IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/3549.html
   My bibliography  Save this paper

Self-Selection, Prenatal Care, and Birthweight Among Blacks, Whites and Hispanics in New York City

Author

Listed:
  • Theodore Joyce

Abstract

Most research on birth outcomes has found a direct relationship between appropriate prenatal care and increased birthweight. Researchers concede, however, that without a randomized design, which is clearly unethical, one cannot determine how much of the association is due to the medical intervention and how much is due to the characteristics of the women receiving the care. In short, the degree of selection bias is unknown and potentially substantial. In this paper we test for selection bias and estimate its direction and magnitude. We find that adjusted mean differences in birthweight between women who obtain intermediate as opposed to inadequate prenatal care substantially underestimate the effects of care that would be observed under random assignment. In particular, ordinary least squares estimates indicate that the gains to intermediate care are 113 grams for black infants, 76 grams for white infants and 92 grams for Hispanic infants. Under random assignment, black infants would experience gains of 130 grams, whites 234 grams, and Hispanics 183 grams. The gains for adequate as opposed to intermediate care are relatively minor. The results point to adverse selection in the demand for prenatal care.

Suggested Citation

  • Theodore Joyce, 1990. "Self-Selection, Prenatal Care, and Birthweight Among Blacks, Whites and Hispanics in New York City," NBER Working Papers 3549, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:3549
    Note: HE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w3549.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Newey, Whitney K & Powell, James L & Walker, James R, 1990. "Semiparametric Estimation of Selection Models: Some Empirical Results," American Economic Review, American Economic Association, vol. 80(2), pages 324-328, May.
    2. Mark R. Rosenzweig & T. Paul Schultz, 1982. "The Behavior of Mothers as Inputs to Child Health: The Determinants of Birth Weight, Gestation, and Rate of Fetal Growth," NBER Chapters, in: Economic Aspects of Health, pages 53-92, National Bureau of Economic Research, Inc.
    3. Stein, Z. & Kline, J., 1983. "Smoking, alcohol and reproduction," American Journal of Public Health, American Public Health Association, vol. 73(10), pages 1154-1156.
    4. 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.
    5. Jeffrey E. Harris, 1982. "Prenatal Medical Care and Infant Mortality," NBER Chapters, in: Economic Aspects of Health, pages 13-52, National Bureau of Economic Research, Inc.
    6. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, May.
    7. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    8. 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.
    9. Mroz, Thomas A, 1987. "The Sensitivity of an Empirical Model of Married Women's Hours of Work to Economic and Statistical Assumptions," Econometrica, Econometric Society, vol. 55(4), pages 765-799, July.
    10. Gortmaker, S.L., 1979. "The effects of prenatal care upon the health of the newborn," American Journal of Public Health, American Public Health Association, vol. 69(7), pages 653-660.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. O'Neill June E & O'Neill Dave M, 2008. "Health Status, Health Care and Inequality: Canada vs. the U.S," Forum for Health Economics & Policy, De Gruyter, vol. 10(1), pages 1-45, April.
    2. Habibov, Nazim N. & Fan, Lida, 2011. "Does prenatal healthcare improve child birthweight outcomes in Azerbaijan? Results of the national Demographic and Health Survey," Economics & Human Biology, Elsevier, vol. 9(1), pages 56-65, January.
    3. Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
    4. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    5. Michael Grossman, 1999. "The Human Capital Model of the Demand for Health," NBER Working Papers 7078, National Bureau of Economic Research, Inc.
    6. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
    7. David Mmopelwa, 2019. "Prenatal care utilization and infant health in Botswana," Discussion Papers 2019-09, University of Nottingham, CREDIT.
    8. 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.
    9. Resul Cesur & Inas Rashad, 2008. "High Birth Weight and Cognitive Outcomes," NBER Working Papers 14524, National Bureau of Economic Research, Inc.
    10. Kaestner, Robert & Joyce, Theodore & Wehbeh, Hassan, 1996. "The Effect of Maternal Drug Use on Birth Weight: Measurement Error in Binary Variables," Economic Inquiry, Western Economic Association International, vol. 34(4), pages 617-629, October.
    11. Diether W. Beuermann & Patricia Garcia & Jose Perez Lu & Rafael Anta & Alessandro Maffioli & Maria Fernanda Rodrigo, 2020. "Information and Communication Technologies, Prenatal Care Services, and Neonatal Health," Journal of Economics, Race, and Policy, Springer, vol. 3(1), pages 41-59, March.
    12. Aparna Lhila & Sharon Long, 2012. "What is driving the black–white difference in low birthweight in the US?," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 301-315, March.
    13. George L. Wehby & Jeffrey C. Murray & Eduardo E. Castilla & Jorge S. Lopez‐Camelo & Robert L. Ohsfeldt, 2009. "Quantile effects of prenatal care utilization on birth weight in Argentina," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1307-1321, November.
