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Source: American Society of Health Economists (ASHE)
Resulting in 2 citations.
1. Baughman, Reagan A.
The Effects of Child Support Payments on Child Health Outcomes
Presented: Ithaca, NY, 3rd Biennial Conference of the American Society of Health Economists, June 2010
Cohort(s): Children of the NLSY79
Publisher: American Society of Health Economists (ASHE)
Keyword(s): Child Health; Child Support; Children, Illness; Health/Health Status/SF-12 Scale; Insurance, Health; Modeling, Fixed Effects

Permission to reprint the abstract has not been received from the publisher.

The 1988 Family Support Act mandated that all states develop and use quantitative guidelines for establishing child support awards. The goal of this Act, and of the subsequent design of most state child support guideline formulas, has been to improve the well-being of children by ensuring that they have approximately the same standard of living in a single parent family that they would have if they lived with both of their parents.

This paper examines the impact of child support on one important set of indicators of child well-being: health outcomes. We expect that, all else equal, higher levels of child support payments improve a child's health status, assuming that health is a normal good. This effect could work either directly through greater out-of-pocket spending on health inputs (i.e. food, medical care or medication) or indirectly through the purchase of health insurance coverage. Based upon research on other outcomes related to child support, we also expect that higher levels of child support will be positively correlated with a child's health status, even after controlling for total family income. The literature provides several possible explanations for this finding, including unobserved heterogeneity, decreased child receipt of public benefits, an improved relationship between the parents and strategic bargaining between the parents.

The data for the project comes from a sample of single, custodial mothers in the 1979 National Longitudinal Survey of Youth (NLSY). NLSY79 respondents, who are between the ages of 41 and 48 in the latest interview wave, have reported data on their families over the course of the panel, including children as they were born. The matched Child and Young Adult (CYA) file provides individual-level panel data on those children, including health insurance coverage, utilization of non-emergency medical care, and several indicators of health status.

Using this data, we estimate a set of models in which a child's health outcomes are a function of the annual child support received by his or her custodial parent, controlling for a full set of demographic characteristics of child and parent. Actual child support awards are likely to be endogenous because most state child-support guidelines include supplemental awards for children with extraordinary health care needs. In order to address this endogeneity problem, we instrument for actual child support using the set of parameters in each state's child support guideline formula, which change at least once for most states during the 1990 to 2006 period of our analysis. Our preliminary results suggest that higher levels of child support receipt increase health insurance coverage rates, and may also result in more annual doctor check-ups and fewer children who are underweight. This holds true even after controlling for total family income. Our next step will be to add family-level fixed effects and control variables such as public program participation to the model in order to try to identify the mechanism (from the list of possible explanations from the literature) by which child support improves health above and beyond its income effect.

Bibliography Citation
Baughman, Reagan A. "The Effects of Child Support Payments on Child Health Outcomes." Presented: Ithaca, NY, 3rd Biennial Conference of the American Society of Health Economists, June 2010.
2. Duchovny, Noelia
The Impact of the Earned Income Tax Credit on Childhood Health Outcomes
Presented: Ithaca, NY, 3rd Biennial Conference of the American Society of Health Economists, June 2010
Cohort(s): Children of the NLSY79
Publisher: American Society of Health Economists (ASHE)
Keyword(s): Child Health; Child Support; Earned Income Tax Credit (EITC); Health/Health Status/SF-12 Scale; Obesity; Poverty

Permission to reprint the abstract has not been received from the publisher.

Motivation: The federal Earned Income Tax Credit (EITC) provides wage subsidies to working families earning below $48,000 per year in the form of refundable tax credits. The EITC has been the nation's largest federal transfer program for the poor for almost two decades and is credited with lifting 3.3 million children out of poverty in 2009. As the credit has been expanded over the last 20 years, a substantial literature has documented the income and labor supply effects of the program. This literature together with the identified relationship between income and health suggests that the expansion of the EITC could have had an effect on health outcomes of children. However, with several exceptions , little research exists on how EITC participants use their credits and how the program affects measures of well-being beyond income.

Objectives: The goal of the paper is to evaluate the impact of the EITC on 4 discrete indicators of child health outcomes: poor overall health, mental health problems, activity limitations, and body weight (overweight, obese and underweight). In general, the income effect of the credit should lead to better health along each of these dimensions by enabling families to afford inputs to better health, including medical care and healthier food. We also analyze the effect of the EITC on insurance coverage and regular doctor visits to get a sense of how income is related to health.

Methodology: The primary data come from the Child and Young Adult supplement to the 1979 National Longitudinal Survey of Youth (NLSY79); this supplement contains panel data on all children born to NLSY79 participants. Our sample consists of children ages 2 to 14 between 1990 and 2006. The effect of the EITC is identified in a natural experiment framework, where the basic difference-in-difference comes from the fact that the federal EITC provided a higher benefit ($60 more) to families with 2 or more children starting in 1992, and the differential benefit became economically meaningful ($490 more) starting in 1994. We exploit this differential benefit implementation by comparing changes in outcomes between 1990-1993 and 1994-2006 for children in one-child families and children in larger families. To further isolate the causal impact of the EITC, we compare these trends for families above and below 200% of the federal poverty line (FPL); families above 200% FPL are eligible for at most small EITC credits and serve as an additional control group in the analysis.

Results: The preliminary results suggest that the EITC may be responsible for significant reductions in the fraction of children who are overweight (but not obese) and in the fraction of children in poor health. The reduction in overweight is concentrated among older children. The mechanism for these effects, however, is unclear. While the EITC appears to increase health insurance coverage rates, there are no significant effects on annual doctor or dental visits. The next step in our analysis is to test the robustness of these results by using an alternative source of variation in the EITC – state-level EITC supplements.

Bibliography Citation
Duchovny, Noelia. "The Impact of the Earned Income Tax Credit on Childhood Health Outcomes." Presented: Ithaca, NY, 3rd Biennial Conference of the American Society of Health Economists, June 2010.