Violence and Birth Outcomes
- Presenter:
Chair: Michael Grossman; Discussant: TBA Tue June 6, 2006 15:30-17:00 Room 332
Everyday roughly 14 thousand women in the US are battered and four are killed by their intimate partners, prompting former Surgeon General C. Everett Koop to label domestic violence “the single most important health issue in the US.” In this paper, we examine the impact of violence against women on birth outcomes. Estimates from the medical literature suggest that as many as one in five pregnant women is the victim of intimate partner violence. Trauma during pregnancy is associated with poor birth outcomes including low birth weight, preterm birth and neonatal mortality. Using a unique dataset that combines data on hospitalization for assaults with birth outcomes from vital statistics records for the state of California for 1990-2000, we estimate the impact of violence on birth outcomes. Because violence is highly correlated with poverty and other risk factors associated with poor birth outcomes, we instrument for violence using variation in the prosecution of domestic violence across counties and over time. Over this period, policies regarding the prosecution of domestic violence offenses changed dramatically and the probability that a man convicted of spouse abuse increased considerably. We use variation in these policies to instrument for the probability of assault. Based on the IV results, we find that reductions in violence are responsible for roughly three quarters of the improvements in birth outcomes witnessed over the last decade. This work sheds new light on the health production process as well as observed income gradients in health. Violence is considerably more prevalent among low income families. We find that violence against women is responsible for roughly 15 percent of observed income gradients in health.
