IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v24y2005i3p489-513.html
   My bibliography  Save this article

Is prenatal care really ineffective? Or, is the 'devil' in the distribution?

Author

Listed:
  • Conway, Karen Smith
  • Deb, Partha

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.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
    • Handle: RePEc:eee:jhecon:v:24:y:2005:i:3:p:489-513
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167-6296(05)00006-8
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March.
    4. Karen Smith Conway & Lisa DeFelice Kennedy, 2004. "Maternal Depression and the Production of Infant Health," Southern Economic Journal, John Wiley & Sons, vol. 71(2), pages 260-286, October.
    5. Warner, Geoffrey L, 1995. "Prenatal Care Demand and Birthweight Production of Black Mothers," American Economic Review, American Economic Association, vol. 85(2), pages 132-137, May.
    6. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    7. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, John Wiley & Sons, vol. 65(1), pages 42-63, July.
    8. Theodore Joyce, 1994. "Self-Selection, Prenatal Care, and Birthweight among Blacks, Whites, and Hispanics in New York City," Journal of Human Resources, University of Wisconsin Press, vol. 29(3), pages 762-794.
    9. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    10. 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 1263-1296, December.
    11. 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.
    12. 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..
    13. 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.
    14. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, John Wiley & Sons, vol. 65(1), pages 42-63, July.
    15. John Geweke & Michael P. Keane, 1997. "Mixture of normals probit models," Staff Report 237, Federal Reserve Bank of Minneapolis.
    16. 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.
    17. Fuchs, Victor R. (ed.), 1982. "Economic Aspects of Health," National Bureau of Economic Research Books, University of Chicago Press, number 9780226267852, September.
    18. Grossman, Michael & Joyce, Theodore J, 1990. "Unobservables, Pregnancy Resolutions, and Birth Weight Production Functions in New York City," Journal of Political Economy, University of Chicago Press, vol. 98(5), pages 983-1007, October.
    19. Jonathan Gruber, 1997. "Policy Watch: Medicaid and Uninsured Women and Children," Journal of Economic Perspectives, American Economic Association, vol. 11(4), pages 199-208, Fall.
    20. Peiming Wang & Iain Cockburn & Martin L. Puterman, "undated". "A Mixed Poisson Regression Model for Analysis of Patent Data," Computing in Economics and Finance 1996 _049, Society for Computational Economics.
    21. Rosenzweig, Mark R & Schultz, T Paul, 1983. "Estimating a Household Production Function: Heterogeneity, the Demand for Health Inputs, and Their Effects on Birth Weight," Journal of Political Economy, University of Chicago Press, vol. 91(5), pages 723-746, October.
    22. Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Karen Smith Conway & Andrea Kutinova, 2006. "Maternal health: does prenatal care make a difference?," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 461-488, May.
    2. Karen Smith Conway & Lisa DeFelice Kennedy, 2004. "Maternal Depression and the Production of Infant Health," Southern Economic Journal, John Wiley & Sons, vol. 71(2), pages 260-286, October.
    3. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    4. Deb, Partha & Trivedi, Pravin K., 2002. "The structure of demand for health care: latent class versus two-part models," Journal of Health Economics, Elsevier, vol. 21(4), pages 601-625, July.
    5. Vincenzo Atella & Francesco Brindisi & Partha Deb & Furio C. Rosati, 2004. "Determinants of access to physician services in Italy: a latent class seemingly unrelated probit approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 657-668, July.
    6. Wehby, George L. & Murray, Jeffrey C. & Castilla, Eduardo E. & Lopez-Camelo, Jorge S. & Ohsfeldt, Robert L., 2009. "Prenatal care demand and its effects on birth outcomes by birth defect status in Argentina," Economics & Human Biology, Elsevier, vol. 7(1), pages 84-95, March.
    7. Nastis, Stefanos A. & Crocker, Thomas D., 2012. "Valuing mother and child health: The intrauterine environment," Economics & Human Biology, Elsevier, vol. 10(3), pages 318-328.
    8. Deb, Partha & TRIVEDI, PRAVIN K, 1998. "Moment-based Estimation of Latent Class Models of Event Counts," University of California at San Diego, Economics Working Paper Series qt6r282286, Department of Economics, UC San Diego.
    9. Aparna Lhila & Sharon Long, 2012. "What is driving the black–white difference in low birthweight in the US?," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 301-315, March.
    10. Padmaja Ayyagari & Partha Deb & Jason Fletcher & William Gallo & Jody L. Sindelar, 2013. "Understanding Heterogeneity In Price Elasticities In The Demand For Alcohol For Older Individuals," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 89-105, January.
    11. Partha Deb & William T. Gallo & Padmaja Ayyagari & Jason M. Fletcher & Jody L. Sindelar, 2009. "Job Loss: Eat, drink and try to be merry?," NBER Working Papers 15122, National Bureau of Economic Research, Inc.
    12. Partha Deb & Ann M. Holmes, 2000. "Estimates of use and costs of behavioural health care: a comparison of standard and finite mixture models," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 475-489, September.
    13. Sonchak, Lyudmyla, 2015. "Medicaid reimbursement, prenatal care and infant health," Journal of Health Economics, Elsevier, vol. 44(C), pages 10-24.
    14. Deb, Partha & Gallo, William T. & Ayyagari, Padmaja & Fletcher, Jason M. & Sindelar, Jody L., 2011. "The effect of job loss on overweight and drinking," Journal of Health Economics, Elsevier, vol. 30(2), pages 317-327, March.
    15. David Mmopelwa, 2019. "Prenatal care utilization and infant health in Botswana," Discussion Papers 2019-09, University of Nottingham, CREDIT.
    16. Brutscher, P., 2012. "Self-Disconnection Among Pre-Payment Customers - A Behavioural Analysis," Cambridge Working Papers in Economics 1214, Faculty of Economics, University of Cambridge.
    17. Gray, Bradley, 2001. "Do Medicaid physician fees for prenatal services affect birth outcomes?," Journal of Health Economics, Elsevier, vol. 20(4), pages 571-590, July.
    18. Cygan-Rehm, Kamila & Karbownik, Krzysztof, 2022. "The effects of incentivizing early prenatal care on infant health," Journal of Health Economics, Elsevier, vol. 83(C).
    19. Ana I. Balsa & Patricia Triunfo, 2012. "The Effectiveness of Prenatal Care in a Low Income Population: A Panel Data Approach," Documentos de Trabajo/Working Papers 1204, Facultad de Ciencias Empresariales y Economia. Universidad de Montevideo..
    20. Geoffrey Warner, 1998. "Birthweight Productivity of Prenatal Care," Southern Economic Journal, John Wiley & Sons, vol. 65(1), pages 42-63, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:24:y:2005:i:3:p:489-513. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.