Essays in health economics. Essay I. Effects of welfare reform on prenatal care utilization and birth outcomes. Essay II. Abortion availability and unintended births.

摘要

This dissertation consists of two papers, not directly related yet both involved with infants' well being. The first paper investigates the effects of welfare reform, a social change that transformed the United States during the 1990's, on prenatal care utilization and birth outcomes. Natality files from 1991 to 1998 were the data set of this research. Employing a treatment group-focused multivariate estimation bolstered by a difference in difference econometrics method, the study found a negative association of welfare reform both with prenatal care utilization and birth outcomes. The magnitudes are quite small, yet discernable negative magnitudes are consistently present.; However, "low" intensity reform, which indicates the states that implemented only "time limit," without other welfare reform components, is associated with enhanced prenatal care utilization although a negative association obtains between this "low" intensity reform and birth outcomes. Among the components of welfare reform, sanction and family cap appear to play particularly negative roles in prenatal care utilization and birth outcomes, while income disregard policy dampens the negative effect.; The second paper bears on the extent to which the availability of abortion, measured by number of abortion providers and distance to nearest abortion provider, affects the probability of unintended birth. An association between abortion access measures and the probability of unintended/unwanted birth is, albeit not strong, positive, at the aggregate level. When education and Medicaid receipt are proxied for income and opportunity cost, these variables interact positively with abortion access measures, particularly least endogenous variables. These variables tend to increase by 0.8 to 6 percentage points the likelihood that a woman will deliver unwanted babies, relative to the mean of 11.7% from 1993 to 1997. The positive association implies that notwithstanding the presence of providers, impoverished women will either fail to abort or fail to use contraception, thereby increasing the probability of unintended/unwanted birth.