    14. Issidor Noumba & Quentin Lebrun Nzouessah Feunke, 2020. "Parental Education, Household Health, and Household Standard of Living: Evidence from Rural Cameroon," International Business Research, Canadian Center of Science and Education, vol. 13(7), pages 113-113, July.
    15. 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.
    16. Okeke, Edward N. & Abubakar, Isa S., 2020. "Healthcare at the beginning of life and child survival: Evidence from a cash transfer experiment in Nigeria," Journal of Development Economics, Elsevier, vol. 143(C).
    17. Cesur Resul & Kelly Inas Rashad, 2010. "From Cradle to Classroom: High Birth Weight and Cognitive Outcomes," Forum for Health Economics & Policy, De Gruyter, vol. 13(2), pages 1-26, March.
    18. Adjiwanou, Vissého & LeGrand, Thomas, 2013. "Does antenatal care matter in the use of skilled birth attendance in rural Africa: A multi-country analysis," Social Science & Medicine, Elsevier, vol. 86(C), pages 26-34.
    19. Michele Ploeg, 2009. "Do Benefits of U.S. Food Assistance Programs for Children Spillover to Older Children in the Same Household?," Journal of Family and Economic Issues, Springer, vol. 30(4), pages 412-427, December.
    20. Wehby, George L. & Murray, Jeffrey C. & Castilla, Eduardo E. & Lopez-Camelo, Jorge S. & Ohsfeldt, Robert L., 2009. "Prenatal care demand and its effects on birth outcomes by birth defect status in Argentina," Economics & Human Biology, Elsevier, vol. 7(1), pages 84-95, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alison Snow Jones & Deborah J. Miller & David S. Salkever, 1999. "Parental use of alcohol and children's behavioural health: a household production analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(8), pages 661-683, December.
    2. Janet Currie & Lucia Nixon & Nancy Cole, 1993. "Restrictions on Medicaid Funding of Abortion: Effects on Pregnancy Resolutions and Birth Weight," NBER Working Papers 4432, National Bureau of Economic Research, Inc.
    3. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    4. Kenneth Y. Chay & James L. Powell, 2001. "Semiparametric Censored Regression Models," Journal of Economic Perspectives, American Economic Association, vol. 15(4), pages 29-42, Fall.
    5. Theodore J. Joyce, 1986. "The Demand for Health Inputs and Their Impact on the Black Neonatal Mortality Rate in the U.S," NBER Working Papers 1966, National Bureau of Economic Research, Inc.
    6. Naci H. Mocan & Kudret Topyan, 1993. "Illicit Drug Use and Health: Analysis and Projections of New York City Birth Outcomes Using a Kalman Filter Model," NBER Working Papers 4359, National Bureau of Economic Research, Inc.
    7. Currie, Janet & Gruber, Jonathan & Fischer, Michael, 1995. "Physician Payments and Infant Mortality: Evidence from Medicaid Fee Policy," American Economic Review, American Economic Association, vol. 85(2), pages 106-111, May.
    8. Aydemir, Abdurrahman, 2002. "Effects of Selection Criteria and Economic Opportunities on the Characteristics of Immigrants," Analytical Studies Branch Research Paper Series 2002182e, Statistics Canada, Analytical Studies Branch.
    9. 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.
    10. Joyce, Theodore J. & Grossman, Michael & Goldman, Fred, 1989. "An assessment of the benefits of air pollution control: The case of infant health," Journal of Urban Economics, Elsevier, vol. 25(1), pages 32-51, January.
    11. Blundell, Richard & Macurdy, Thomas, 1999. "Labor supply: A review of alternative approaches," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 27, pages 1559-1695, Elsevier.
    12. Jorge Gonzalez Chapela, 2011. "Recreation, home production, and intertemporal substitution of female labor supply: evidence on the intensive margin," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 14(3), pages 532-548, July.
    13. Stern, Steven, 1996. "Semiparametric estimates of the supply and demand effects of disability on labor force participation," Journal of Econometrics, Elsevier, vol. 71(1-2), pages 49-70.
    14. Laurence C. Baker & Anne Beeson Royalty, 2000. "Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 480-502.
    15. Richard G. Frank & Donna Strobino & David S. Salkever & Catherine Jackson, 1989. "Poverty Programs, Initiation Of Prenatal Care And The Rate Of Low Birthweight Births," NBER Working Papers 3215, National Bureau of Economic Research, Inc.
    16. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
    17. Mwabu, Germano, 2008. "The Production of Child Health in Kenya: A Structural Model of Birth Weight," Working Papers 52, Yale University, Department of Economics.
    18. Jeffrey J. Rous & R. Todd Jewell & Robert W. Brown, 2004. "The effect of prenatal care on birthweight: a full‐information maximum likelihood approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 251-264, March.
    19. Casey B. Mulligan & Yona Rubinstein, 2005. "Selection, Investment, and Women's Relative Wages Since 1975," NBER Working Papers 11159, National Bureau of Economic Research, Inc.
    20. Leung, Siu Fai & Yu, Shihti, 1996. "On the choice between sample selection and two-part models," Journal of Econometrics, Elsevier, vol. 72(1-2), pages 197-229.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:3549. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.