Does Child Abuse Cause Crime?

Child maltreatment, which includes both child abuse and child neglect, is a major social problem. This paper focuses on measuring the effects of child maltreatment on crime using data from the National Longitudinal Study of Adolescent Health (Add Health). We focus on crime because it is one of the most socially costly potential outcomes of maltreatment, and because the proposed mechanisms linking maltreatment and crime are relatively well elucidated in the literature. Our work addresses many limitations of the existing literature on child maltreatment. First, we use a large national sample, and investigate different types of abuse in a similar framework. Second, we pay careful attention to identifying the causal impact of abuse, by using a variety of statistical methods that make differing assumptions. These methods include: Ordinary Least Squares (OLS), propensity score matching estimators, and twin fixed effects. Finally, we examine the extent to which the effects of maltreatment vary with socio-economic status (SES), gender, and the severity of the maltreatment.We find that maltreatment approximately doubles the probability of engaging in many types of crime. Low SES children are both more likely to be mistreated and suffer more damaging effects. Boys are at greater risk than girls, at least in terms of increased propensity to commit crime. Sexual abuse appears to have the largest negative effects, perhaps justifying the emphasis on this type of abuse in the literature. Finally, the probability of engaging in crime increases with the experience of multiple forms of maltreatment as well as the experience of Child Protective Services (CPS) investigation. Working Paper 06-3

Hospitals, Managed Care, and the Charity Caseload in California

Many observers have blamed HMOs for increasing financial pressures on private hospitals and causing them to cut back on the provision of charity care. We examine this issue using data on all hospital discharges in California between 1988 and 1996. We find that public hospitals in counties with higher HMO penetration do take on a larger share of the county's charity caseload. However, these public hospitals also take on larger shares of most other types of patients. At the hospital level, we find little evidence that either for-profit or non-profit private hospitals respond to HMO penetration by turning away uninsured and Medicaid patients. On the contrary, in the for-profit sector higher HMO penetration is linked to reductions in the share of privately insured patients in the caseload, and corresponding increases in the share of Medicare patients and Medicaid births. Since HMO penetration reduces the price paid by privately insured patients they may be less attractive to for-profit hospitals relative to the publicly insured.

Transfers in Cash and In Kind: Theory Meets the Data

We review theoretical explanations for in-kind transfers in light of the limited empirical evidence. After reviewing the traditional paternalistic arguments, we consider explanations based on imperfect information and self-targeting. We then discuss the large literature on in-kind programs as a way of improving the efficiency of the tax system and a range of other possible explanations including the "Samaritan's Dilemma", pecuniary effects, credit constraints, asymmetric information amongst agents, and political economy considerations. Our reading of the evidence suggests that paternalism and interdependent preferences are leading overall explanations for the existence of in-kind transfer programs, but that some of the other arguments may apply to specific cases. Political economy considerations must also be part of the story.

Health Insurance and Less Skilled Workers

We begin this research with the belief that low and declining levels of private-employer sponsored health insurance were a continuing problem, especially among less skilled workers. Our analysis, however, paints a more complex picture. Using data from the March CPS, the SIP, and CPS benefits surveys, we find that while many less skilled workers remain uncovered, the decline in private employer-sponsored health insurance coverage has slowed recently and may even have reversed. Neither crowdout nor a deterioration in the quality of jobs available to the less skilled seems likely to fully explain these time-series trends in health insurance coverage. A simple explanation that has been largely overlooked is that rising health care costs have driven much of the reduction in private insurance coverage, but it is more difficult to test this hypothesis given the available data.

Air Pollution and Infant Health: What Can We Learn From California's Recent Experience

We examine the impact of air pollution on infant death in California over the 1990s. Our work offers several innovations: First, many previous studies examine populations subject to far greater levels of pollution. In contrast, the experience of California in the 1990s is clearly relevant to current debates over the regulation of pollution. Second, many studies examine a few routinely monitored pollutants in isolation, generally because of data limitations. We examine four criteria' pollutants in a common framework. Third, we develop an identification strategy based on within zip code variation in pollution levels that controls for potentially important unobserved characteristics of high pollution areas. Fourth, we use rich individual-level data to investigate effects of pollution on infant mortality, fetal deaths, low birth weight and prematurity in a common framework. We find that the reductions in carbon monoxide (CO) and particulates (PM10) over the 1990s in California saved over 1,000 infant lives. However, we find little consistent evidence of pollution effects on fetal deaths, low birth weight or short gestation.

Socioeconomic Status and Health: Why is the Relationship Stronger for Older Children?

Case, Lubotsky, and Paxson (2001) show that the well-known relationship between socio- economic status (SES) and health exists in childhood and grows more pronounced with age. However, in cross-sectional data it is difficult to distinguish between two possible explanations. The first is that low-SES children are less able to respond to a given health shock. The second is that low SES children experience more shocks. We show, using panel data on Canadian children that: 1) the gradient we estimate in the cross section is very similar to that estimated previously using U.S. children; 2) both high and low-SES children recover from past health shocks to about the same degree; and 3) that the relationship between SES and health grows stronger over time mainly because low-SES children receive more negative health shocks. In addition, we examine the effect of health shocks on math and reading scores. We find that health shocks affect test scores and future health in very similar ways. Our results suggest that public policy aimed at reducing SES-related health differentials in children should focus on reducing the incidence of health shocks as well as on reducing disparities in access to palliative care.

Does Child Abuse Cause Crime?

Child maltreatment, which includes both child abuse and child neglect, is a major social problem. This paper focuses on measuring the effects of child maltreatment on crime using data from the National Longitudinal Study of Adolescent Health (Add Health). We focus on crime because it is one of the most socially costly potential outcomes of maltreatment, and because the proposed mechanisms linking maltreatment and crime are relatively well elucidated in the literature. Our work addresses many limitations of the existing literature on child maltreatment. First, we use a large national sample, and investigate different types of abuse in a similar framework. Second, we pay careful attention to identifying the causal impact of abuse, by using a variety of statistical methods that make differing assumptions. These methods include: Ordinary Least Squares (OLS), propensity score matching estimators, and twin fixed effects. Finally, we examine the extent to which the effects of maltreatment vary with socio-economic status (SES), gender, and the severity of the maltreatment. We find that maltreatment approximately doubles the probability of engaging in many types of crime. Low SES children are both more likely to be mistreated and suffer more damaging effects. Boys are at greater risk than girls, at least in terms of increased propensity to commit crime. Sexual abuse appears to have the largest negative effects, perhaps justifying the emphasis on this type of abuse in the literature. Finally, the probability of engaging in crime increases with the experience of multiple forms of maltreatment as well as the experience of Child Protective Services (CPS) investigation.