Public Policy and Fertility
Paper Session
Sunday, Jan. 5, 2025 8:00 AM - 10:00 AM (PST)
- Chair: Orgul Ozturk, University of South Carolina
Forced Migration and Reproductive Health Care Services: Evidence from Turkey
Abstract
Do mass shocks to the supply and demand of the healthcare system affect access to those services? Are wealthier regions better equipped to handle such shocks? Mass migration is often considered to be a major shock to public health goods provision—one argument is increased demand may overwhelm the availability of goods and services, and affect natives’ access to resources. To understand how host governments and natives respond, I exploit the exogenous Syrian refugee displacement into Turkey after the 2011 civil war and assess the causal impact on native women’s access to reproductive health care services using the Turkish Demographic and Health Services (TDHS). Using a distance-based instrument, I find that Turkish women exposed to a higher concentration of migrants experience higher rates of reproductive healthcare access, as compared to women who are not exposed to the migrant shock. I estimate that a one standard deviation increase in the refugee-to-natives ratio increases antenatal and postnatal care usage among native women by 1.87 and 3.2 percentage points, respectively. The main mechanism through which access to reproductive health services improves for natives is a shift to private healthcare usage, likely due to crowding out in public healthcare spaces. These effects are largely driven by wealthy provinces in Turkey, measured as those with above-the-median GDP levels, whereas the effects disappear for provinces that are less developed. This has important implications for both the ideal allocation of migrants across Turkey, and how policymakers can optimize the distribution of resources to compensate for the increased demand on the healthcare system.Roe v. Rates: Reproductive Healthcare and Public Financing Costs
Abstract
After the U.S. Supreme Court overturned Roe v. Wade, states enacting near-total abortion bans experience an increase in municipal bond yields relative to states with preexisting laws protecting abortion. The effects are stronger in counties with higher ex-ante utilization of abortion services, sharper ex-post declines in access to abortion, greater public support for abortion rights, and higher dependence on female labor force participation. Using the stock market’s reaction to abortion bans following the overturning of Roe v. Wade and the staggered state-level adoption of laws restricting abortion providers in earlier years, we identify negatively impacted firms and reduced net in-migration as key factors underlying the rise in yields. Together, our results highlight the importance of reproductive healthcare, in particular abortion policies, in driving public financing costs.Long-run and Multigenerational Impact of Abortion Legalization in the US
Abstract
Previous research has shown that the legalization of abortion in the U.S. during 1969-1973 led to significant improvements in the health, educational, and economic outcomes of women directly affected by this policy. In this study, I analyze how children born to these women and exposed in-utero to abortion legalization fare in life, particularly in terms of lifecycle health. I leverage the state-level variation in changes to abortion laws predating Roe v. Wade as well as the changes brought about by Roe v. Wade. I implement difference-in-difference and event study techniques on data from restricted-use administrative microdata on births and deaths in the U.S. Using decade-wise cumulative survival probability for cohorts, I find that having abortion legalized in the state of birth at the time of conception improves survivorship by 0.1 to 0.4 percent, with the magnitude varying depending on age and specification. The likelihood of cohorts conceived under legal abortion surviving the first decade of their lives gets markedly better than that of cohorts born in the pre-legalization era. This implies that the probability of surviving the most vulnerable time of life improves. The health gain during childhood potentially translates to long-term health, and my findings suggest significant improvement in cohorts' survival in middle age (ages 45-49). I observe relatively larger improvements in the white population, among those aged 30-49, and longer-term persistence of health improvements in women. Cause-of-death analysis reveals reduced acute and accidental deaths in the first decade, which persists later in life, during ages 30-49. Additionally, improved immunity to infectious diseases is observed in terms of reduced mortality caused by infectious diseases. These findings highlight that access to legal abortion can have far-reaching implications spreading over generations, re-emphasizing the far-reaching impacts of legal abortion.Discussant(s)
Siobhan O'Keefe
,
Davidson College
Bilge Erten
,
Northeastern University
Marianne Bitler
,
University of California-Davis
Devika Hazra
,
California State University-Los Angeles
JEL Classifications
- J1 - Demographic Economics
- I1 - Health