The Long-Term Effects of Income for At-Risk Infants: Evidence from Supplemental Security Income
This paper examines whether a generous cash intervention early in life can "undo" some of the long-term disadvantage associated with poor health at birth. We use new linkages between several large-scale administrative datasets to examine the short-, medium-, and long-term effects of providing low-income families with low birthweight infants support through the Supplemental Security Income (SSI) program. This program uses a birthweight cutoff at 1200 grams to determine eligibility. We find that families of infants born just below this cutoff experience a large increase in cash benefits totaling about 27% of family income in the first three years of the infant's life. These cash benefits persist at lower amounts through age 10. Eligible infants also experience a small but statistically significant increase in Medicaid enrollment during childhood. We examine whether this support affects health care use and mortality in infancy, educational performance in high school, post-secondary school attendance and college degree attainment, and earnings, public assistance use, and mortality in young adulthood for all infants born in California to low-income families whose birthweight puts them near the cutoff. We also examine whether these payments had spillover effects onto the older siblings of these infants who may have also benefited from the increase in family resources. Despite the comprehensive nature of this early life intervention, we detect no improvements in any of the study outcomes, nor do we find improvements among the older siblings of these infants. These null effects persist across several subgroups and alternative model specifications, and, for some outcomes, our estimates are precise enough to rule out published estimates of the effect of early life cash transfers in other settings.
We are also grateful to Yerís Mayol-Garcia, Melanie Guldi, for valuable feedback, as well as seminar and conference participants at the American Society of Health Economists (ASHEcon), Brandeis University, the Celebration of Michigan Labor Economics conference, the Nebraska Labor Summit, University of California - Santa Barbara, University of Chicago Harris, University of Illinois Chicago, and San Diego State University. We would like to thank Ellen Badley, Sandra Bannerman, Colin Chew, Heather Fukushima, Steven Hoang, Amanda Jackson, Michelle Miles, Eric Neuhauser, Jenn Rico, and other staff at the California Department of Public Health (CDPH) for their help in accessing restricted California birth records; Chris Crettol, Betty Henderson-Sparks, Jasmine Neeley, and other staff at the California Department of Health Care Access and Information (formerly the Office of Statewide Health Planning and Development) for help in accessing hospital discharge data; Alex Barrios, Alan Chan, Austin Chan, Anthony Dalton, Palvinder Dhillon, Marissa Kraynak, Juliana Kumpf, Elliot Lopez, Alex Menjivar, Kohei Narron, and other staff at Educational Results Partnership for help accessing K-12 educational data; Olivia Burke, Joshua Leake, and Tracy Locklin for help with access to National Student Clearinghouse data; and, Emilio Garcia, Victoria McCoy-Cosentino, and Lawrence Mirsky at NYU for help with data use agreements and linkages. We would also like to thank Ashley Austin, Casey Blalock, Scott Boggess, Clint Carter, Melissa Chiu, Diane Cronkite, Carrie Dennis, Barbara Downs, Denise Flanagan-Doyle, Adam Galemore, Katie Genadek, Katlyn King, Shawn Klimek, Shirley Liu, Kathryn Mcnamara, Bonnie Moore, John Sullivan and other staff at Census, as well as Robert Goerge and Leah Gjertson at Chapin Hall for their help with the linkages to Census data. We are grateful to Educational Results Partnership for providing data for this study. All data provided by Educational Results Partnership were de-identified prior to analysis. This research was conducted as a part of the U.S. Census Bureau's Evidence Building Project Series. Any opinions and conclusions expressed herein are those of the authors and do not represent the views of the U.S. Census Bureau, California Departments of Public Health or Health Care Access and Information, National Student Clearinghouse, Educational Results Partnership, or other data providers. The Census Bureau has ensured appropriate access and use of confidential data and has reviewed these results for disclosure avoidance protection (Project P-7523134: CBDRB-FY23-CES021-002 and CBDRB-FY23-0451). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.