Abstract
We study the mechanism of action of an early-life social safety net program, and quantify its impact on child health outcomes at birth. We consider both the equity and efficiency implications of program impacts, and provide a metric to compare various such programs around the world. In particular, we estimate the impact of participation in Chile Crece Contigo (ChCC), Chile's flagship early-life health and social welfare program, using administrative birth data matched to social benefits usage. We find that this targeted social program had significant effects on birth weight (approximately 10 grams) and other early life human capital measures. These benefits are largest among the most socially vulnerable groups, however shift outcomes toward the middle of the distribution of health at birth. We show that the program is efficient when compared to other successful neonatal health programs around the world, and find some evidence to suggest that maternal nutrition components and increased links to the social safety net are important mechanisms of action.
Highlights
The importance of early life health over the entire life course of an individual has been extensively recognised in the economic literature (Almond, Currie and Duque, 2017; Almond and Currie, 2011b; Barker, 1990). This justifies the central role that spending on infant and maternal health plays as a pillar of the social safety net in many countries (see for example discussion in Bitler and Karoly (2015) with respects to the US) as well as considerable public spending focused on remedial investments to improve neonatal health outcomes (Almond et al, 2010; Bharadwaj, Løken and Neilson, 2013)
We find no impact of Chile Crece Contigo (ChCC) on size at birth, but do observe a small increase in gestational length of 0.24 weeks
In Panel A we examine the impact of ChCC use among the 20% most vulnerable of the population, which are both the targeted group, and the group most likely to receive the most intensive set of program inputs, in panel B we focus on the 40% most vulnerable, in panel C we focus on the 60% must vulnerable, and in panel D we examine the impact of ChCC usage in the non-targeted group
Summary
The importance of early life health over the entire life course of an individual has been extensively recognised in the economic (and non-economic) literature (Almond, Currie and Duque, 2017; Almond and Currie, 2011b; Barker, 1990) This justifies the central role that spending on infant and maternal health plays as a pillar of the social safety net in many countries (see for example discussion in Bitler and Karoly (2015) with respects to the US) as well as considerable public spending focused on remedial investments to improve neonatal health outcomes (Almond et al, 2010; Bharadwaj, Løken and Neilson, 2013).
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