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Is Prenatal Care Really Ineffective? Or, is the 'Devil' in the Distribution?

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Author Info
Partha Deb () (Hunter College, Department of Economics)
Karen Smith Conway

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Abstract

It is widely believed that expanding prenatal care should improve infant health; yet research typically finds weak effects of prenatal care on infant health. We argue that there are two kinds of pregnancies, 'complicated' and 'normal' ones, and that combining these pregnancies, as past research does, may lead prenatal care to appear ineffective. Data from the NMIHS offers compelling evidence supporting our view. The standard 2SLS approach yields residuals that are obviously bimodal and prenatal care coefficients that are frequently insignificant. In contrast, estimating birth weights with a finite mixture model yields estimates that are much more robust and that clearly suggest that prenatal care has a consistent, substantial effect on ?normal? pregnancies. Our Monte Carlo experiment confirms that ignoring even a small proportion of ?complicated? pregnancies can lead the onset of prenatal care to appear unimportant.

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Paper provided by Hunter College: Department of Economics in its series Hunter College Department of Economics Working Papers with number 02/2.

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Length: 39 pages
Date of creation: 2002
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Handle: RePEc:htr:hcecon:02/2

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  1. Joyce, Theodore, 1999. "Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City," Journal of Health Economics, Elsevier, vol. 18(1), pages 31-67, January. [Downloadable!] (restricted)
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  2. John F. Geweke & Michael P. Keane, 1997. "Mixture of normals probit models," Staff Report 237, Federal Reserve Bank of Minneapolis. [Downloadable!]
  3. Wang, Peiming & Cockburn, Iain M & Puterman, Martin L, 1998. "Analysis of Patent Data--A Mixed-Poisson-Regression-Model Approach," Journal of Business & Economic Statistics, American Statistical Association, vol. 16(1), pages 27-41, January.
  4. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December. [Downloadable!] (restricted)
  5. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, Southern Economic Association, vol. 65(1), pages 42-63, July.
  6. Warner, Geoffrey L, 1995. "Prenatal Care Demand and Birthweight Production of Black Mothers," American Economic Review, American Economic Association, vol. 85(2), pages 132-37, May. [Downloadable!] (restricted)
  7. Mark R. Rosenzweig & T. Paul Schultz, 1982. "The Behavior of Mothers as Inputs to Child Health: The Determinants of Birth Weight, Gestation, and Rate of Fetal Growth," NBER Chapters, in: Economic Aspects of Health, pages 53-92 National Bureau of Economic Research, Inc. [Downloadable!]
  8. Janet Currie & Jeffrey Grogger, 2000. "Medicaid Expansions and Welfare Contractions: Offsetting Effects on Prenatal Care and Infant Health?," NBER Working Papers 7667, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  9. Gritz, R. Mark, 1993. "The impact of training on the frequency and duration of employment," Journal of Econometrics, Elsevier, vol. 57(1-3), pages 21-51. [Downloadable!] (restricted)
  10. Theodore Joyce, 1995. "Self-Selection, Prenatal Care, and Birthweight Among Blacks, Whites and Hispanics in New York City," NBER Working Papers 3549, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  11. Cutler, David M & Gruber, Jonathan, 1996. "Does Public Insurance Crowd Out Private Insurance?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 391-430, May. [Downloadable!] (restricted)
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  12. Michael Grossman & Theodore J. Joyce, 1991. "Unobservables, Pregnancy Resolutions, and Birthweight Production Functions in New York City," NBER Working Papers 2746, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  13. Morduch, Jonathan J. & Stern, Hal S., 1997. "Using mixture models to detect sex bias in health outcomes in Bangladesh," Journal of Econometrics, Elsevier, vol. 77(1), pages 259-276, March. [Downloadable!] (restricted)
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  14. Wedel, M, et al, 1993. "A Latent Class Poisson Regression Model for Heterogeneous Count Data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 8(4), pages 397-411, Oct.-Dec.. [Downloadable!] (restricted)
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  1. Olena Nizalova & Maria Vyshnya, 2009. "Evaluation of the Impact of the Mother and Infant Health Project in Ukraine," Discussion Papers 18, Kyiv School of Economics. [Downloadable!]
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