Perinatal Health Among 1 Million American-Born Chinese

Son preference is well documented in many Asian counties. Sex selection generates sex ratios (# of males/# of females) above the biologically normal ratio of around 1.05 at birth. For China, Chen, Li, and Meng [2013] argue that availability of prenatal sex determination through ultrasound lead to a 40-50% increase in the sex imbalance during the 1980s. Son preference manifests in sibling sex composition, where the sex ratio of firstborn children is relatively normal but rises at higher birth orders in the absence of a previous son [Yi et al., 1993]. Because official birth certificate and hospital discharge microdata are not publicly available for China, most studies analyze population census data. This tends to focus empirical work on the sex imbalance itself. A key unanswered question is the effect of gender preference on “survivors”. An exception is Li and Wu [2011], who use the China Health and Nutrition Survey to show that mother’s nutrition may deteriorate postpartum upon having a daughter relative to a son. Gender preference aside, perinatal health has a profound impact on population health. The WHO defines the perinatal period as running from 22 weeks gestation to 7 days after birth. Over half of infant deaths occur within first 7 days of life. The death rate for children under age one is more than 13 times higher than the death rate for children age 15 to 19, the group with the next highest rate. Moreover, the fetal origins hypothesis suggests that small gaps in perinatal health can map to large later-life gaps. In the absence of data for China, we explore the perinatal health of American-born Chinese (1.2% of US population)

Chernobyl's subclinical legacy: prenatal exposure to radioactive fallout and school outcomes in Sweden

Japanese atomic bomb survivors irradiated 8-25 weeks after ovulation subsequently suffered reduced IQ [Otake and Schull, 1998]. Whether these findings generalize to low doses (less than 10 mGy) has not been established. This paper exploits the natural experiment generated by the Chernobyl nuclear accident in April 1986, which caused a spike in radiation levels in Sweden. In a comprehensive data set of 562,637 Swedes born 1983-1988, we find the cohort in utero during the Chernobyl accident had worse school outcomes than adjacent birth cohorts, and this deterioration was largest for those exposed approximately 8-25 weeks post conception. Moreover, we find larger damage among students born in regions that received more fallout: students from the eight most affected municipalities were 3.6 percentage points less likely to qualify to high school as a result of the fallout. Our findings suggest that fetal exposure to ionizing radiation damages cognitive ability at radiation levels previously considered safe

Land Reform and Sex Selection in China

Following the death of Mao in 1976, agrarian decision-making shifted from the collective to individual households, unleashing rapid growth in farm output and unprecedented reductions in poverty. In new data on reform timing in 914 counties, we find an immediate trend break in the fraction of male children following rural land reform. Among second births that followed a firstborn girl, sex ratios increased from 1.1 to 1.3 boys per girl in the four years following reform. Larger increases are found among families with more education and in counties with larger output gains due to reform. Proximately, increased sex selection was achieved in part through prenatal ultrasounds obtained in provincial capitals. The land reform estimate is robust to controlling for the county-level rollout of the One Child Policy. Overall, we estimate land reform accounted for roughly half of the increase in sex ratios in rural China from 1978-86, or about 1 million missing girls

Impacts of classifying New York City students as overweight

US schools increasingly report body mass index (BMI) to students and their parents in annual fitness “report cards.” We obtained 3,592,026 BMI reports for New York City public school students for 2007–2012. We focus on female students whose BMI puts them close to their age-specific cutoff for categorization as overweight. Overweight students are notified that their BMI “falls outside a healthy weight” and they should review their BMI with a health care provider. Using a regression discontinuity design, we compare those classified as overweight but near to the overweight cutoff to those whose BMI narrowly earned them a “healthy” BMI grouping. We find that overweight categorization generates small impacts on girls’ subsequent BMI and weight. Whereas presumably an intent of BMI report cards was to slow BMI growth among heavier students, BMIs and weights did not decline relative to healthy peers when assessed the following academic year. Our results speak to the discrete categorization as overweight for girls with BMIs near the overweight cutoff, not to the overall effect of BMI reporting in New York City

Childhood Circumstances and Adult Outcomes Act II

That prenatal events can have life-long consequences is now well established. Nevertheless, research on the Fetal Origins Hypothesis is flourishing and has expanded to include the early childhood (postnatal) environment. Why does this literature have a “second act?” We summarize the major themes and contributions driving the empirical literature since our 2011 reviews, and try to interpret the literature in light of an overarching conceptual framework about how human capital is produced early in life. One major finding is that relatively mild shocks in early life can have substantial negative impacts, but that the effects are often heterogeneous reflecting differences in child endowments, budget constraints, and production technologies. Moreover, shocks, investments, and interventions can interact in complex ways that are only beginning to be understood. Many advances in our knowledge are due to increasing accessibility of comprehensive administrative data that allow events in early life to be linked to long-term outcomes. Yet, we still know relatively little about the interval between, and thus about whether it would be feasible to identify and intervene with affected individuals at some point between early life and adulthood. We do know enough, however, to be able to identify some interventions that hold promise for improving child outcomes in early life and throughout the life course

Retention Heterogeneity in New York City Schools

Performance on proficiency exams can be a key determinant of whether students are retained or “held back” in their grade. In New York City, passing the statewide proficiency exam essentially guarantees promotion, while roughly 13% of those students who fail the exam are retained. Using regression discontinuity methods, we find that female students are 25% more likely to be retained in their grade due to exam failure than boys. Hispanic students are 60% more likely and Black students 120% more likely to be retained due to exam failure (relative to White students). Poverty and previous poor performance also increase the likelihood of retention, while being young for grade or short does not. We conclude that “patterned discretion” exists in how standardized test results are utilized

Retention Heterogeneity in New York City Schools

Performance on proficiency exams can be a key determinant of whether students are retained or “held back” in their grade. In New York City, passing the statewide proficiency exam essentially guarantees promotion, while roughly 13% of those students who fail the exam are retained. Using regression discontinuity methods, we find that female students are 25% more likely to be retained in their grade due to exam failure than boys. Hispanic students are 60% more likely and Black students 120% more likely to be retained due to exam failure (relative to White students). Poverty and previous poor performance also increase the likelihood of retention, while being young for grade or short does not. We conclude that “patterned discretion” exists in how standardized test results are utilized

Long-Run Impacts of Childhood Access to the Safety Net

We examine the impact of a positive and policy-driven change in economic resources available in utero and during childhood. We focus on the introduction of the Food Stamp Program, which was rolled out across counties between 1961 and 1975. We use the Panel Study of Income Dynamics to assemble unique data linking family background and county of residence in early childhood to adult health and economic outcomes. Our findings indicate access to food stamps in childhood leads to a significant reduction in the incidence of metabolic syndrome and, for women, an increase in economic self-sufficiency

In Utero Ramadan Exposure and Children’s Academic Performance

A large literature has linked the in utero environment to health in adulthood. We consider how prenatal nutrition may shape human capital acquisition in childhood, utilising the month‐long Ramadan fast as a natural experiment. In student register data for Pakistani and Bangladeshi families in England, we examine whether Ramadan's overlap with pregnancy affects subsequent academic outcomes at age 7. We find that test scores are 0.05–0.08 standard deviations lower for students exposed to Ramadan in early pregnancy. Our results suggest that brief prenatal investments may be more cost effective than traditional educational interventions in improving academic performance