Anna
Aizer - Research
Working
Papers
Maternal Stress and Child
Well-Being: Evidence from Siblings (April 2009)
with Laura Stroud and Stephen Buka
We study how maternal stress affects child outcomes. We find that in-utero exposure to elevated levels of the stress hormone cortisol negatively affects the cognition, health and
educational attainment of offspring.
These findings are based on comparisons between siblings to control for
unobserved differences between mothers that could bias estimates. Our results
are consistent with recent experimental results in the neuro-biological
literature linking exogenous exposure to coritsol in-utero with reduced growth in the hippocampal
region of the brain and declines in offspring cognitive, behavioral and motor
development. Moreover, we find that poor
mothers have both higher average levels of cortisol
and greater variability, suggesting that prenatal stress may play an important
role in explaining why relatively few children born into poverty are able to
escape it as adults.
Peer Effects, Institutions and
Human Capital Accumulation: The Externalities of ADD (April 2009) under review
Recent
work shows that peers affect student achievement, but the mechanisms are not
well understood. I show that peer behavior is an important mechanism, perhaps
more so than ability, by exploiting exogenous timing in diagnosis/treatment of
ADD among peers that improves peer behavior while holding peer achievement
constant. Improvements in peer behavior
increase student achievement. Moreover,
resources mitigate the negative effects of peer behavior. These findings imply
that the optimal response in the presence of peer effects is not necessarily to
reorganize classrooms. Rather, existing institutions can modify peer effects by
improving behavior and/or mitigating the impact of poor behavior.
Poverty, Violence and
Health (October
2009) under review
Two
percent of women in the
Education,
Knowledge and the Evolution of Disparities in Health (November 2009)
with Laura Stroud
We study
how advances in scientific knowledge affect the evolution of disparities in
health. Our focus in the 1964 Surgeon General Report on
Smoking and Health – the first widely publicized report of the negative effects
of smoking on health. Using an
historical dataset that includes the smoking habits of pregnant women
1959-1966, we find that immediately after the 1964 Report, more educated
mothers immediately reduced their smoking as measured by both self-reports and
serum cotinine levels, while the less educated did
not. We also find strong peer effects in
the response to information: after the 1964 report, educated women surrounded
by other educated women were more likely to reduce smoking relative to those
surrounded by less educated women. The
immediate increase in the education gradient in smoking resulted in a similar
increase in the gradient in newborn health as measured by birth weight and
fetal death. Over time, the education gradient in both smoking and newborn
health continued to increase, peaking in the 1980s and then shrinking,
eventually returning to initial levels.
These results imply that future advances in medical knowledge may lead
to a short run increase in health disparities that declines over the long run.
Published/Forthcoming
Papers
The Gender Wage Gap and Domestic
Violence American Economic Review,
forthcoming
Three quarters of all violence against women is
perpetrated by domestic partners. This study exploits exogenous changes in the
demand for labor in female-dominated industries to estimate the impact of the
male-female wage gap on domestic violence.
Decreases in the wage gap reduce violence against women, consistent with
a household bargaining model. These findings shed new light on the health
production process as well as observed income gradients in health and suggest
that in addition to addressing concerns of equity and efficiency, pay parity
can also improve the health of American women via reductions in violence.
Love,
Hate and Murder: Commitment Devices in Violent Relationships (with Pedro Dal Bo) Journal of
Public Economics, 2009.
Many
violent relationships are characterized by a high degree of cyclicality: women
who are the victims of domestic violence often leave and return multiple times.
To explain this we develop a model of time inconsistent preferences in the
context of domestic violence. This time inconsistency generates a demand for
commitment. We present supporting evidence that women in violent relationships
display time inconsistent preferences by examining their demand for commitment
devices. We find that no-drop policies – which compel the prosecutor to
continue with prosecution even if the victim expresses a desire to drop the
charges – result in an increase in reporting. No-drop policies also result in a
decrease in the number of men murdered by intimates suggesting that some women
in violent relationships move away from an extreme type of commitment device
when a less costly one is offered.
