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Health, Development and Behavior
Friday, Jan. 4, 2019
12:30 PM - 2:15 PM
Chinese Economists Society
Investing in the Womb: Identifying Gender Discrimination through the Lens of Prenatal Ultrasounds
In utero is a critical period of human development during which parents act on children’s behalf in health investments. These investments may have a profound impact on the life trajectory of a child. We investigate whether parents in China who choose to carry the pregnancy to term allocate resources differently between their sons and daughters over the course of pregnancy after the sex of the child is disclosed to parents. Using unique and large-scale hospital electronic records of prenatal ultrasound scans and birth outcomes as well as a longitudinal survey of parents’ health behavior during pregnancy, we estimate how parental health behaviors and prenatal health investments change after parents gain access to gender information from post-20 gestational week ultrasound scans. In addition to the state-of-the-art difference-in-differences model, we employ a novel fetus fixed effect model to identify shifts in prenatal investments when information on child gender is disclosed. We document sex-selective prenatal investments as an early channel through which parents practice discriminatory behavior. We show that parents favorably shift certain parental health investments when pregnant with a boy. Specifically, the chance of exposure to passive smoking decreases while more mothers take nutrient supplements when parents expect boys compared to girls after receiving a post-20th gestational week ultrasound scan. Preferential prenatal treatment of males is greater for areas with stronger son preference. A set of key placebo tests using pre-pregnancy and early pregnancy behaviors reassure us that our identified effects are likely causal. Our findings have implications for eliminating gender discrimination and improving maternal and child health in the earliest stage of life. These findings also call for utilizing the window of opportunity during pregnancy to more effectively promote smoking cessation.
Does Financial Knowledge Alleviate Risk Attitude and Risk Behavior Inconsistency?
We investigate the relationship between risk preference and risk behavior using China House- hold Finance Survey (CHFS). Empirical results lend support to the existence of an inconsistency between risk preference and risk behavior. However, financial knowledge seems to help decrease the inconsistency between risk preference and risk behavior. We show that financial knowledge works in two channels. First, it could decrease the inconsistency between risk propensity and risk behavior. Second, it could encourage risky behavior. We also document that the heterogeneous risk sensitivities of households lead to different outcomes. More specifically, financial knowledge increases the inconsistency between risk preference and risk behavior when people are risk averse, and it decreases this inconsistency by increasing risky behavior when people are risk seeking.
Investigation of Service Distortion in China's New Cooperative Medical Scheme
In 2003, the Chinese government implemented a nationwide health insurance program called the New Cooperative Medical Scheme (NCMS). The literature has found that this program failed to provide sufficient financial protection. One possible reason is that some insurers undercover the health services that involve significant medical expenses. This study aims to understand the degree of distortion in the NCMS benefit plan and inform program modification to improve the effectiveness. We evaluate the service-level coverage of NCMS through quantifying each service’s shadow price. Based on China Health and Nutrition Survey data, we divide the whole sample into four geographical regions and assess each region’s population health status, distribution of health spending, and shadow prices of different health services. To inform NCMS benefit modification, we investigate the distortion under different risk-adjusted premiums empirically. Our results reveal challenges of financial sustainability faced by the NCMS program, especially in the Northeast region. The NCMS plan tends to undercover the services that are predictable and negatively correlated with plan profits, such as inpatient treatments. We also find that the efficiency of the NCMS can be improved if its risk premiums are adjusted based on individual demographic characteristics and disease history.