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The Long-Term Effects of Income for At-Risk Infants: Evidence from Supplemental Security Income
March 2024
Working Paper Number:
CES-24-10
This paper examines whether a generous cash intervention early in life can "undo" some of the long-term disadvantage associated with poor health at birth. We use new linkages between several large-scale administrative datasets to examine the short-, medium-, and long-term effects of providing low-income families with low birthweight infants support through the Supplemental Security Income (SSI) program. This program uses a birthweight cutoff at 1200 grams to determine eligibility. We find that families of infants born just below this cutoff experience a large increase in cash benefits totaling about 27%of family income in the first three years of the infant's life. These cash benefits persist at lower amounts through age 10. Eligible infants also experience a small but statistically significant increase in Medicaid enrollment during childhood. We examine whether this support affects health care use and mortality in infancy, educational performance in high school, post-secondary school attendance and college degree attainment, and earnings, public assistance use, and mortality in young adulthood for all infants born in California to low-income families whose birthweight puts them near the cutoff. We also examine whether these payments had spillover effects onto the older siblings of these infants who may have also benefited from the increase in family resources. Despite the comprehensive nature of this early life intervention, we detect no improvements in any of the study outcomes, nor do we find improvements among the older siblings of these infants. These null effects persist across several subgroups and alternative model specifications, and, for some outcomes, our estimates are precise enough to rule out published estimates of the effect of early life cash transfers in other settings.
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Coverage of Children in the American Community Survey Based on California Birth Records
September 2023
Working Paper Number:
CES-23-46
The U.S. Census Bureau's American Community Survey (ACS) collects information on individuals and households. The ACS provides survey-based estimates of children drawn from a sample of the U.S. population. However, survey responses may not match administrative records, such as birth records. Birth records should provide a complete account of all births, along with child-parent relationships and demographic characteristics. California is a state that has both a large population of children and a high undercount for young children. This paper uses California as a case study to examine differences between reported versus unreported children in the ACS based on state birth records. Child reporting rates were lower for more recent data years, younger children, for Black and Hispanic mothers, and for more complex households. Child reporting rates were higher for more educated mothers and for households above the poverty line. Using mother's race and Hispanic ethnicity from the birth records combined with poverty indices from the ACS, this analysis also finds that child reporting does not uniformly vary with poverty status across all race and ethnicity groups. This research builds support for the utility of state birth records in analyzing the undercount of children.
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Maternal and Infant Health Inequality: New Evidence from Linked Administrative Data
November 2022
Working Paper Number:
CES-22-55
We use linked administrative data that combines the universe of California birth records, hospitalizations, and death records with parental income from Internal Revenue Service tax records and the Longitudinal Employer-Household Dynamics file to provide novel evidence on economic inequality in infant and maternal health. We find that birth outcomes vary nonmonotonically with parental income, and that children of parents in the top ventile of the income distribution have higher rates of low birth weight and preterm birth than those in the bottom ventile. However, unlike birth outcomes, infant mortality varies monotonically with income, and infants of parents in the top ventile of the income distribution---who have the worst birth outcomes---have a death rate that is half that of infants of parents in the bottom ventile. When studying maternal health, we find a similar pattern of non-monotonicity between income and severe maternal morbidity, and a monotonic and decreasing relationship between income and maternal mortality. At the same time, these disparities by parental income are small when compared to racial disparities, and we observe virtually no convergence in health outcomes across racial and ethnic groups as income rises. Indeed, infant and maternal health in Black families at the top of the income distribution is markedly worse than that of white families at the bottom of the income distribution. Lastly, we benchmark the health gradients in California to those in Sweden, finding that infant and maternal health is worse in California than in Sweden for most outcomes throughout the entire income distribution.
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Long-Run Adult Socio-economic Outcomes
from In Utero Airborne Lead Exposure
November 2022
Working Paper Number:
CES-22-53
As a neurotoxin, early exposure to lead has long been assumed to affect socioeconomic out-comes well into adulthood. However, the empirical literature documenting such effects has been limited. This study documents the long-term effects of in utero exposure to air lead on adult socio-economic outcomes, including earnings, disabilities, employment, public assistance, and education, using US survey and administrative data. Specifically, we match individuals in the 2000 US Decennial Census and 2001-2014 American Community Surveys to average lead concentrations in the individual's birth county during his/her 9 months in utero. We find a 0.5 'g/m3 decrease in air lead, representing the average 1975-85 change resulting from the passage of the U.S. Clean Air Act, is associated with an increase in earnings of 3.5%, or a present value, at birth, of $21,400 in lifetime earnings. Decomposing this effect, we find greater exposure to lead in utero is associated with an increase in disabilities in adulthood, an increase in receiving public assistance, and a decrease in employment. Looking at effects by sex, long-term effects for girls seem to fall on participation in the formal labor market, whereas for boys it appears to fall more on hours worked. This is the first study to document such long-term effects from lead using US data. We estimate the present value in 2020, from all earnings impacts from 1975 forward, to be $4,230 Billion using a discount rate of 3%. In 2020 alone, the benefits are $252 B, or about 1.2% of GDP. Thus, our estimates imply the Clean Air Act's lead phase out is still returning a national dividend of over 1% every year.
