Household income at birth and preschool child health

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PROJECT SUMMARY: Evidence on significant associations between income and child health is accumulating. But relatively little is known about effectiveness of income transfer policies around birth in improving child health, especially in low- and middle-income countries (LMICs). About 250 million children under 5y of age in LMICs are at risk of failing to reach their full developmental potential, and 138 million children are projected to be stunted in 2020.This project will contribute unique knowledge about impacts of minimum wages (MWs) around the time of birth on preschool child nutritional status in Indonesia up to 5y after birth. Indonesia carries the fifth highest burden of stunted children in the world, and MWs are an integral part of the Indonesian social policy debate. To identify causal effects, the basic model exploits timing of births relative to timing of changes in MWs: some children happen to be born in years with higher MWs whereas others are born in years with lower MWs. Comparisons among siblings born from the same biological mothers help address concerns about the potential role of unobserved factors leading some mothers to time births relative to changes in MWs. This basic strategy is strengthened with a difference-in-differences (DiD) framework that compares cohort differences among biological siblings across provinces with higher versus lower MWs. Data are used on child (ages 0-5) anthropometrics and on health, health investments, employment and socio-economic status from all 5 waves of the Indonesian Family Life Survey (IFLS), a nationally representative longitudinal dataset spanning over 21 years- 1993 (7,224 households) to 2014 (15,761 households). A panel of policy data, from the Indonesian Bureau of Statistics, will be constructed for province- specific MWs that covers 26y (1988-2014) and will be merged with the IFLS. The larger time coverage of MW data ensures that MWs can be matched for each child 0-5y in each relevant wave of the IFLS. Specific Aims are: (SA1) To use quasi-experimental methods (DiD and biological sibling fixed effects) to estimate the causal effects of MWs at birth on child height-for-age (stunting) and weight-for-height (wasting) z scores up to 5y after birth and whether the effects at birth year are different from effects up to 2y before and 2y after birth to shed light on critical periods in child growth for policy interventions. (SA2) To investigate whether effects of MWs on child health vary (interact) by child sex, baseline parental characteristics (e.g. education and occupation), communal characteristics (urbanization, past stunting/wasting rates, province GDP/capita and past province unemployment). (SA3) To investigate mechanisms/pathways by studying effects of MWs on parental health investments in children before, during and after birth, for those expected to benefit and as well as for those who may potentially suffer any unintended harms (e.g. unemployment) from MW increases. This proposal is responsive to current NIH research priorities on social factors shaping child development, multilevel interaction and inputs to human health and to health and disease across the lifespan, by evaluating the impact of variations in provincial MWs during a critical period (year of birth) on child nutritional status up to 5y after birth, paying attention to interactive effects by parental and societal background and behavioral responses by firms and parents and critical periods of child development.