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

描述(申请人提供)：1999年，美国疾病控制中心(CDC)将计划生育列为20世纪十大公共卫生成就之一。然而，缺乏数据和可信的评估策略限制了社会科学对这些项目的好处的了解。在《反贫困战争》(1964-1970)和《公共卫生服务法》(1970-1980)第十章中，联邦政府对美国计划生育计划的投资大幅增加，这为评估这些计划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间断，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1964-1980年联邦政府对计划生育服务的年度投资的最全面的数据集；(1950-1980年按种族和县划分的生育率；以及从1950年到1980年按种族和县划分的母婴健康指标；(2)开发和测试两种替代方法来估计计划生育计划的效益；(3)量化计划生育计划对生育率和健康结果的影响；(4)量化计划生育项目对种族群体、低收入和高收入妇女以及社区之间生育率和健康结果差异的影响。几个额外的功能使这个项目特别新颖。首先，对五个项目年的所有(不仅仅是联邦资助的)计划生育服务进行全面总结，可以检查联邦政府的挤出。其次，服务提供效果的异质性可以按提供者类型进行分析，因为诊所人口普查提供了关于每个方案的地点(医院或其他地方)和部门(非营利或公共部门)的信息。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，可以用来理解许多此类计划在今天以及在发展中国家的有效性。通过汇编、编码和传播关于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项目、生育率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.