Prenatal Smoking Cessation and Infant Health: Evidence from Sibling Births

This article uses a large data set of sibling births to examine when mothers must quit smoking in pregnancy to deliver healthy babies. It applies sibling fixed effects models to provide robust evidence that smoking cessation in the first trimester has a negligible effect on infant health, but cessation as late as second trimester or smoking throughout pregnancy is associated with substantially lower birth weights and higher risks of delivering low birth weight babies. In particular, about two thirds of the total detrimental smoking impact on birth outcomes occurs in the second trimester. Therefore, reallocating resources on prenatal smoking cessation towards the first trimester can lead to a significant efficiency gain. This study also shows when the timing information of prenatal smoking cessation is improperly used, it will introduce a new nontrivial downward bias in estimating the causality between the conventionally used group measure “prenatal smoker” and infant health.     

Early Effects of the Affordable Care Act on Health Care Access,Risky Health Behaviors,and Self-Assessed Health

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both Medicaid expansion and nonexpansion states, with the gains being larger in expansion states along some dimensions. However, we do not find clear effects on risky behaviors or self-assessed health.     

Health insurance generosity and conditional coverage: Evidence from medicaid managed care in Kentucky

This article estimates the impact of the introduction of Medicaid managed care (MMC) on the formal Medicaid participation of children. We employ a quasi‐experimental approach exploiting the location‐specific timing of MMC implementation in Kentucky. Using data from the March Current Population Survey from 1995 to 2003, our findings suggest that the introduction of MMC increases the likelihood of being uninsured and decreases formal Medicaid participation. This finding is consistent with an increase in “conditional coverage,” waiting until medical care is needed to sign up or re‐enroll in Medicaid. These effects are concentrated among low‐income children and absent for high‐income children. We find no evidence of “crowd‐in,” substituting private coverage for Medicaid. These results are robust to multiple placebo tests and imply the potential for less formal participation (i.e., more conditional coverage) among the Affordable Care Act‐Medicaid expansion population (which is likely to be primarily covered under MMC) than is typically predicted.     

Does wealth matter? An assessment of China's rural-urban migration on the education of left-behind children

This paper decomposes the impact of parental migration on the education of children left behind. In particular, we examine whether children are enrolled in school on a timely basis according to their age when their parents are away. We found both theoretical and empirical evidence to support that parental migration generates a strong positive impact on timely enrollment if a child is from a less wealthy background. However, the effect decreases with family wealth, and reverses after reaching a threshold; we find this point using family house size as our proxy and the turning point occurs at a moderate size of approximately 148 square meters. In addition, we find a compensating effect that migrants tend to spend more on a child's education investment to offset for the loss of parental time care. Lastly, we found the overall impact of parental migration is negative on the timely enrollment of child. Thus, with the important heterogeneities attributed to wealth, our results suggest that the left behind children of more affluent parents may be pushed into worse human capital outcomes; given the rapid development of China, it may be the case that the current cohort of left behind children is less likely to be enrolled in school than earlier cohorts.     

Developing Social Citizenship？ A Case Study of Education and Health Services in Yantian Village of Guangdong Province

Social policy is an indispensable element of rule and China’s current leadership has moved policy to a more inclusive system based on a notion of citizenship.The extension of social welfare provision is examined through a case study of education and health care in the South China village of Yantian.Yantian lies at the core of the Pearl River Delta,which has become a key link in the global reorganization of manufacturing and production.Consequently,the village is home to some 80 000 migrant workers who complement the 3000 registered inhabitants.A study of education and health-care provision reveals that in terms of equity, registered villagers enjoy significant advantages in seeking welfare resources.Although living in the same village,the two groups inhabit "different worlds." However,provision, while selective,has become more inclusive.The present research suggests that "social citizenship " will precede "political citizenship."     

