IDEAS home Printed from
   My bibliography  Save this paper

The Effect of Welfare Reform on Prenatal Care and Birth Weight


  • Robert Kaestner
  • Won Chan Lee


Welfare reform has resulted in a dramatic decline in welfare caseloads and some have claimed that a significant number of low-income women may be without health insurance as a result. The loss of insurance may reduce low-income, pregnant women's health care utilization, and this may adversely affect infant health. Welfare reform also may affect healthcare utilization and health of pregnant women and infants because of welfare-induced changes in family disposable income, time available for health investments, and levels of stress. In this paper we examine the effect of welfare reform on prenatal care utilization and birth weight of low-educated women and their infants. We find that a 50 percent reduction in the caseload, which is similar to that which occurred in the 1990s, is associated with a zero to seven percent decrease in first trimester prenatal care; a zero to five percent decrease in the number of prenatal care visits; and a zero to 10 percent increase in low birth weight.

Suggested Citation

  • Robert Kaestner & Won Chan Lee, 2003. "The Effect of Welfare Reform on Prenatal Care and Birth Weight," NBER Working Papers 9769, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9769
    Note: HE CH

    Download full text from publisher

    File URL:
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    1. 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.
    2. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, Oxford University Press, vol. 119(1), pages 249-275.
    3. Kaestner, Robert & Kaushal, Neeraj, 2003. "Welfare reform and health insurance coverage of low-income families," Journal of Health Economics, Elsevier, vol. 22(6), pages 959-981, November.
    4. Rebecca M. Blank, 2002. "Evaluating Welfare Reform in the United States," Journal of Economic Literature, American Economic Association, vol. 40(4), pages 1105-1166, December.
    5. Neeraj Kaushal & Robert Kaestner, 2001. "From Welfare to Work: Has Welfare Reform Worked?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(4), pages 699-719.
    6. repec:aph:ajpbhl:1999:89:10:1514-1521_5 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)


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

    Cited by:

    1. Komlos, John & Baur, Marieluise, 2004. "From the tallest to (one of) the fattest: the enigmatic fate of the American population in the 20th century," Economics & Human Biology, Elsevier, vol. 2(1), pages 57-74, March.
    2. Marianne P. Bitler & Jonah Gelbach & Hilary Hoynes, 2003. "Welfare Reform and Health," Working Papers WR-102-1-NICHD/NIA, RAND Corporation.
    3. Ana I. Balsa & Patricia Triunfo, 2012. "The Effectiveness of Prenatal Care in a Low Income Population: A Panel Data Approach," Documentos de Trabajo/Working Papers 1204, Facultad de Ciencias Empresariales y Economia. Universidad de Montevideo..
    4. Hope Corman & Dhaval M. Dave & Dhiman Das & Nancy E. Reichman, 2013. "Effects Of Welfare Reform On Illicit Drug Use Of Adult Women," Economic Inquiry, Western Economic Association International, vol. 51(1), pages 653-674, January.
    5. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    6. repec:pri:crcwel:wp06-04-ff is not listed on IDEAS
    7. Hope Corman & Dhaval M. Dave & Nancy E. Reichman, 2017. "Evolution of the Infant Health Production Function," NBER Working Papers 24131, National Bureau of Economic Research, Inc.
    8. Leonard, Jonathan & Mas, Alexandre, 2008. "Welfare reform, time limits, and infant health," Journal of Health Economics, Elsevier, vol. 27(6), pages 1551-1566, December.
    9. Jean Knab & Sara McLanahan & Irv Garfinkel, 2007. "The Effects of Welfare and Child Support Policies on Maternal Health and Wellbeing," Working Papers 931, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Research on Child Wellbeing..
    10. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    11. Marianne Bitler & Hilary W. Hoynes, 2006. "Welfare Reform and Indirect Impacts on Health," NBER Working Papers 12642, National Bureau of Economic Research, Inc.
    12. Robert Kaestner & Elizabeth Tarlov, 2006. "Changes in the welfare caseload and the health of low-educated mothers," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 25(3), pages 623-643.
    13. van den Berg, Gerard J. & Modin, Bitte, 2013. "Economic Conditions at Birth, Birth Weight, Ability, and the Causal Path to Cardiovascular Mortality," IZA Discussion Papers 7605, Institute for the Study of Labor (IZA).
    14. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    15. Guidetti, Giovanni & Mazzanti, Massimiliano, 2007. "Firm-level training in local economic systems: Complementarities in production and firm innovation strategies," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 36(6), pages 875-894, December.
    16. Wehby, George & Dave, Dhaval M. & Kaestner, Robert, 2016. "Effects of the Minimum Wage on Infant Health," IZA Discussion Papers 10039, Institute for the Study of Labor (IZA).
    17. Ayala, Luis & Rodríguez, Magdalena, 2013. "Health-related effects of welfare-to-work policies," Social Science & Medicine, Elsevier, vol. 93(C), pages 103-112.
    18. Herbst, Chris M., 2014. "Are Parental Welfare Work Requirements Good for Disadvantaged Children? Evidence from Age-of-Youngest-Child Exemptions," IZA Discussion Papers 8485, Institute for the Study of Labor (IZA).
    19. Ana Inés Balsa & Patricia Triunfo, 2012. "¿Son los cuidados prenatales efectivos? Un enfoque con datos individuales de panel," Documentos de Trabajo (working papers) 0612, Department of Economics - dECON.

    More about this item

    JEL classification:

    • I2 - Health, Education, and Welfare - - Education
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    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:9769. 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: .

    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 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.

    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.