Multi-generational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation’s Health
We examine multi-generational impacts of positive in utero health interventions using a new research design that exploits sharp increases in prenatal Medicaid eligibility that occurred in some states. Our analyses are based on U.S. Vital Statistics Natality files, which enables linkages between individuals' early life Medicaid exposure and the next generation's health at birth. We find evidence that the health benefits associated with treated generations' early life program exposure extend to later offspring. Our results suggest that the returns on early life health investments may be substantively underestimated.
First version: September 2017. This version: January 23, 2022. We thank Henrik Kleven, Thomas Lemieux, Liran Einav, Andrew Goodman-Bacon, Michelle Marcus, Adam Schickedanz, Barton Willage, four anonymous referees, and seminar participants at Duke University, Indiana University O'Neill School, Institute for Poverty Research, National Bureau of Economic Research, New York University, Norwegian School of Economics, Purdue University, San Diego State University, Texas A&M, UCLA, UC Davis, University of Connecticut, University of Mannheim, University of Notre Dame, University of Pennsylvania, University of Southern California, Uppsala University, and University of Virginia. We also thank session participants at the All-California Labor Economics, American Economic Association, American Society of Health Economists, Association of Public Policy and Management, Federal Statistical Research Data Center, Population Association of America, and Western Economic Association annual meetings, for their helpful comments. We also thank Pat Barnes, Amy Branum, Clint Carter, and John Sullivan for their assistance in accessing the restricted data used in this project at the California and Michigan Census Research Data Centers. This project was supported by funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, R01 HD093898), National Science Foundation (SMA1327768), the Robert Wood Johnson Foundation (74926-0), and a University of California Davis Interdisciplinary Frontiers in the Humanities and Arts seed grant. Wherry benefited from facilities and resources provided by the California Center for Population Research at UCLA (CCPR), which receives core support (R24-HD041022) from the NICHD. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2023. "Multigenerational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation's Health," American Economic Review, American Economic Association, vol. 113(1), pages 98-135, January. citation courtesy of