Essays in health and gender economics
- Autores: Ana Rodríguez González
- Directores de la Tesis: Maria Libertad González Luna (dir. tes.)
- Lectura: En la Universitat Pompeu Fabra ( España ) en 2020
- Idioma: español
- Tribunal Calificador de la Tesis: Matilde Pinto Machado (presid.), Alessandro Tarozzi (secret.), Kristiina Huttunen (voc.)
- Programa de doctorado: Programa de Doctorado en Economía, Finanzas y Empresa por la Universidad Pompeu Fabra
- Materias:
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- Resumen
This thesis consists of four independent articles within the fields of health and gender economics.
The first two papers study the causal effect of cesarean sections on child health. The literature has recognized the importance of early-life circumstances for a wide range of long-term outcomes. At the same time, a large number of studies have reported associations between cesarean sections and worse infant health. However, we know relatively little about the causal nature of this relationship. These papers contribute to filling this gap by providing credible causal estimates of the impact of C-sections.
In the first paper, joint with Ana Costa-Ramón, Miquel Serra-Burriel and Carlos Campillo-Artero, we use data from public hospitals in Spain and exploit exogenous variation in C-section rates by time of birth to study the impact of avoidable unplanned C-sections on newborn health. Our findings show that C-sections have a negative impact on neonatal health indicators, which is however small compared to previous associations reported in the medical literature.
In the second paper, coauthored with Ana Costa-Ramón, Mika Kortelainen and Lauri Sääksvuori, we use high-quality administrative data from Finland to study the impact of C-sections on children's longer-term outcomes, following them until age 15. For identification of the causal effect, we combine an instrumental variable strategy that exploits the increase in C-sections on days preceding a weekend or public holiday, with a difference-in-difference analysis that exploits variation within and across sibling pairs. Our results show that unplanned C-sections increase the risk of asthma from early childhood, but we do not find evidence that they affect the probability of other immune-related diagnoses previously associated with C-sections. Hence, while our findings highlight the long-term costs of potentially avoidable interventions at birth, they also paint a more nuanced picture of the effects of cesarean delivery.
The third paper studies the effects of the increasing female-male gap in education in the marriage market on marriage and fertility. Recent years have seen a reversal of the traditional gender gap in education in favor of men in many countries. This emerging phenomenon could have profound implications for the family, challenging traditional patterns of union formation, which were characterized by educational hypergamy (that is, an educational advantage in favor of the husband). My empirical strategy exploits the gradual implementation of a large school reform in Finland that increased women’s relative level of education. I study the reduced-form relationship between marriage market exposure to the reform and marriage and fertility outcomes. The results show that in marriage markets with a larger female advantage in education, men had fewer children and a lower probability of being in a couple by age 40. I provide suggestive evidence that these results are mostly driven by the mismatch between the distributions of educational attainment of men and women, which present ``excess'' numbers of high-educated women and low-educated men. My findings also point at potential negative consequences for low-educated men's health behaviors and mental health.
Finally, the fourth article, joint with Libertad González, analyzes the evolution of inequality in mortality in Spain during recent decades, from 1990 to 2014. We follow the recent literature by focusing on age-specific mortality and considering inequality across small geographical areas, ranked by average socioeconomic status. Our results show substantial declines in mortality for most age groups, which were particularly pronounced for men. We find low levels of inequality during the whole period, except for the elderly, and no evidence of an increase after the recent recession.