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Covering Undocumented Immigrants: The Effects of a Large-Scale Prenatal Care Intervention
August 2022
Working Paper Number:
CES-22-28
Undocumented immigrants are ineligible for public insurance coverage for prenatal care in most states, despite their children representing a large fraction of births and having U.S. citizenship. In this paper, we examine a policy that expanded Medicaid pregnancy coverage to undocumented immigrants. Using a novel dataset that links California birth records to Census surveys, we identify siblings born to immigrant mothers before and after the policy. Implementing a mothers' fixed effects design, we find that the policy increased coverage for and use of prenatal care among pregnant immigrant women, and increased average gestation length and birth weight among their children.
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Maternal Labor Dynamics: Participation, Earnings, and Employer Changes
December 2019
Working Paper Number:
CES-19-33
This paper describes the labor dynamics of U.S. women after they have had their first and subsequent children. We build on the child penalty literature by showing the heterogeneity of the size and pattern of labor force participation and earnings losses by demographic characteristics of mothers and the characteristics of their employers. The analysis uses longitudinal administrative earnings data from the Longitudinal Employer-Household Dynamics database combined with the Survey of Income and Program Participation survey data to identify women, their fertility timing, and employment. We find that women experience a large and persistent decrease in earnings and labor force participation after having their first child. The penalty grows over time, driven by the birth of subsequent children. Non-white mothers, unmarried mothers, and mothers with more education are more likely to return to work following the birth of their first child. Conditional on returning to the labor force, women who change employers earn more after the birth of their first child than women who return to their pre-birth employers. The probability of returning to the pre-birth employer and industry is heterogeneous over both the demographics of mothers and the characteristics of their employers.
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Planning Parenthood: The Affordable Care Act Young Adult Provision and Pathways to Fertility
January 2017
Working Paper Number:
CES-17-65
This paper investigates the effect of the Affordable Care Act young adult provision on fertility and related outcomes. The expected effect of the provision on fertility is not clear ex ante. By expanding insurance coverage to young adults, the provision may affect fertility directly through expanded options for obtaining contraceptives as well as through expanded options for obtaining pregnancy-, birth-, and infant-related care, and these may lead to decreased or increased fertility, respectively. In addition, the provision may also affect fertility indirectly through marriage or labor markets, and the direction and magnitude of these effects is difficult to determine. This paper considers the effect of the provision on fertility as well as the contributing channels by applying difference-in-differences-type methods using the 2008-2010 and 2012-2013 American Community Survey, 2006-2009 and 2012-2013 Centers for Disease Control and Prevention abortion surveillance data, and 2006-2010 and 2011-2013 National Survey of Family Growth. Results suggest that the provision is associated with decreases in the likelihood of having given birth and abortion rates and an increase in the likelihood of using long-term hormonal contraceptives.
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Income Effects in Labor Supply: Evidence from Child-Related Tax Benefits
May 2016
Working Paper Number:
CES-16-24
A parent whose child is born in December can claim child-related tax benefits when she files her tax return a few months later. Parents of children born in January must wait more than a year before they can receive child-related tax benefits. As a result, families with December births have higher after-tax income in the first year of a child's life than otherwise similar families with January births. This paper estimates the corresponding income effect on maternal labor supply, testing whether mothers who give birth in December work and earn less in the months following birth. We use data from the American Community Survey, the Survey of Income and Program Participation, and the 2000 Decennial Census. We find that December mothers have a lower probability of working, particularly in the third month after a child's birth. Earnings data from the SIPP indicate that an additional dollar of child-related tax benefits reduces annual maternal earnings in the year following a child's birth by approximately one dollar.
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The Timing of Teenage Births: Estimating the Effect on High School Graduation and Later Life Outcomes
January 2016
Working Paper Number:
CES-16-39R
We examine the long-term outcomes for a population of teenage mothers who give birth to their children around the end of their high school year. We compare the mothers whose high school education was interrupted by childbirth, because the child was born before her expected graduation date to mothers who did not experience the same disruption to their education. We find that mothers who give birth during the school year are seven percent less likely to graduate from high school, are less likely to be married, and have more children than their counterparts who gave birth just a few months later. The labor market outcomes for these two sets of teenage mothers are not statistically different, but with a lower likelihood of marriage and more children, the households of the treated mothers are more likely to fall below the poverty threshold. While differences in educational attainment have narrowed over time, the differences in labor market outcomes and family structure have remained stable.
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The Relationship of Personal and Neighborhood Characteristics to Immigrant Fertility
August 2002
Working Paper Number:
CES-02-20
We find that fertility varies by immigrant generation, with significant declines between the first and subsequent generations for groups with large immigrant population. However, we find that personal characteristics--such as educational attainment, marital status, and income levels--are much more important than immigrant generation in understanding fertility outcomes. In fact, generations are not independently important once these personal characteristics are controlled for. We maintain that declining fertility levels among the descendants of Mexican and Central American immigrants are primarily the result of higher educational attainment levels, lower rates of marriage, and lower poverty. For example, a four-year increase in educational attainment decreases children ever born (CEB) by half a child. We conclude that immigrant generation serves as a proxy for changes in other personal characteristics that decrease fertility. Neighborhood characteristics have some bearing on fertility, but the correlations are relatively weak. Among Mexican and Central American immigrants and their descendants, the most consistent predictor of children ever born (CEB) at the neighborhood level is the percentage of Hispanic adults. However, no neighborhood characteristics bear any statistical relationship to current fertility, the measure that emphasizes recent births. This pattern of evidence suggests that the observed relationships between neighborhood characteristics and fertility are based on selection into the neighborhood rather than on neighborhood influences as such.
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