Parental migration,educational achievement,and mental health of junior high school students in rural China

China's rapid development has led to an unprecedented increase in migration rates as an ever-growing number of rural residents migrate to urban areas to seek better job opportunities and help alleviate family poverty. Economic pressures and structural restrictions force many of these migrant workers to leave their children behind in their rural homes, which has led to the emergence and expansion of a new subpopulation in China: left-behind children (LBCs). This study examines the impacts of parental migration on the educational outcomes (specifically math achievement) and mental health (specifically anxiety) of LBCs using data covering 7495 children in a prefecture of Shaanxi Province (from three surveys conducted between 2012 and 2014). We distinguish between “both parents migrating,” “one parent migrating,” “only a father migrating,” and “only a mother migrating.” We also explore the impacts on male versus female LBCs. We find no significant impact of parental migration on the math achievement of LBCs. In terms of mental health, however, our results indicate that left-behind girls were negatively affected by one parent migrating, especially if the migrating parent was the father. The findings suggest that it may not be necessary for policy makers to design special programs to improve educational outcomes of LBCs in general. However, local committees, schools, and parents should pay particular attention to left-behind girls living with only one parent, as they may be more vulnerable to mental health problems than their peers.     

Parental Education and Child Health: Evidence from China*

This paper examines the effect of parental, household and community character‐istics on the health of children in China. We find that birth order, death of elder siblings, use of prenatal care and alcohol consumption by the mother when pregnant have statistically significant effects on the health of children. Although parental education does not have a significant direct effect on child health, it does affect mothers’ behavior during pregnancy and inflfluences the use of health inputs, indirectly impacting the health of children. The research findings have important implications for both family planning programs and broader social policies in China.     

Sibling Rivalry and Strategic Parental Transfers

This paper develops a noncooperative Nash model in which two siblings compete for their parents' financial transfers. Treating sibling rivalry as a “rent-seeking contest” and using a Tullock-Skaperdas contest success function, we derive the conditions under which more financial resources are transferred to the sibling with lower earnings. We find that parental transfers are compensatory and that the family as an institution serves as an “income equalizer.” Within a sequential game framework, we characterize the endogeneity of parental transfers and link it to parents' income, altruism, and children's supply of merit goods (e.g., parent-child companionship or child services). We show that merit goods are subject to a “moral hazard” problem from the parents' perspective.     

Access to savings and household welfare evidence from a household survey in The Gambia

In this study, we provide evidence on the impact of access to formal savings on household well‐being in The Gambia. Specifically, we study how access to formal savings can impact household outcomes such as total spending, ownership of durable assets, health spending, and education spending. Using a representative household survey and kernel ridge regression method, we find that household access to formal savings has a positive and statistically significant impact on all outcomes except health spending. Furthermore, we find that the largest effect size of access to savings is on education spending. However, the impact estimates on education and food expenditure are not very robust to a mild presence of hidden bias. Overall, we find a robust impact for total spending and asset ownership. Hence, increasing household access to formal savings can improve household well‐being in The Gambia.     

Are Antidumping Duties for Sale? Case‐Level Evidence on the Grossman‐Helpman Protection for Sale Model

Do contributions to politicians affect trade policy? To examine this question, we have compiled a new, unique database containing information on political donations by the specific firms and labor organizations that have petitioned for antidumping protection from imports, as well as data on the outcomes of their requests. Using an empirical framework based on the 1994 “protection for sale” model, we examine the relationship between antidumping decisions and political activism. Our results indicate that money does matter. We find that politically active petitioners are more likely to receive protection and that antidumping duty rates tend to be higher for that group. In addition, the relationship between the import penetration ratio and duties imposed depends on whether or not petitioners are politically active—antidumping duties are positively correlated with the import penetration ratio for politically inactive petitioners but negatively correlated for politically active petitioners, consistent with the Grossman‐Helpman model's predictions.     

The effect of family planning exposure on fertility choices and reproductive health care in rural Pakistan

This paper investigates whether family planning exposure mainly through the Lady Health Worker Program has had any effect on women’s fertility choices and use of reproductive health care service in rural Pakistan, using the 2013 Pakistan Demographic and Health Survey (PDHS). Exploiting variations in the program intensity across regions, we conduct instrumental variables (IV) estimation on the impact of family planning exposure on women’s fertility preferences and reproductive behaviors. Our analysis shows that even in the presence of strong son preferences in Pakistan, increasing family planning exposure reduces women’s incentive to have additional children. Moreover, family planning exposure is associated with more antenatal care visits, more deliveries performed by skilled professionals, and a greater chance of delivery at the health center. Finally, we examine the heterogeneity in the effect on fertility preference by age group and education level, and find that the effect is mainly significant for the educated and young women.     

