Effects of Prenatal Poverty on Infant Health

Abstract

This study estimates the effects of prenatal poverty on birth weight using changes in state Earned Income Tax Credits (EITC) as a natural experiment. We seek to answer two questions about poverty and child wellbeing. First, are there associations between prenatal poverty and lower birth weights even after factoring out unmeasured potential confounders? Because birth weight predicts a range of outcomes across the life course, lower birth weights that result from poverty may have lasting consequences for children’s life chances. Second, how have recent expansions of a work-based welfare program (i.e., the EITC) affected maternal and infant health? In recent decades, U.S. poverty relief has become increasingly tied to earnings and labor markets, but the consequences for children’s wellbeing remain controversial. We find that state EITCs increase birth weights and reduce maternal smoking. However, results related to AFDC/TANF and varying EITC effects across maternal ages raise cautionary messages.

Effects of state-level Earned Income Tax Credit laws in the U.S. on maternal health behaviors and infant health outcomes

“…State EITCs vary tremendously in terms of generosity, ranging from dollar values representing a mere 3.5% of the federal benefit to a high of 75% of the federal benefit. As with the federal EITC, research on state EITCs shows these state programs encourage employment among women (Strully et al, 2010). …”

“…But they provide some evidence that the state EITC improves health for older children. Strully et al (2010) evaluate the effects of state EITCs, through 2002, on infant birth weight and maternal prenatal smoking. They find that the presence of a state EITC is associated with increased birth weight and lower maternal smoking.…”

“…Second, we include multiple infant health outcomes and maternal health behaviors, including timely receipt of prenatal care, maternal drinking and smoking, birth weight, and gestation length in order to advance understanding of possible mechanisms for EITC health effects. Strully et al (2010) examine birth weight and maternal smoking while Baughman and Duchovny (2016) examine health insurance coverage, use of medical care and health status for children ages 0–5. Third, we use birth certificate data spanning two decades, from 1994 to 2013.…”

“…Third, we use birth certificate data spanning two decades, from 1994 to 2013. Data used by Strully et al (2010) ended in 2002 when only 16 states had an EITC and before many states significantly raised EITC generosity levels. Our expanded time period includes substantially more variation in the policy, improving power to identify effects on infant health outcomes.…”

The EARN-Health Trial: protocol for a randomised controlled trial to identify health effects of a financial savings programme among low-income US adults

“…While several studies have investigated the health effects of strategies to increase income among US adults, [30][31][32][33][34][35][36][37][38] none, to the best of our knowledge, have investigated the health effects of encouraging financial savings after income is generated. The existing literature on the health effects of income-generating interventions in the USA has been surprisingly mixed.…”