Further Tests of Abortion and Crime: A Response to Donohue and Levitt (2001,2004, 2006)

The association between legalized abortion and crime remains a contentious finding with major implications for social policy. In this paper, I replicate analyses of Donohue and Levitt (2001, 2004, 2006) in which they regress age-specific arrests and homicides on cohort-specific abortion rates. I find that the coefficient on the abortion rate in a regression of age-specific homicide or arrest rates has either the wrong sign or is small in magnitude and statistically insignificant when adjusted for serial correlation. Efforts to instrument for measurement error are flawed and attempts to identify cohort from selection effects are mis-specified. Nor are their findings robust to alternative identification strategies. A convincing test of abortion and crime should be based on an exogenous change in abortion that had a demonstrable effect on fertility. Thus, I analyze changes in abortion rates before and after Roe to identify changes in unwanted fertility. I use within-state comparison groups to net out hard to measure period effects. I also follow Donohue and Levitt (2004) and average the effects of abortion on crime over 15 to 20 years of the life of a cohort to lessen the impact of the crack epidemic. I find little support for a credible association between legalized abortion and crime.

The Demand for Health Inputs and Their Impact on the Black Neonatal Mortality Rate in the U.S.

Relatively high birth rates among black adolescents and unmarried women as well as inadequate access to medical care are considered primary reasons why the black neonatal mortality rate is almost double that of whites. Using household production theory, this paper examines the determinants of input utilization and estimates the impact of utilization on the survival of black infants across large counties in the U.S. in 1977. The results indicate that expanding the availability of family planning clinics increases the number of teenagers served resulting in a lower neonatal mortality rate. Accessibility to abortion services operates in a similar manner. Moreover, the use of neonatal intensive care, which is strongly related to its availability, is an important determinant of newborn survivability whereas the initiation of early prenatal care is not. Overall, the results suggest that lowering the incidence of low weight and preterm births among blacks by helping women to avoid an unwanted birth, may be the moat cost-effective way of improving black infant health.

A Time-Series Analysis of Unemployment and Health: The Case of Birth Outcomes in New York City

Lifetime income is less variable than annual household income, since the latter reflects transitory shocks to wages, family status, and employment. The paper presents an aggregate time-series analysis of unemployment and infant health that improves on previous work in several ways. First, the data is monthly as opposed to annual and pertains to New York City from January, 1970 to December, 1986. Second, a structural production function is estimated in which the race-specific percentage of low-birthweight births is the health outcome. Because we are able to control for the race-specific percentage of women who begin care in the first trimester as well as the percentage of births to unmarried mothers, the unemployment rate as a proxy for maternal stress enters the production function as one among a set of well-defined health Inputs. Third, because a pregnancy is limited to at most ten months, we can specify a lag length with confidence. Fourth. the data is tested for stationarity and the production function is estimated in levels as well as in deviations from trend. We find no cyclical variation in the percentage of low-birthweight births. The results are insensitive to changes in lag length. the omission of relevant inputs, and the functional form of the coefficients on the distributed lag.

The Impact of Induced Abortion on Birth Outcomes in the U.S.

This paper examines the impact of induced abortion on birth outcomes by treating abortion as an endogenous input into the production of infant health. To gauge the direct and indirect effect of abortion, three measures of infant health are considered simultaneously: the neonatal sortality rate, the percentage of low-birth weight births, and the percentage of pretera births. All three are race-specific and all pertain to large counties in the U.S. in 1977. Because the utilization of health inputs nay be conditioned on the expected birth outcome, estimates obtained by two-stage least squares are emphasized. The results sake clear that abortion is an important determinant of infant health. This suggests that by reducing the number of unwanted births, abortion enhances the healthiness of newborns of a given weight and gestational age, as well as improving the distribution of births among high-risk groups. Moreover, these direct and indirect effects differ by race.

Demographic Analysis of Birthweight-Specific Neonatal Mortality

This paper explores the determinants of birthweight-specific neonatal mortality rates across States in the U.S. in 1980. We are able to explore the interactions between the determinants and birthweight because of the new data available through the National Infant Mortality Surveillance (NIMS). The NIMS links birth and death certificates for each state, resulting in a data base with race-specific neonatal mortality rates by birthweight, and other characteristics. Using a reduced-form model, we find abortion and neonatal intensive care availability to be the most important determinants of overall neonatal mortality. For whites, the two factors are of approximately equal importance in determining neonatal mortality. For blacks, abortion availability has twice the impact of neonatal inexpensive care. Moreover, our results suggest that neonatal mortality rates could be lowered by policies that reduce the inequality in these health resources across states.

An Assessment of the Benefits of Air Pollution Control: The Case of Infant Health

This paper contains estimates of the impacts of air pollutants on race-specific neonatal mortality rates based on data for heavily populated counties of the U.S. in 1977. Unlike previous research in this area, these estimates are obtained from awell specified behavioral model of the production of health, which is estimated with the appropriate simultaneous equations techniques. The results suggest that sulfur dioxide is the dominant air pollutant in newborn survival outcomes. There is also evidence that an increase in sulfur dioxide raises the neonatal mortality rate by raising the percentage of low-birth weight births. Based on marginal-willingness-to-pay computations, we estimate that the benefits of a 10 percent reduction insulfur dioxide levels range between $54 million and$1.09 billion in 1977 dollars.

