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Early intervention and child health: Evidence from a Dublin-based randomized controlled trial

Author

Listed:
  • Orla Doyle

    (UCD School of Economics and UCD Geary Institute for Public Policy, University College Dublin)

  • Nick Fitzpatrick

    (UCD Geary Institute for Public Policy, University College Dublin)

  • Judy Lovett

    (UCD Geary Institute for Public Policy, University College Dublin)

  • Caroline Rawdon

    (UCD School of Psychology, University College Dublin)

Abstract

This article investigates the impact of an early intervention program, which experimentally modifies the parenting and home environment of disadvantaged families, on child health in the first 3 years of life. We recruited and randomized 233 (115 intervention, 118 control) pregnant women from a socioeconomically disadvantaged community in Dublin, Ireland into an intervention or control group. The treatment includes regular home visits commencing antenatally and an additional parenting course commencing at 2 years. Maternal reports of child health are assessed at 6, 12, 18, 24, and 36 months. Treatment effects are estimated using permutation testing to account for small sample size, inverse probability weighting to account for differential attrition, and the stepdown procedure to account for multiple hypothesis testing. Following adjustment for multiple testing and attrition, we observe a positive and statistically significant main treatment effect for wheezing/asthma. The intervention group are 15.5 percentage points (pp) less likely to require medical attention for wheezing/asthma compared to the control group. Statistically significant individual main effects which do not survive multiple testing and IPW-adjustment are found for general health (10.0 pp), hospitalizations (8.2 pp), immunizations (8.6 pp), chest infections (12.2 pp) and the number of health problems (d = 0.34). Subgroup analysis reveals more statistically significant adjusted treatment effects for boys than girls regarding fewer health problems (d = 0.63), accidents (23.9 pp), and chest infections (22.8 – 37.9 pp). Our results suggest that a community-based home visiting program may have favorable impacts on early health conditions. As child ill health is costly to society due to an increased demand on health resources and long-term productivity losses, identifying effective interventions to counteract inequalities in health is important from a policy perspective.

Suggested Citation

  • Orla Doyle & Nick Fitzpatrick & Judy Lovett & Caroline Rawdon, 2015. "Early intervention and child health: Evidence from a Dublin-based randomized controlled trial," Working Papers 201505, Geary Institute, University College Dublin.
  • Handle: RePEc:ucd:wpaper:201505
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    References listed on IDEAS

    as
    1. Orla Doyle, 2012. "Breaking the Cycle of Deprivation: An Experimental Evaluation of an Early Childhood Intervention," Working Papers 201212, Geary Institute, University College Dublin.
    2. James Heckman & Flavio Cunha, 2007. "The Technology of Skill Formation," American Economic Review, American Economic Association, vol. 97(2), pages 31-47, May.
    3. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    4. Doyle, Orla & Harmon, Colm P. & Heckman, James J. & Tremblay, Richard E., 2009. "Investing in early human development: Timing and economic efficiency," Economics & Human Biology, Elsevier, vol. 7(1), pages 1-6, March.
    5. repec:mpr:mprres:7934 is not listed on IDEAS
    6. Duflo, Esther & Glennerster, Rachel & Kremer, Michael, 2008. "Using Randomization in Development Economics Research: A Toolkit," Handbook of Development Economics,, Elsevier.
    7. Rosemary Hyson & Janet Currie, 1999. "Is the Impact of Health Shocks Cushioned by Socioeconomic Status? The Case of Low Birthweight," American Economic Review, American Economic Association, vol. 89(2), pages 245-250, May.
    8. Doyle, O. & Harmon, C. & Heckman, J.J. & Logue, C,; & Moon, S.H., 2013. "Measuring Investment in Human Capital Formation: An Experimental Analysis of Early Life Outcomes," Health, Econometrics and Data Group (HEDG) Working Papers 13/18, HEDG, c/o Department of Economics, University of York.
    9. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
    10. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
    11. James Heckman & Seong Hyeok Moon & Rodrigo Pinto & Peter Savelyev & Adam Yavitz, 2010. "Analyzing social experiments as implemented: A reexamination of the evidence from the HighScope Perry Preschool Program," Quantitative Economics, Econometric Society, vol. 1(1), pages 1-46, July.
    12. Bryan Keller, 2012. "Detecting Treatment Effects with Small Samples: The Power of Some Tests Under the Randomization Model," Psychometrika, Springer;The Psychometric Society, vol. 77(2), pages 324-338, April.
    13. Joseph P. Romano & Michael Wolf, 2005. "Exact and Approximate Stepdown Methods for Multiple Hypothesis Testing," Journal of the American Statistical Association, American Statistical Association, vol. 100, pages 94-108, March.
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    15. 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.
    16. James Heckman & Seong Hyeok Moon & Rodrigo Pinto & Peter Savelyev & Adam Yavitz, 2010. "Analyzing social experiments as implemented: evidence from the HighScope Perry Preschool Program," CeMMAP working papers CWP22/10, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    17. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
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    Cited by:

    1. Orla Doyle, 2017. "The First 2,000 Days and Child Skills: Evidence from a Randomized Experiment of Home Visiting," Working Papers 201715, School of Economics, University College Dublin.

    More about this item

    Keywords

    Randomized controlled trial; home visiting; child health; early intervention;

    JEL classification:

    • C12 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Hypothesis Testing: General
    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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