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Public policies, fertility and neonatal health

12nd National Competition for Economic Research Grants

Public economics

Senior Researcher : Libertad González Luna

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Research Centre or Institution : Universidad Pompeu Fabra. Barcelona


The fertility rate and infant health are two key factors for the well-being of a society. An excessively low birth rate can compromise the long-term sustainability of the social protection system, due to the progressive ageing of the population. On the other hand, there is a strong correlation between indicators of neonatal health, such as weight at birth, and a large number of measurements of individual well-being in the long term, including health during childhood and as an adult and those of a socio-economic nature. For these reasons, it is relevant to understand the factors that can affect the evolution of the birth rate and neonatal health, in order, for example, to inform public policies in this regard.

Recent investigations at international level suggest that public policies have an important potential to affect fertility. The tax and social transfers system, the education system and public nurseries, maternity and paternity policies, etc., can significantly affect families' decisions with regard to how many children to have and when.

On the other hand, even in developed societies, a large number of newborns present risk factors (such as prematurity or low weight). Recent studies suggest that neonatal health can be affected by different circumstances during pregnancy, such as factors which affect the mother's health (diet, environmental quality, etc.). This suggests the possibility that public policies could play a role in attenuating the risk of poor neonatal health for the most vulnerable population.

With this project, I aim to advance this literature in several directions, using data for Spain. There are some works related to data in developing countries, and also some for developed countries. However, many important questions remain unanswered, and Spain, for a number of reasons, represents a good study case for this subject.

More specifically, in recent years I have identified various reforms with important potential impacts on the two dimensions of interest (birth rate and neonatal health), whose effects I propose to analyse. First of all, one policy with an important potential effect is the legal regulation of abortion. In this regard, there are two important reforms in Spain: the law of 1985, and its reform in 2010. There have also been important changes in the financial incentives associated with the fertility rate, both through the tax system and the system of public transfers. One example is the introduction in 2007 (and subsequent elimination in 2011) of a generous universal assistance for each newborn child (the so-called "baby-cheque" of 2,500 euros). Another example, related more directly to health care aspects, are the two recent laws (2006 and 2011) on tobacco, which limited the right to smoke in public spaces. These laws, if they were effective, could have affected the health of the mother during the pregnancy, and thus in turn the health of the newborn.

Finally, at a time of economic crisis, which in Spain is very profound and still ongoing, it seems important to understand whether the economic situation is increasing social inequality right from the time of birth, and/or compromising the opportunities of future generations. For example, the high unemployment rate could have affected the health of pregnant women, with the consequent effect on neonatal health. If that is the case, it would be relevant to promote informed public policies which could be aimed, for example, at protecting the health of women of child-bearing age during times of recession.

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