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Estimating Inter­generational Returns to Medical Care : New Evidence from At ­Risk Newborns

Estimating Inter­generational Returns to Medical Care : New Evidence from At ­Risk Newborns

639/2022 Damian Clarke, Nicolás Lillo Bustos & Kathya Tapia-Schythe
culture, behaviour and development, working papers

639/2022 Damian Clarke, Nicolás Lillo Bustos & Kathya Tapia-Schythe

Targeted treatments of newborns with delicate health stocks have been shown to have considerable returns in terms of survival and later life outcomes. We seek to determine to what degree such treatments are transmitted across generations. We follow three generations of linked microdata from Chile, and use a regression discontinuity design to study the impacts of targeted neonatal health policies based on birth weight assignment rules. While we observe well­ -known first generation impacts of intensive treatment targeted to very low birth weight newborns, we document the surprising fact that these policies have negative impacts on measures of well­being at birth for second­ generation individuals born to mothers who were treated at birth. We show that the mechanism which explains this is a strong impact of early life medical treatment on the likelihood that marginal treated individuals go on to give birth later in life, with receipt in the first generation considerably reverting negative gradients in early life health and eventual fertility. These new stylised facts and results suggest the long­ term implications of health policies within family lineages may be quite different to their short term implications, placing more weight on necessary reinforcing interventions.