Working Paper: NBER ID: w27775
Authors: Douglas Almond; Yi Cheng
Abstract: The literature on "missing girls" suggests a net preference for sons both in China and among Chinese immigrants to the West. Perhaps surprisingly, we find that newborn Chinese-American girls are treated more intensively in US hospitals: they are kept longer following delivery, have more medical procedures performed, and have more hospital charges than predicted (by the non-Chinese gender difference). What might explain more aggressive medical treatment? We posit that hospitals are responding to worse health at birth of Chinese-American girls. We document higher rates of low birth weight, congenital anomalies, maternal hypertension, and lower APGAR scores among Chinese Americans girls – outcomes recorded prior to intensive neonatal medical care and relative to the non-Chinese gender gap. To the best of our knowledge, we are the first to find that son preference may also compromise "survivor" health at birth. On net, compromised newborn health seems to outweigh the benefit of more aggressive neonatal hospital care for girls. Relative to non-Chinese gender differences, death on the first day of life and in the post-neonatal period is more common among Chinese-American girls, i.e. later than sex selection is typically believed to occur.
Keywords: No keywords provided
JEL Codes: I1; I12; J13; J16
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Chinese-American girls (J82) | worse health outcomes at birth (I14) |
| worse health outcomes at birth (I14) | more intensive medical care (I11) |
| more intensive medical care (I11) | higher mortality rates (I12) |
| Chinese-American girls (J82) | higher hospital charges (I11) |
| Chinese-American girls (J82) | longer hospital stays (I11) |
| Chinese-American girls (J82) | increased medical procedures (I11) |