Theses Doctoral

Essays on Health Economics

Moncasi-Gutierrez, Xavier

This dissertation consists of three essays on Health Economics. Chapter 1 analyzes the effects of abortion costs for minors on abortions, sexual behavior, and births. We exploit a 2015 change in parental involvement (PI) laws in Spain as a natural experiment in costs, together with rich population-level data on abortions and births. Using the exact date of teenager birth, we first document a decrease in abortions by 17-years-olds using a difference-in-difference comparison with 18-years-olds, consistent with the law that targeted Spanish minors. Using bunching methods from the Public Finance literature, we show evidence of temporal displacement. Some 17-years-old delayed their abortion and waited until they turned 18 and thereby avoided involving their parents. Second, we consider how the law change may have influenced health-related behaviors, finding implicitly that sexual behaviors changed so as to reduce the likelihood of becoming pregnant before turning 18 (and thereby internalized the cost of parental involvement). This is seen in the permanent shift in the number of abortions at age 18 that exists after removing the temporal displacement abortions around the age 18 threshold and an increase in the number of births to mothers who were pregnant at age 17. This paper finds that an important dimension of risky youth behavior responds to incentives contained in parental notification laws.

Chapter 2 analyzes the effects of abortion costs on sex-selection by exploiting a 2010 abortion liberalization in Spain and the difference in son-preferences by nationality and child order documented in the literature. We show using a difference-in-difference comparison a significant increase in the fraction of boys for Chinese parents giving birth to their third child or above relative to children born of Spanish parents. Consistent with the literature, we do not find any effect on the fraction of boys for the first or the second child. Using the provincial number of abortion centers per person as a measure of access to abortion, we show, at the correlation level, that the effects come from those provinces with higher access to abortions. Finally, we find suggestive evidence that birth outcomes of Chinese girls who are the third children, and thus are now more likely to be ``wanted'' after the reform, improve. Gestational weeks increase, and the chance of being born prematurely decrease although our evidence suffers from lack of power.

Finally, chapter 3 analyzes the effects of a universal, unconditional cash transfer announcement on birth outcomes by exploiting the 2007 cheque bebé policy in Spain that provided 2,500 euros per child to all mothers giving birth immediately after its announcement (Jul 2007). We use a difference-in-difference analysis comparing those born before and after the announcement. By exploiting the timing of the policy announcement we can avoid the composition effects caused by the incentives to have children generated by the policy. We show that the birth weight of those children born after the policy announcement (Sept-Dec) significantly improved relative to those born before (Apr-Jun) using previous years to control for the seasonal effects. Moreover, we provide suggestive evidence that those who are more vulnerable, as measured by the average municipality income level, parents' marital status, or parents' age, experience the most substantial improvements on birth weight.

Geographic Areas


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More About This Work

Academic Units
Thesis Advisors
Almond, Douglas
Ph.D., Columbia University
Published Here
July 15, 2020