Health Endowments and Parental Investments in Infancy: Evidence from Rural India
Posted: 22 Jun 2007
Date Written: June 14, 2007
Background and Objectives: In several developing countries parents face significant uncertainties about children's survival. These uncertainties are likely to affect intra-household investments in children. Theories of intra-household resource allocation are inconclusive regarding parental behavior. For example, parents might follow a reinforcing strategy and invest more in the healthy infant who they believe is more likely to survive and enjoy the fruits of their investment. On the other hand, parents might choose to compensate for low initial health endowments by investing more in their less endowed infant. Whether parents reinforce or compensate for children's endowments has important long term consequences for both intrafamily and population health disparities. In this paper, we estimate the relationship between a child's initial health endowment and parental health investments. We also evaluate how this relationship changes with changes in infant mortality risks. Methods: We use data on rural households from wave I (1992-93) of the National Family Health Survey conducted in India. We utilize variation in birth size across siblings to estimate mother fixed effects models with additional controls for pre- and post-natal attributes that vary across siblings. Further, we stratify villages by infant mortality rate to investigate how parental investment strategies are affected by the background mortality risk. We also examine whether differences in parental behavior between high- and low-infant mortality areas can be explained in terms of preferences for discrimination or access to health infrastructure. Parental investments studied in the paper include age appropriate immunizations against polio and non-polio diseases, and whether a child was breastfed for six months.
Results: We find evidence of reinforcing investment in child health - children with relatively smaller birth size are less likely to be immunized and breastfed compared to their larger birth size siblings. We also find that high background mortality risks magnify this pattern of reinforcing investment. This finding is robust and cannot be explained by either differences in preferences or access to health infrastructure across high- and low-infant mortality areas.
Conclusion: These results show that children's endowment differences as well as background mortality risk can have sizeable impacts on intrahousehold resource allocations in a developing country. Also, these results have important implications for public policies seeking to improve birth outcomes and immunization coverage in developing countries. In particular, our results suggest that public policies that improve infant survival create unique incentives for parents to invest in their children. Improving infant survival will also increase incentives for investing in less endowed children, consequently reducing health disparities in the population.
Keywords: Health endowments, Parental investment, Child health
JEL Classification: C23, D13, I12, J13
Suggested Citation: Suggested Citation