Place Effects and Geographic Inequality in Health at Birth

This paper uses birth records from California and mothers who move to quantify the absolute and relative importance of birth location in early-life health. Using a model that includes mother and location fixed effects, we find that moving from a below- to an above-median birth weight location leads to a 19-gram increase in average birth weight. These causal place effects explain 16 percent of geographic variation in birth weight, with family-specific factors accounting for the remaining 84 percent. Place effects are more influential for children of non-college-educated mothers, and are most strongly correlated with local levels of pollution. The improvement in birth weight from moving to a higher-quality area compares favorably to policies that target maternal health, and could have a small, lasting effect on long-run outcomes.