Projects

The Impact of Monthly Unconditional Cash on Food Security, Spending, and Consumption: Three Year Follow-Up Findings from the Baby's First Years Study

with Matthew Maury, Hema Shah, and the the Baby’s First Years study PIs: Lisa Gennetian, Katherine Magnuson, Kimberly Noble, Greg Duncan, Nathan Fox, Sarah Halpern-Meekin, and Hirokazu Yoshikawa

Available at SSRN: https://ssrn.com/abstract=4781670

Causal Impact of Poverty Reduction on Housing Conditions of Low-Income, U.S. Families: Evidence from Baby's First Years

This is joint work with the Baby’s First Years study PIs: Lisa Gennetian, Katherine Magnuson, Kimberly Noble, Greg Duncan, Nathan Fox, Sarah Halpern-Meekin, and Hirokazu Yoshikawa

Abstract: Early housing environments are critical for children’s healthy development, yet a worsening housing affordability crisis and insufficient housing supports has left millions of low-income families with children unable to find safe, affordable rental housing. With increase interest in guaranteed income programs and unconditional cash support, understanding whether direct cash assistance can improve housing outcomes of low-income children represents an important policy question. This paper evaluates the impact of an unconditional cash transfer on housing conditions for low-income families with young children using data from the Baby’s First Years randomized control trial. 1000 low-income mothers were recruited in maternity wards between May 2018 and June 2019 shortly after giving birth to their infants and randomized into a high-cash ($333 per month; 40% of all mothers) or low-cash gift group ($20 per month; 60% of all mothers). Using data from the Age 1, 2, and 3 survey, we find no impacts of the high-cash gift on likelihood of mothers experiencing evictions or homelessness, but some indication that high-cash gift mothers had lower levels of residential mobility during the first three years and lower levels of excessive mobility at age 3. The high-cash gift mothers were also less likely to have ever received housing assistance and may have been more likely to own a home at age 1 and age 2. At age 3, mothers had a decreased likelihood of being cost burdened (>30% of income toward rent) and severely cost burdened (>50% of income toward rent). Mothers in the high-cash gift group were also less likely to ever live in a doubled-up (living with an adult who is not a partner) or multigenerational household between birth and age 3. We find no statistically significant differences in survey reports of housing quality.

Interactive Mobile Support for Lady Health Workers Promoting Breastfeeding

with Erica Field, Nicola Singletary, and Kate Vyborny

Abstract: Breastfeeding is critical for infant health, particularly in poor settings, as it ensures infants receive key nutrients and protects infants from lethal water-borne infections such as diarrheal disease and pneumonia. Worldwide, adoption of WHO-recommended breastfeeding practices could avert over 820,000 infant deaths annually, which include: (1) early initiation (< 1 hour after birth), (2) exclusive breastfeeding for the first 6 months, and (3) continued breastfeeding with appropriate complementary foods for > 2 years. Collaborating with UNICEF and the Government of Punjab, we will conduct a randomized evaluation of an innovative mobile health app designed to support the promotion of WHO-recommended breastfeeding practices by Pakistan’s Lady Health Workers. Using variation in breastfeeding behavior induced by the intervention, we will quantify the causal effect of breastfeeding on infant and maternal health outcomes. Innovative sub-experiments will also allow us to estimate the impact of measurement error on the relationship between breastfeeding and health outcomes.

This project is being implemented by the Centre for Economic Research in Pakistan (CERP) and has been funded by USAID DIV, The Weiss Fund, and the Fund for Innovation in Development (FID).

Evaluating the impact of community health workers on maternal and child health outcomes: Evidence from a natural experiment

with Erica Field and Kate Vyborny

Abstract: Community Health Workers (CHWs) are uniquely positioned to reduce maternal and child health disparities in developing countries. Over 4 million CHWs worldwide provide health services to millions of households, with many programs focusing specifically on maternal and child health (Schneider et al. 2016; WHO, 2023). However, despite the wide reach of these programs, there exists little, high-quality evidence on the causal impact of CHWs on maternal and child health outcomes (Lewin et al., 2010). We propose to leverage detailed micro-data from over 100,000 households in Punjab, Pakistan in combination with a quasi-experimental change in CHW coverage. Punjab’s CHW program focuses on child and maternal health and has a wide reach in rural areas where access to other health care is limited. By exploiting the quasi-experimental change in coverage, we aim to address the following research questions: (1) How does CHW coverage affect health beliefs, behaviors, and maternal and child health outcomes?; (2) What are the medium-term effects on health outcomes for children exposed to CHW support in utero / in infancy?; and (3) How do effects evolve over time after a community loses access to a CHW? This project will provide robust evidence on the impact of Punjab’s CHW program and lay a strong foundation for future collaborations with the government to study the CHW program. More broadly, this study will provide critical evidence on the causal impact of CHWs on child and maternal well-being and their role in promoting global health equity.

Days at Home among Children with Medical Complexity: Differences by Payer and Place of Residence in North Carolina

with Caleb Easterly, Justin G. Trogdon, David Y. Ming, and Neal A. deJong