a Cohort of British Children," Journal of Human Resources, University of Wisconsin Press, vol. 46(4), pages 669-694.
    54. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2016. "Does Grief Transfer across Generations? Bereavements during Pregnancy and Child Outcomes," American Economic Journal: Applied Economics, American Economic Association, vol. 8(1), pages 193-223, January.
    55. 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.
    56. Sarah Miller & Laura R. Wherry, 2019. "The Long-Term Effects of Early Life Medicaid Coverage," Journal of Human Resources, University of Wisconsin Press, vol. 54(3), pages 785-824.
    57. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
    58. Editors The, 2007. "From the Editors," Basic Income Studies, De Gruyter, vol. 2(1), pages 1-5, June.
    59. Douglas Almond & Bhashkar Mazumder, 2011. "Health Capital and the Prenatal Environment: The Effect of Ramadan Observance during Pregnancy," American Economic Journal: Applied Economics, American Economic Association, vol. 3(4), pages 56-85, October.
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    2. Cygan-Rehm, Kamila & Karbownik, Krzysztof, 2022. "The effects of incentivizing early prenatal care on infant health," Journal of Health Economics, Elsevier, vol. 83(C).
    3. Laura Rodríguez, 2022. "Violence and newborn health: Estimates for Colombia," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 112-136, January.
    4. Libertad González & Sofia Trommlerová, 2021. "Prenatal Transfers and Infant Health: Evidence from Spain," Working Papers 1261, Barcelona School of Economics.
    5. Jonathan Colmer & John Voorheis, 2020. "The Grandkids Aren't Alright: The Intergenerational Effects of Prenatal Pollution Exposure," Working Papers 20-36, Center for Economic Studies, U.S. Census Bureau.
    6. Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2018. "Safety Nets Investments in Children," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 49(1 (Spring), pages 89-150.
    7. Libertad González Luna & Sofia Trommlerová, 2021. "Prenatal transfers and infant health: Evidence from Spain," Economics Working Papers 1783, Department of Economics and Business, Universitat Pompeu Fabra.
    8. Bhashkar Mazumder & Maria Fernanda Rosales & Margaret Triyana, 2019. "Social Interventions, Health and Wellbeing: The Long-Term and Intergenerational Effects of a School Construction Program," Working Paper Series WP-2019-09, Federal Reserve Bank of Chicago.
    9. repec:bin:bpeajo:v:49:y:2019:i:2018-01:p:89-150 is not listed on IDEAS
    10. Nobles, Jenna & Hamoudi, Amar, 2019. "Detecting the Effects of Early-Life Exposures: Why Fecundity Matters," SocArXiv x4zm6, Center for Open Science.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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