BIRTH OUTCOME PRODUCTION FUNCTIONS IN THE U.S.: A STRUCTURAL MODEL (UNITED STATES).
Item
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Title
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BIRTH OUTCOME PRODUCTION FUNCTIONS IN THE U.S.: A STRUCTURAL MODEL (UNITED STATES).
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Identifier
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AAI8601659
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identifier
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8601659
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Creator
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JOYCE, THEODORE JAY.
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Contributor
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Michael Grossman
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Date
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1985
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Language
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English
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Publisher
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City University of New York.
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Subject
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Economics, General
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Abstract
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This dissertation examines the determinants of the race-specific neonatal mortality rate and the percentage of low-birth weight births across large counties in the U.S. in 1977. Applying the framework from household production theory, this study emphasizes the use of abortion, prenatal care, family planning clinics, and neonatal intensive care as endogenous inputs in the production of infant health.;Direct correlational estimates between a set of health inputs and a health outcome are potentially suspect due to the importance of an unobserved genetic component in the determination of health. The results from this study indicate that ordinary least squares (OLS) underestimates the impact of the aforementioned health inputs on neonatal mortality when no attempt is made to control for the effect of the parents' health endowment. However, when the percentage of lowbirth weight births is held constant, a proxy for the health endowment, tests show that OLS is appropriate in some specifications.;This study also underscores the importance of abortion and neonatal intensive care in explaining variations in the neonatal mortality rate across counties in the U.S. The former input operates primarily by lowering the percentage of high-risk births, in particular births to teenage and unwed mothers. In the case of whites, however, abortion also has a negative, risk-specific effect on neonatal mortality.;Using the number of inpatient days per birth in a Level II or Level III neonatal intensive care unit as a measure of this technology, this study confirms the importance of neonatal intensive care in explaining variations in the neonatal mortality rate. These results should not be interpreted as support for a national health policy that would increase the availability of such technology at the expense of other programs designed to lower the incidence of low-birth weight. To the contrary, these results suggest that a policy aimed at preventing the proportion of births to unwed teenagers could have a significant impact on the percentage of low-birth weight births resulting in a lower neonatal mortality rate.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
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Program
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Economics