Neighborhood
Violence and Urban Youth in “The Problems of Disadvantaged Youth: An Economic Perspective”
Jonathon Gruber, editor, forthcoming
Three quarters of American children have been exposed to neighborhood violence in their lifetimes. Most of the existing research has concluded that exposure to violence leads to restricted emotional development, aggressive behavior and poor school outcomes. However, this literature fails to account for the fact that children exposed to neighborhood violence are highly disadvantaged in other ways: they are more likely to be black, poor and have poorly educated parents. As such, it is not clear whether exposure to violence or the underlying measures of disadvantage are responsible for the poor child outcomes observed. Using individual survey data on urban youth and their families from Los Angeles, we find that the most violent neighborhoods are also characterized by the highest degree of disadvantage: greatest poverty, highest unemployment, least education. And while living in a violent neighborhood increases the probability of exposure to violence, within violent neighborhoods those personally exposed to street violence are significantly more disadvantaged and are more likely to associate with violent peers than their unexposed neighbors. Once we control for observed and unobserved family disadvantage, the impact of violence declines for some child outcomes, suggesting that underlying disadvantage explains some of the negative outcomes observed, but not all - it is still the case that associating with violent peers is negatively correlated with cognitive test scores. In addition, when we control for underlying differences across families, the relationship between violence and internalizing behavioral problems appears stronger.
Public
Health Insurance, Program Take-up and Child Health,
Review of Economics and Statistics, August 2007.
Of
the ten million uninsured children in 1996, nearly half were eligible for
public health insurance (Medicaid) but not enrolled. In response, policy
efforts to reduce the uninsured have shifted from expanding Medicaid
eligibility to increasing take-up among those eligible. However, little is
known about the reasons poor families fail to enroll or consequences. Using a
unique data set I find that information and administrative costs are important
barriers to enrollment, especially for Hispanics and Asians. In addition,
enrolling children in Medicaid before get sick promotes the use of preventative
care, reduces the need for hospitalization, and improves health.
Does Managed Care Hurt Health? Evidence
from Medicaid Mothers (with Janet Currie
and Enrico Moretti) Review of Economics and
Statistics, August 2007.
Most
Americans are now in some form of managed care plan that restricts access to
services in order to reduce costs. It is difficult to determine whether these
restrictions affect health because individuals and firms self-select into
managed care. We investigate the effect of managed care using a California law
that required some pregnant women on Medicaid to enter managed care.We use a unique longitudinal database of California
births in which we observe changes in the regime faced by individual mothers
between births. We find that Medicaid managed care reduced the quality of
prenatal care and increased low birth weight, prematurity, and neonatal death.
The
Impact of Child Support on Fertility, Parental Investments and Child Well-being
(with Sara McLanahan)
Journal of
Human Resources, Winter
2006.
Increasing
the probability of paying child support, in addition to increasing resources
available for investment in children, also may alter the incentives faced by
men to have children out of wedlock. We find that strengthening child support
enforcement leads men to have fewer out-of-wedlock births and among those who
do become fathers, to do so with more educated women and those with a higher
propensity to invest in children. Thus, policies that compel men to pay child
support may affect child outcomes through two pathways: an increase in
financial resources and a birth selection process.
Access to
Care, Provider Choice and the Infant Health Gradient
(with Adriana Lleras-Muney
and Mark Stabile) American
Economic Review Papers and Proceedings, May 2005.
This paper explores whether choice of provider explains any of the observed infant health gradients, and if so, why poor women choose different providers than their richer neighbors. We exploit an exogenous change in policy that occurred in California in the early 1990s that suddenly increased Medicaid payments to hospitals and which lead to a sharp change in where women with Medicaid delivered. To characterize the extent to which poor women responded to the increase in provider access, we calculate hospital segregation indices (which measure the extent to which Medicaid mothers delivered in separate hospitals than privately insured mothers residing in the same geographic area) both before and after the policy change for each market in California and show that it fell sharply after the policy change. Even though black mothers responded least to the increase in provider choice afforded by the policy change, they benefited the most from hospital desegregation in terms of reduced neonatal mortality and decreased incidence of very low birth weight. In contrast, other groups with lower initial neonatal mortality moved more and gained less in terms of improvements in birth outcomes.
Home
Alone: Supervision After School and Child Behavior, Journal
of Public Economics, 2004.