Abortion and Crime: A Review

Ten years have passed since John Donohue and Steven Levitt initially proposed that legalized abortion played a major role in the dramatic decline in crime during the 1990s. Criminologists largely dismiss the association because simple plots of age-specific crime rates are inconsistent with a large cohort affect following the legalization of abortion. Economists, on the other hand, have corrected mistakes in the original analyses, added new data, offered alternative tests and tried to replicate the association in other countries. Donohue and Levitt have responded to each challenge with more data and additional regressions. Making sense of the dueling econometrics has proven difficult for even the most seasoned empiricists. In this paper I review the evidence. I argue that the most straightforward test given available data involves age-specific arrest and homicide rates regressed on lagged abortion rates in the 1970s or indicators of abortion legalization in 1970 and 1973. Such models provide little support for the Donohue and Levitt hypothesis in either the US or the United Kingdom.

Regulating Abortion: Impact on Patients and Providers in Texas

The state of Texas began enforcement of the Woman’s Right to Know (WRTK) Act on January 1, 2004. The law requires that all abortions at 16 weeks gestation or later be performed in an ambulatory surgical center (ASC). In the month the law went into effect, not one of Texas’s 54 non-hospital abortion providers met the requirements of a surgical center. The effect was immediate and dramatic. The number of abortions performed in Texas at 16 weeks gestation or later dropped 88 %, from 3642 in 2003 to 446 in 2004, while the number of residents who left the state for a late abortion almost quadrupled. By 2006, an ASC had opened in 4 major cities down from 9 in 2003 but the abortion rate 16 weeks or more gestation remained 50 percent below its pre-Act level. Regulations of abortion providers that require new facilities or costly renovations could have profound effects on the market for second trimester abortions.

Parental Education and Child Health: Evidence from a Natural Experiment in Taiwan

This paper exploits a natural experiment to estimate the causal impact of parental education on child health in Taiwan. In 1968, the Taiwanese government extended compulsory education from six to nine years. From that year through 1973, the government opened 254 new junior high schools, an 80 percent increase, at a differential rate among regions. We form treatment and control groups of women or men who were age 12 or under on the one hand and between the ages of 13 and 20 or 25 on the other hand in 1968. Within each region, we exploit variations across cohorts in new junior high school openings to construct an instrument for schooling. We employ this instrument to estimate the causal effects of mother's or father's schooling on the incidence of low birthweight and mortality of infants born to women in the treatment and control groups or the wives of men in these groups in the period from 1978 through 1999. Parents' schooling, especially mother's schooling, does indeed cause favorable infant health outcomes. The increase in schooling associated with the reform saved almost 1 infant life in 1,000 live births, resulting in a decline in infant mortality of approximately 11 percent.

Differential Impact of Recent Medicaid Expansions by Race and Ethnicity

Objective. Between 1989 and 1995, expansions in Medicaid eligibility provided publicly financed health insurance to an additional 7 million poor and near-poor children. It is not known whether these expansions affected children’s insurance coverage, use of health care services, or health status differently, depending on their race/ethnicity. The objective of this study was to examine, by race/ethnicity, the impact of the recent Medicaid expansions on levels of uninsured individuals, health care service utilization, and health status of the targeted groups of children. Methods. Using a stratified set of longitudinal data from the National Health Interview Surveys of 1989 and 1995, we compared changes in measures of health insurance coverage, health services utilization, and health status for poor white, black, and Hispanic 1- to 12-year-old children. To control for underlying trends over time, we subtracted 1989 to 1995 changes in these outcomes among nonpoor children from changes among the poor children for each race/ethnicity group. Measures of coverage included uninsured rates and Medicaid rates. Utilization measures included annual probability of visiting a doctor, annual number of doctor visits, and annual probability of hospitalization. Health status measures included self-reported health status and number of restricted-activity days in the 2 weeks before the interview. Differences in means were analyzed with the use of Student’s t tests accounting for the clustering sample design of the National Health Interview Surveys. Results. Among poor children between 1989 and 1995, uninsured rates declined by 4 percentage points for whites, 11 percentage points for blacks, and 19 percentage points for Hispanics. Medicaid rates for these groups increased by 16 percentage points, 22 percentage points, and 23 percentage points, respectively. With respect to utilization, the annual probability of seeing a physician increased 7 percentage points among poor blacks and Hispanics but only 1 percentage point among poor whites (not significant) for children in good, fair, or poor health. Among those in excellent or very good health, the respective increases were 1 percentage point for poor whites (not significant), 7 percentage points for poor blacks, and 3 percentage points for poor Hispanics (not significant). Significant increases in numbers of doctor visits per year were recorded only for poor Hispanics who were in excellent or very good health, whereas significant decreases in hospitalizations were recorded for Hispanics who were in good fair or poor health. Measures of health status remained unchanged for poor children over time. The recorded decreases in uninsured rates and increases in Medicaid coverage remained robust to adjustments for underlying trends for all 3 race/ethnicity groups. With respect to adjusted measures of utilization and health status, the only significant differences found were among poor blacks who were in good, fair, or poor health and who registered increases in the likelihood of hospitalization and in poor Hispanics who were in excellent or very good health and who registered decreases in the numbers of restricted-activity days. Conclusions. Recent expansions in the Medicaid program from 1989 to 1995 produced greater reductions in uninsured rates among poor minority children than among poor white children. Regardless of race/ethnicity, poor children did not seem to experience significant changes during the period of the expansions in either their level of health service utilization or their health status. Reproduced with permission from Pediatrics, Copyright (c) 2001 by the AAP