Essays on child health and family economics
- Autores: Ana María Costa Ramón
- Directores de la Tesis: Guillem López i Casasnovas (dir. tes.), Maria Libertad González Luna (codir. tes.)
- Lectura: En la Universitat Pompeu Fabra ( España ) en 2020
- Idioma: español
- Tribunal Calificador de la Tesis: Marcos Vera Hernández (presid.), Pilar García Gómez (secret.), Hannes Schwandt (voc.)
- Materias:
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- Resumen
This dissertation consists of three chapters that investigate the effect of children's health shocks on children's and family's well-being. To do so, I exploit rich administrative data sources and apply cutting-edge econometric techniques that allow me to contribute to the previous literature by providing credible causal estimates of the impact of health shocks during childbirth, and from childhood to teenage years.
In the first two chapters, I study the causal impact of being born by cesarean section on neonatal and infant health. Cesarean sections have been associated in the literature with poorer newborn and infant health. Most studies suffer, however, from potential omitted variable bias, as they are based on simple comparisons of mothers who give birth vaginally with those who give birth by cesarean section. These two papers overcome this limitation by exploiting different sources of variation in the probability of C-section, which are unrelated to maternal and child characteristics.
In the first chapter, co-authored with Ana Rodríguez-González, Miquel Serra-Burriel, and Carlos Campillo, we investigate the impact of C-sections on newborn health. Using a sample of hospitals in Spain, we first show that the rate of unplanned C-sections is higher during the early hours of the night compared to the rest of the day. We use this variation as an instrument for the type of birth. We find a small negative impact on neonatal health, as measured by Apgar Scores, but the effect is not severe enough to translate into more extreme outcomes.
In the second chapter, joint work with Mika Kortelainen, Ana Rodríguez-González, and Lauri Sääksvouri, we continue with the same line of research and study the long-term effects of C-sections. Using Finnish administrative data, we document that physicians perform more unplanned C-sections during their regular working hours on days that precede a weekend or a public holiday and use this exogenous variation as an instrument for C-sections. We supplement our instrumental variables results with a differences-in-differences estimation that exploits variation in birth mode within sibling pairs and across families. We find that avoidable unplanned C-sections increase the risk of asthma, but do not affect other immune-mediated disorders previously associated with C-sections.
In the last chapter of my thesis, I study the causal impact of children's severe health shocks on parental labor market outcomes and mental well-being. Although economists have long been interested in understanding the relationship between income and health, we know relatively little about the potential spillover effects of health shocks on other family members. The illness of a child is a stressful event that can have major implications for the well-being of the whole household. Families can incur substantial costs when deciding how to best cope with these health shocks and their associated long-term burden. In this paper, I contribute to filling this gap by providing new credible causal evidence on the impact of children's adverse health events on parental labor outcomes. To do so, I leverage long panels of high-quality Finnish administrative data combined with a research design that allows me to overcome previous limitations. In particular, identification comes from comparisons among parents of the same age cohorts, with children of the same age, whose children experienced the health shock at different ages. This enables me to abstract from differences across treated and untreated families. My results show that parental earnings suffer a substantial and persistent decline following a child's adverse health event. I also find that these shocks impact parents' mental well-being.
