Child Support Enforcement and Child Mortality

ABSTRACT

This paper explores the potential benefit of enforcements in Child Support policies to child mortality rates. Exploiting the sharp changes in Child Support laws across states and over the years 1975–1993, we find that adoption of a full set of policies reduces the child death rate by 23% relative to the mean. The results are robust across multiple subsamples and a variety of specifications. Three potential mechanisms of impact include better health utilization during the prenatal period, improved birth outcomes, and moving towards better-quality health insurance for children.

KEYWORDS:

• Child support
• child mortality
• health utilization
• health insurance

JEL CLASSIFICATION:

• K36
• H75
• J13
• I13

Disclosure statement

The authors have no conflicts of interest to disclose.

Notes

¹ ‎Appendix A reviews the construction of CS-Index based on CS laws.

² Appendix Table ‎A-1 reports a summary statistics of each law over the sample period.

³ The child mortality counts in each state-year-age-race-gender cell is extracted from Multiple-Cause-of-Death data files from National Centre for Health Statistics.

⁴ The population data for the denominator is taken from SEER (2019) for each state-year-age-race-gender group.

⁵ For example, infant death is also affected by birth outcomes and prenatal development period. In ‎Appendix C, we show that CS laws have an effect on birth outcomes and mother’s health utilization in prenatal period. Using the lagged values is also consistent with similar studies, see Aizer and McLanahan (2006).

⁶ Data Source: SEER (2019)

⁷ Data Source: Bureau of Economic Analysis

⁸ Data Source: Kaplan (2018)

⁹ The results (not reported here) are robust to clustering at census region, year, and also two-way clustering on state and year levels.

¹⁰ ‎Appendix A provides a summary statistics of the final sample and a map of CS-law-change distribution across states.

¹¹ We used the coefficient in column 6, and the fact that total death counts to children aged 0–4 in US in 1993 was 40,639 counts.

Additional information

Funding

The authors received no financial support for the research, authorship, and publication of this article.