Does health insurance decrease health expenditure risk in developing countries? The case of China

This article studies the impact of health insurance on individual out‐of‐pocket health expenditures in China. Using China Health and Nutrition Survey data between 1991 and 2006, we apply two‐part and sample selection models to address issues caused by censored data and selection on unobservables. We find that, although the probability of accessing health care increases with the availability of health insurance, the level of out‐of‐pocket health expenditure decreases. Our results from a selection model with instrumental variables suggest that having health insurance reduces the expected out‐of‐pocket health expenditure of an individual by 29.42% unconditionally. Meanwhile, conditional on being subjected to positive health expenditure, health insurance helps reduce out‐of‐pocket spending by 44.38%. This beneficial effect of health insurance weakens over time, which may be attributable to increases in the coinsurance rates of health insurances in China.     

An Examination of the Government Spending and Economic Growth Nexus for Malaysia Using the Leveraged Bootstrap Simulation Approach

Abstract

The main objective of this study is to re-examine the government spending-growth nexus for Malaysia from the perspective of disaggregated government spending. The yearly data from 1960 to 2007 is used in this study. This study applied the bounds testing for co-integration and the leveraged bootstrap simulation approaches to examine the relationship between three different categories of government spending and national income in Malaysia. It is found that government spending on education and defence are co-integrated with national income. Nevertheless, there is no evidence of co-integrating relation between government spending on health and national income. The MWALD causality test shows strong evidence of unidirectional causal relationship running from national income to the three major government spending in Malaysia. However, bilateral causality evident exists only between government spending on health and national income.     

Do Parents Invest Less in Worse-Performing Children? Evidence from the Asian Financial Crisis

This article uses data from Indonesia around the time of the 1997–98 Asian financial crisis to examine the role of parental preferences in human capital accumulation. Using a household fixed-effects estimation, I test whether parental education spending is affected by child mathematics test scores. I find that parents are more sensitive to the human capital of younger children, who are penalised for having lower skills than their older siblings. Differences in investment by child gender or birth order are evident in 2000 but not in 1997. This suggests that parents may have an efficiency investment strategy only when resource-constrained, and that education of younger children may be a luxury good.     

Are immigrants really attracted to the welfare state? Evidence from OECD countries

This paper examines the impact of fiscal policies on both the size and educational levels of immigrants in destination countries. We find that whether or not a country’s policies are attracting highly educated immigrants goes beyond the issue of the “welfare state”. Immigrants are making important distinctions between the different benefits provided by a receiving country’s government. Health and education spending are found to have a positive impact on the education levels of immigrants while the reverse is true for unemployment and retirement benefits. Welfare programs are found to be insignificant once other government programs/taxes and other factors are taken into account. These results imply that countries should be less concerned about whether they are a “big government” with regards to attracting immigrants, and more concerned with what types of benefits they offer.     

Elderly long-term care policy and sandwich caregivers’ time allocation between child-rearing and market labor

Using an overlapping generations model, we present analyses of public long-term care provision effects on fertility and time allocation decisions of sandwich caregivers, those caring for young children and old parents simultaneously. If the public long-term care level runs short of the necessary level, then working children must compensate for the difference by spending their time. Reportedly, about a third of university students’ parents are sandwich caregivers in Japan, although Japan has a Long-Term Care Insurance system, which is a mandatory system with universal coverage. With a rapidly aging population, demand for long-term care is predicted to increase, thereby affecting family time allocation, e.g., fertility decisions, in Japan. Results show that if public long-term care production is costly relative to family care provision, then increases in public care provision lower the fertility rate. If labor productivity in the public long-term care sector improves, then it increases the fertility rate by freeing caregivers’ time from family care provision. It will also increase social welfare. The effects on labor employment in the goods production sector are generally ambiguous because the increased public care provision requires more labor.     

Anti-Poverty Programs in Indonesia

Between 1994/95 and 1997/98, Indonesia's spending on anti-poverty programs grew from 0.1% to 0.3% of GDP. The introduction of the 'social safety net' raised anti-poverty spending to 1.4% of GDP in 1998/99 and changed its main focus from job creation schemes, financed mainly by loans and grants to small firms and community groups, to in-kind subsidies for rice, public health care, scholarships for children in poor families and grants to schools in poorareas. The most accurately targeted program was health care, which covered twice as many people in the two poorest deciles as in the remaining eight. For most other programs, this targeting ratio was only about 1.5. We argue that the education and health care programs were the most successful, and doubt that the rice subsidy, job creation and loans schemes were worthwhile.