The role of self-selection in determining prenatal health care and infant health for Asian women.
Item
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Title
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The role of self-selection in determining prenatal health care and infant health for Asian women.
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Identifier
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AAI9820556
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identifier
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9820556
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Creator
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Ling, Jianjing.
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Contributor
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Advisers: Linda N. Edwards | Michael Grossman
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Date
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1998
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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 | Women's Studies | Education, Health | Health Sciences, Public Health | Sociology, Ethnic and Racial Studies | Sociology, Demography
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Abstract
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This study examines the role of self-selection in determining prenatal health care and the infant health for Asian women in the U.S. The goal is to investigate the effect of using health inputs on the infant's health at birth, and to investigate the differences in birth outcomes and maternal behaviors between this minority group and whites. The dataset consists of vital statistic records in 1991 supplemented with local health area information from the 1990 Census of Population. The Asian sample includes people of the following ethnic backgrounds: Chinese, Japanese, Filipino, Hawaiian, and other Asian or Pacific Islanders.;I estimated infant health (measured by birth weight) production functions controlling for endogeneity and self-selection in the demand for prenatal care and private medical service. Estimates controlling for self-selection in using private medical service provide an extension of the model prenatal care is measured by a modified version of the Kotelchuck index.;Tests for the endogeneity of the prenatal care inputs indicate that, rather than OLS, the appropriate estimation technique is Heckman's two-stage methodology to correct for sample selection bias. I find that the effects of prenatal care on birth weight are elevated as utilization of prenatal care increases except for the level of Adequate or Adequate plus, and the effects of private medical service on birth weight are less significant than that of prenatal care. In addition, I find that the demand for these two health inputs are determined primarily by women's health endowments and their financial status. The three notable differences between Asian and white women are: first, the proportion of receiving intensive levels of prenatal care or using a private physician service is lower for Asian women; second, the effect of prenatal care on birth weight is lower for Asian women; third, the use of substances such as alcohol, tobacco, and illicit drugs is highly associated with the probability of low birth weight for white infants, but not for Asian women. Furthermore, I find strong evidence of adverse selection in the decision to seek an intensive care.
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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.
