Family Planning Programs and the Health and Fertility of US Women, 1960-1980

描述（由申请人提供）：1999年，美国疾病控制中心（CDC）将计划生育列为20世纪十大“伟大公共卫生成就”之一。然而，缺乏数据和可靠的估计策略限制了社会科学对这些计划的好处的认识。在向贫困宣战（1964年至1970年）和《公共卫生服务法》第十章（1970年至1980年）期间，美国计划生育项目的联邦投资急剧增加，这为评估这些项目的重要性提供了一个尚未实现的机会。该项目将利用1964年至1980年联邦计划生育拨款的不连续性，对这些项目对美国生育率和母婴健康的影响进行新的估计。该项目有四个具体目标：(1)汇编、编码、链接和传播关于1964年至1980年计划生育服务年度联邦投资的最全面数据集；1950年至1980年各种族和县的生育率；1950 - 1980年各种族和县的母婴健康状况；(2)开发和试验两种估算计划生育方案效益的备选方法；(3)量化计划生育方案对生育和健康结果的影响；(4)量化计划生育方案对种族群体之间、低收入和高收入妇女之间以及社区之间生育和健康结果差异的影响。几个附加功能使这个项目特别新颖。首先，对5年计划期内的所有计划生育服务（不仅仅是联邦政府资助的）进行全面总结，以便对联邦政府的拥挤情况进行审查。其次，由于诊所普查提供了每个项目的位置（医院或其他地方）和部门（非营利或公共）的信息，因此可以根据提供者类型来分析有效性服务交付的异质性。最后，20世纪60年代和70年代的美国是一个特别有用的比较点，可以用来理解当今以及发展中国家许多这些项目的有效性。通过汇编、编码和传播20世纪60年代和70年代美国的信息，该项目将帮助其他对这一时期的生育和母婴健康感兴趣的研究人员。

DESCRIPTION (provided by applicant): In 1999, the United States Center for Disease Control (CDC) named family planning as one of the top ten "Great Public Health Achievements" of the twentieth century. However, the lack of data and credible estimation strategies has limited social science knowledge about the benefits of these programs. Dramatic increases in federal investments in U.S. family planning programs under the War on Poverty (1964 to 1970) and Title X of the Public Health Service Act (1970-1980) presents an unrealized opportunity to evaluate the importance of these programs. This project will exploit discontinuities in federal family planning grants from 1964 to 1980 to create new estimates of these programs' impact on U.S. fertility and maternal and infant health. This project has four specific aims: (1) To compile, encode, link and disseminate the most comprehensive dataset on annual federal investments in family planning services from 1964 to 1980; fertility rates by race and county from 1950 to 1980; and maternal and infant health measures by race and county from 1950 to 1980; (2) To develop and test two alternative methodologies for estimating the benefits of family planning programs; (3) To quantify the impact of family planning programs on fertility and health outcomes; (4) To quantify the impact of family planning programs on disparities in fertility and health outcomes between racial groups, low-income and higher-income women, and between communities. Several additional features make this project particularly novel. First, a comprehensive summary of all (not just federally funded) family planning services in five program years allows an examination of federal crowd-out. Secondly, heterogeneity in the effectiveness service delivery can be analyzed by provider type, because the clinic censuses provide information on the location (hospital or elsewhere) and sector (nonprofit or public) of each program. Finally, the 1960s and 1970s in the U.S. are a particularly useful point of comparison for understanding the effectiveness of many of these programs today as well as in developing countries. By compiling, encoding and disseminating information on the U.S. during the 1960s and 1970s, this project will aid other researchers interested in these programs, fertility and maternal and infant health during this period.