Skip to main content

Advertisement

SpringerLink
Log in

Family size and maternal health: evidence from the One-Child policy in China

  • Original Paper
  • Published:
Journal of Population Economics Aims and scope Submit manuscript

Abstract

In this paper, we examine the impact of family size on maternal health outcomes by exploiting the tremendous change in family size under the One-Child policy in China. Using data from the China Health and Nutrition Survey 1993–2006, we find that mothers with fewer children have a higher calorie intake and a lower probability of being underweight and having low blood pressure; meanwhile, they have a higher probability of being overweight. This would occur if a smaller family size increases the food consumption of mothers, leading underweight women to attain a normal weight and normal weight women becoming overweight. Robust tests are performed to provide evidence on the hypothesis that the tradeoff between children’s quantity and mother’s “quality” is through a budget constraint mechanism, that is, having more children decreases the resource allocated to mothers and affects their health outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

Notes

  1. See, e.g., Becker (1960, 1991), Becker and Lewis (1973), Becker and Tomes (1976), Rosenzweig and Wolpin (1980), Stafford (1987), Behrman et al. (1989), Kessler (1991), Guo and VanWey (1999), Gomes (1984), Goux and Maurin (2005), Angrist et al. (2006), Black et al. (2005), Qian (2009), Li et al. (2008), Rosenzweig and Zhang (2009).

  2. Women who are pregnant are likely to develop Preeclampsia and have an increase in blood pressure after the twentieth week of pregnancy. However, after the delivery of the baby, it could be cured. (Source: NIH website http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_preg.htm).

  3. Consider a simple model where utility function is \(U = U\left( {n, q_p , q_c , y} \right)\), n is the number of children, q p is parent’s quality, q c is children’s quality, and y is the consumption of all other commodities. The budget constraint is I = nq c p c  + q p p p  + yp y , where I is full income, p’s are respective prices. The marginal rate of substitution between n and q p would be determined by the ratio of their marginal utilities and the ratio of the market prices.

  4. According to the 1% sample of the 1990 Population Census, people with ethnic Han account for approximately 92% of all population in China.

  5. Beginning in 1986, in most provinces, couples living in rural areas can have a second child if the first one is a girl (Greenlaugh 1986).

  6. BMI is a measure of body fat based on height and weight and applies to both adult men and women. It equals to weight divided by the square of height.

  7. Source: Mayo Foundation for Medical Education and Research.

  8. Source: Healthwise’s website www.healthwise.org.

  9. For the concern of sample attrition across years, we conduct a sensitivity test (available upon request) by adding the number of times each individual enters into the sample as a regressor. Its coefficient is not statistically significant, indicating that attrition does not affect our main results.

  10. The death rate for pregnant women was 80 per 100,000 live births in 1990, a level much lower than world average (WHO).

  11. If the degree of exposure to famine is different between the urban and rural (or between ethnic Han and minorities) residents, then the interaction terms between the timing variable and the urban dummy (or ethnic Han dummy) may pick up differences in exposure to the famine between urban and rural (or between ethnic Han and minorities) residents. In this case, these instruments may be directly correlated with the health outcomes.

  12. Alternatively, a data set of women with adopted children would be helpful to differentiate these two mechanisms. To the best of our knowledge, no such data set with a decent sample size is available for Chinese women. Chen and Li (2009) use an adoptee children data set, but it contains little information on mothers.

  13. According to the 1990 Population Census, mixed couples only account for 3.5% of all the married couples. In the northeastern and southwestern provinces that have a large minority population, this fraction is 7.9%.

