Disparities in Maternal Health Behaviors During Pregnancy: Estimating the Role of Income From a Natural Experiment

Molly A. Martin , Pennsylvania State University
Tiffany Green, Virginia Commonwealth University
Elizabeth O. Ananat, Duke University

Women with higher socioeconomic status engage in healthier behaviors during pregnancy and, thereby, transmit their advantages to the next generation. These are correlations, however, and the true causal association between family income gains and maternal behaviors during pregnancy remains unclear. We take advantage of a natural experiment – the boom economy created by the extraction of natural gas from the Marcellus Shale geological formation – to study whether increased family income affects women’s prenatal smoking, adequate weight gain, and prenatal care usage. Using predicted Marcellus Shale income as an instrument, we conduct difference-in-difference analyses to isolate the causal effect of income gains. Initial estimates suggest that the share of women smoking prenatally and the share receiving any prenatal care increase with increasing income. Further, the gains in prenatal care utilization are concentrated in areas with initially high poverty rates.

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 Presented in Session 107. Causes of Adverse Birth Outcomes