As
female participation in the labor force continues to grow in the US, so too
does reliance on non-parental child care. However, the high cost of child care
has impeded the ability of many working mothers to find sufficient child care
for their children. As a result, as recently as 1998 over eight million
children ages five to 14 spent time without adult supervision on a regular
basis in the US. I examine the effect of the lack of adult supervision after
school on a panel of school-age children using ordinary least squares and fixed
effect estimation. I find that children with adult supervision are less likely
to skip school, use alcohol or marijuana, steal something or hurt someone.
These findings suggest that expanding after school or child care programs
typically geared to preschool-age children to accommodate more school-age
children may have important consequences for their human capital development
and labor market outcomes later in life.
Networks or Neighborhoods? Interpreting Correlations in the
Use of Publicly-Funded Maternity Care in California
(with Janet Currie) Journal of Public Economics,
2004.
This
study focuses on ‘‘network effects’’ in the utilization of publicly-funded
prenatal care using Vital Statistics data from California for 1989–2000.
Networks are defined using 5-digit zip codes and a woman’s racial or ethnic
group. Like others, we find evidence that the use of public programs is highly
correlated within groups defined using race/ethnicity
and neighborhoods. These correlations persist even when we control for many
unobserved characteristics by including zip code-year fixed effects, and when
we focus on the interaction between own group behavior and measures of the
potential for contacts with other members of the group (‘‘contact availability’’).
However, the richness of our data allows us to go further and to conduct
several tests of one important hypothesis about networks: that the estimated
effects represent information sharing within groups. The results cast doubt on
the idea that the observed correlations can be interpreted as evidence of
information sharing. In particular, we find estimated effects to be as large or
larger among women who have previously used the program as among first-time
users
Low
Take-up in Medicaid: Does Outreach Matter and For Whom? American
Economic Review Papers and Proceedings, May 2003.
Work
in Progress
Child
Endowments, Parental Investments and the Development of Human capital: Evidence
from Siblings
Previous work has found
that the impact of birth weight on child health and well-being is small in the
short term but increases over time. This divergence over time can potentially
be explained by re-enforcing parental investments. Becker’s theory of parental investment
decisions suggests that parents would invest more in the child with greater
endowments because of complementarities in the production of human
capital. In this paper we explore
empirically how child endowments at birth and parental investments interact to
affect long term outcomes. We focus on
birth weight because it is the most common measure of the overall health of the
child at birth and has been linked with reduced educational attainment, earnings
and IQ. For this analysis we do not define
parental investments as time or expenditures, both because of the lack of data
and because there is likely to be little variation in these measures across
siblings within families. Rather, we
rely on insights from the psychological and neurobiological literature
establishing the importance of strong emotional bonding for child
development. Specifically, our measures
of parental investment are based on observations by trained psychologists of
the mother-child relationship and include measures of maternal affection toward
the child, responsiveness to the child, reaction to
the child’s needs, and focus on the child. We find that parental investments
defined as such increase with birth weight and are indeed more productive for
higher birth weight babies. The results
are consistent with Becker’s theory of re-enforcing parental investments and
can potentially explain why, in part, the impact of health at birth increases
over time.
Juvenile
Incarceration & Adult Outcomes: Evidence from Randomly-Assigned Judges (with Joe Doyle)
Over
100,000 youths are currently incarcerated in the US, yet little is known
whether such a penalty deters future crime or interrupts human capital
formation in a way that increases the likelihood of later criminal behavior.
This paper uses the incarceration tendency of randomly assigned judges as an
instrumental variable to estimate causal effects of juvenile incarceration on
adult recidivism. Using nearly 140,000 juvenile offenders in Cook County,
Illinois, we find that those incarcerated as juveniles are 2.5 times more
likely to be incarcerated as an adult—a correlation that likely overstates the
effect of juvenile incarceration due to endogeneity
concerns. Our instrumental variable estimates are smaller, though still large:
a 70% increase in the likelihood of adult incarceration for juveniles on the
margin of incarceration. Marginal treatment effect estimates show that these
results are found across a relatively wide range of judges, which adds
confidence that our estimates are uncontaminated by selection into juvenile
detention.