References

  • Almond D, Edlund L, Li H, Zhang J (2007) Long-term effects of the 1959–1961 famine: Mainland China and Hong Kong. NBER Working Paper No. 13384

  • Angrist J, Evans W (1998) Children and their parents’ labor supply: evidence from exogenous variation in family size. Am Econ Rev 88(3):450–477

    Google Scholar 

  • Angrist J, Lavy V, Schlosser A (2006) New evidence on the causal link between the quantity and quality of children. MIT Working Paper

  • Becker G (1960) An econometric analysis of fertility. In Becker G (ed) Demographic and economic change in developed countries. Princeton University Press, Princeton

    Google Scholar 

  • Becker G (1991) A treatise on the family. Harvard University Press, Cambridge

    Google Scholar 

  • Becker G, Lewis G (1973) On the interaction between the quantity and quality of children. J Polit Econ 81(2):279–288

    Article  Google Scholar 

  • Becker G, Tomes N (1976) Child endowments and the quantity and quality of children. J Polit Econ 84(4):143–162

    Article  Google Scholar 

  • Behrman J, Pollak R, Taubman P (1989) Family resources, family size and access to financing for education. J Polit Econ 97(2):389–419

    Article  Google Scholar 

  • Black S, Devereux P, Salvanes K (2005) The more the merrier? The effect of family size and birth order on children’s education. Q J Econ 120(2):669–700

    Google Scholar 

  • Boerma T (1987) The magnitude of the maternal mortality problem in sub-Saharan Africa. Soc Sci Med 24(6):551–558

    Article  Google Scholar 

  • Bulte E, Heerink N, Zhang X (2011) China’s One-Child policy and “the mystery of missing women”: ethinic minorities and male-biased sex ratios. Oxf Bull Econ Stat 73(1):21–39

    Article  Google Scholar 

  • Chen Y, Li H (2009) Mother’s education and child health: is there a nurturing effect? J Health Econ 28(2):413–426

    Article  Google Scholar 

  • Chen Y, Zhou L (2007) The long-term health and economic consequences of the 1959–1961 famine in China. J Health Econ 26(4):659–681

    Article  Google Scholar 

  • Chen L, Gesche M, Ahmed S, Chowdhury A, Mosley W (1974) Maternal mortality in rural Bangladesh. Stud Fam Plann 5:334–341

    Article  Google Scholar 

  • Chopra J, Camacho J (1970) Maternal nutrition and family planning. Am J Clin Nutr 23:1043–1058

    Google Scholar 

  • Currie J, Madrian B (1999) Health, health insurance and the labor market. In Ashenfelter O, Card D (ed) Handbook of labor economics 3c

  • Doherty J, Norton E, Veney J (2001) China’s One-Child policy: the economic choices and consequences faced by pregnant women. Soc Sci Med 52:745–761

    Article  Google Scholar 

  • EcKholm E, Newland K (1977) Too many children, too close together. War Hunger 11(4):6–7

    Google Scholar 

  • Gomes M (1984) Family size and education attainment in China. Popul Dev Rev 10(4):647–660

    Article  Google Scholar 

  • Goux D, Maurin E (2005) The effect of overcrowded housing on children’s performance at school. J Public Econ 89(5–6):797–819

    Article  Google Scholar 

  • Greenlaugh S (1986) Shifts in China’s population policy, 1984–1986: views from the central, provincial, and local levels. Popul Dev Rev 12(3):493–515

    Google Scholar 

  • Guo G, VanWey L (1999) Sibship size and intellectual development: is the relationship causal? Am Sociol Rev 64(2):169–187

    Article  Google Scholar 

  • Kessler D (1991) Birth order, family size and achievement: family structure and wage determination. J Labor Econ 9(4):413–426

    Article  Google Scholar 

  • Li L, Wu X (2011) Gender of children, Bargaining power and intrahousehold resource allocation in China. J Hum Resour 46(2):295–316

    Google Scholar 

  • Li H, Zhang J (2006a) Fertility and parental labor supply: identification based on a unique population policy. Mimeo, The Chinese University of Hong Kong

  • Li H, Zhang J (2006b) Fines, limited liability and fertility. Mimeo, The Chinese University of Hong Kong

  • Li H, Zhang J (2007) Do high birth rates hamper economic growth? Rev Econ Stat 89(1):110–117

