Working Paper: CEPR ID: DP13064
Authors: Aline Butikofer; Katrine Løken; Kjell G. Salvanes
Abstract: A growing literature documents the positive long-term effects of policy-induced improvements in early-life health and nutrition. However, there is still scarce evidence on early-life health programs targeting a large share of the population and the role of such programs in increasing intergenerational mobility. This paper uses the rollout of mother and child health care centers in Norway, which commenced in the 1930s, to study the long-term consequences over the whole life cycle of increasing access to well-child visits in the first year of life. These well-childvisits included a physical examination and the provision of information about adequate infant nutrition. Our first results show that access to mother and child health care centers in the first year of life increased the completed years of schooling by 0.15 years and earnings by two percent. Our second set of results reveals that these effects were stronger for children from a low socioeconomic background and contribute to a 10 percent reduction in the persistence of educational attainment across generations. Our third set of findings suggest that better nutrition within the first year of life is a likely mechanism. In particular, we find positive effects on adult height and that individuals suffer from fewer health risks at age 40. In addition, we show that access to well-child visits decreased infant mortality from diarrhea whereas infant mortality from pneumonia, tuberculosis, or congenital malformations are not affected. Finally, we investigate the costs of the program and show that investments in mother and child healthcare centers pass a simple cost–benefit analysis.
Keywords: Child Health; Longterm Outcomes; Health Care Centers; Nutrition
JEL Codes: I14; I18; I24
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Access to mother and child health care centers in the first year of life (J13) | Increase in completed years of schooling (I21) |
| Access to mother and child health care centers in the first year of life (J13) | Increase in earnings (J31) |
| Access to mother and child health care centers in the first year of life (J13) | Reduction in intergenerational persistence of educational attainment (I24) |
| Access to mother and child health care centers (J13) | Better nutrition (I19) |
| Better nutrition (I19) | Improvements in adult height (O15) |
| Access to well-child visits (I19) | Decrease in infant mortality from diarrhea (I14) |