    Article  Google Scholar 

  • Li H, Zhang J (2009) Testing the external effect of household behavior: the case of the demand for children. J Hum Resour 44(4):890–915

    Google Scholar 

  • Li H, Zhang J, Zhu Y (2007) The effect of the One-Child policy on fertility in China: identification based on the differences-in-differences. Mimeo, The Chinese University of Hong Kong

  • Li H, Zhang J, Zhu Y (2008) The quantity–quality tradeoff of children in a developing country: identification using Chinese twins. Demography 45(1):223–243

    Article  Google Scholar 

  • McElroy M, Yang D (2000) Carrots and sticks: fertility effects of China’s population policies. American Economic Review Papers and Proceedings 90(2):389–392

    Article  Google Scholar 

  • Meng X, Qian N (2009) The long run impact of exposure to famine on survivors: evidence from China’s great famine. NBER Working Paper 14917

  • Mu R, Zhang X (2008) Gender difference in the long-term impact of famine. IFPRI Discussion Paper 00760

  • Park A, Rukumnnuaykit P (2004) Eat drink man woman: testing for gender bias in China using individual nutrient intake data. Working Paper, University of Michigan

  • Prentice M, Whitehead G, Paul A (1981) Long term energy balance in child-bearing Gambian women. Am J Clin Nutr 34:2790–2799

    Google Scholar 

  • Qian N (2009) Quantity–quality and the one child policy: the positive effect of family size on school enrollment in China. NBER Working Paper 14973

  • Rosenzweig M, Wolpin K (1980) Testing the quantity–quality fertility model: the use of twins as a natural experiment. Econometrica 48(1):227–240

    Article  Google Scholar 

  • Rosenzweig M, Zhang J (2009) Do population control policies induce more human capital investment? Twins, birthweight, and China’s “One Child” policy. Rev Econ Stud 76(3):1149–1174

    Article  Google Scholar 

  • Royston E, Armstrong S (1989) Preventing maternal deaths. World Health Organization, Geneva

    Google Scholar 

  • Schultz P, Zeng Y (1995) Fertility of rural China. Effects of local family planning and health programs. J Popul Econ 8(4):329–350

    Article  Google Scholar 

  • Stafford F (1987) Women’s work, sibling competition and children’s school performance. Am Econ Rev 77(5):972–980

    Google Scholar 

  • Strauss J, Zhao Y, Park A, Smith J, Shen Y (2009) Socioeconomic gradients of health using the china health and retirement longitudinal study, pilot. Paper presented at the 2009 annual meeting of Population Association of America

  • Winikoff B (1983) The effects of birth spacing on child and maternal health. Stud Fam Plan 14(10):231–245

    Article  Google Scholar 

  • Zhang J, Spencer B (1992) Who signs China’s One-Child certificates, and why? J Popul Econ 5(3):203–215

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Seth Sanders, Christopher McKelvey, Peter Murrell, Ginger Jin, Judy Hellerstein, William Evans, John Iceland, Melissa Kearney, Hongbin Li, seminar participants at University of Maryland, U.S. Census Bureau Center for Economic Studies, 2006 CES Shanghai Conference, 2006 Far-Eastern Meeting of the Econometric Society at Beijing, and 2008 Five Star Economic Forum at Renmin University of China, and two anonymous referees for helpful comments. Financial support from the Ministry of Education, China (10YJC790206) is gratefully acknowledged.

Author information

Authors and Affiliations

  1. China Academy of Public Finance and Public Policy, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing, 100081, China

    Xiaoyu Wu

  2. China Center for Economic Research, National School of Development, Peking University, Beijing, 100871, China

    Lixing Li

Authors
  1. Xiaoyu Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lixing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lixing Li.

Additional information

Responsible editor: Junsen Zhang

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wu, X., Li, L. Family size and maternal health: evidence from the One-Child policy in China. J Popul Econ 25, 1341–1364 (2012). https://doi.org/10.1007/s00148-011-0361-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00148-011-0361-0

Keywords

JEL Classification

Search

Navigation