, Volume 50, Issue 4, pp 1315–1339 | Cite as

Selection and the Marriage Premium for Infant Health

  • Kasey S. BucklesEmail author
  • Joseph Price


Previous research has found a positive relationship between marriage and infant health, but it is unclear whether this relationship is causal or a reflection of positive selection into marriage. We use multiple empirical approaches to address this issue. First, using a technique developed by Gelbach (2009) to determine the relative importance of observable characteristics, we show how selection into marriage has changed over time. Second, we construct a matched sample of children born to the same mother and apply panel data techniques to account for time-invariant unobserved characteristics. We find evidence of a sizable marriage premium. However, this premium fell by more than 40 % between 1989 and 2004, largely as a result of declining selection into marriage by race. Accounting for selection reduces ordinary least squares estimates of the marriage premiums for birth weight, prematurity, and infant mortality by at least one-half.


Marriage Marriage premium Infant health Birth weight Prematurity 



This article has benefitted from the research assistance of Alan Gelder, Phillip Manwaring, Angie Otteson, Craig Palsson, and Kristy Parkinson. We are thankful for comments from Bill Evans, Dan Hungerman, Lucie Schmidt, and participants in seminars at the University of Washington, University of Notre Dame, Brigham Young University, University of Miami, Baylor University, and the 2011 Southern Economics Association Meetings.


  1. Aaronson, D. (1998). Using sibling data to estimate the impact of neighborhoods on children’s educational outcomes. Journal of Human Resources, 33, 915–946.CrossRefGoogle Scholar
  2. Abrevaya, J. (2006). Estimating the effect of smoking on birth outcomes using a matched panel data approach. Journal of Applied Econometrics, 21, 489–519.CrossRefGoogle Scholar
  3. Abrevaya, J., & Dahl, C. (2008). The effects of birth inputs on birthweight. Journal of Business and Economic Statistics, 26, 379–397.CrossRefGoogle Scholar
  4. Aizer, A., & Grogger, J. (2003). Parental Medicaid expansions and health insurance coverage (NBER Working Paper No. 9907). Cambridge, MA: National Bureau of Economic Research.Google Scholar
  5. Almond, D. (2006). Is the 1918 influenza pandemic over? Long-term effects of in utero influenza exposure in the post-1940 U.S. population. Journal of Political Economy, 114, 672–712.CrossRefGoogle Scholar
  6. Almond, D., Chay, K., & Lee, D. (2005). The costs of low birth weight. The Quarterly Journal of Economics, 120, 1031–1083.Google Scholar
  7. Almond, D., & Mazumder, B. (2011). Health capital and the prenatal environment: The effect of maternal fasting during pregnancy. American Economic Journal: Applied Economics, 3(4), 56–85.CrossRefGoogle Scholar
  8. Altonji, J., Elder, T., & Taber, C. (2005). Selection on observed and unobserved variables: Assessing the effectiveness of Catholic schools. Journal of Political Economy, 113, 151–184.CrossRefGoogle Scholar
  9. Bardy, A. H., Seppala, T., Lillsunde, P., Kataja, J. M., Koskela, P., Pikkarainen, J., & Hiilesmaa, V. K. (1993). Objectively measured tobacco exposure during pregnancy: Neonatal effects and relation to maternal smoking. Obstetrics, 100, 721–726.CrossRefGoogle Scholar
  10. Barker, D. (1995). Fetal origins of coronary heart disease. British Medical Journal, 311, 171–174.CrossRefGoogle Scholar
  11. Bartel, A. P. (1979). The migration decision: What role does job mobility play? The American Economic Review, 69, 775–786.Google Scholar
  12. Behrman, J., & Rosenzweig, M. (2004). Returns to birthweight. Review of Economics and Statistics, 86, 586–601.CrossRefGoogle Scholar
  13. Bennett, T. (1992). Marital status and infant health outcomes. Social Science & Medicine, 35, 1179–1187.CrossRefGoogle Scholar
  14. Bennett, T., Braveman, P., Egerter, S., & Kiely, J. (1994). Maternal marital status as a risk factor for infant mortality. Family Planning Perspectives, 26, 252–271.CrossRefGoogle Scholar
  15. Bielby, W., & Bielby, D. (1992). I will follow him: Family ties, gender-role beliefs, and reluctance to relocate for a better job. American Journal of Sociology, 97, 1241–1267.CrossRefGoogle Scholar
  16. Bird, S. T., Chandra, A., Bennett, T., & Harvey, S. M. (2000). Beyond marital status: Relationship type and duration and the risk of low birth weight. Family Planning Perspectives, 32, 281–287.CrossRefGoogle Scholar
  17. Buckles, K., & Hungerman, D. (Forthcoming). Season of birth and later outcomes: Old questions, new answers. Review of Economics and Statistics.Google Scholar
  18. Chay, K., Guryan, J., & Mazumder, B. (2009). Birth cohort and the black-white achievement gap: The role of health soon after birth (NBER Working Paper No. 15078). Cambridge, MA: National Bureau of Economic Research.Google Scholar
  19. Committee on Fetus and Newborn, American Academy of Pediatrics; and Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. (1996). Use and abuse of the Apgar score. Pediatrics, 98, 141–142.Google Scholar
  20. Conde-Agudelo, A., Rosas-Bermúdez, A., & Kafury-Goeta, A. (2006). Birth spacing and risk of adverse perinatal outcomes: A meta-analysis. Journal of the American Medical Association, 295, 1809–1823.CrossRefGoogle Scholar
  21. Currie, J., & Gruber, J. (1996). Saving babies: The efficacy and cost of recent changes in the Medicaid eligibility of pregnant women. Journal of Political Economy, 104, 1263–1296.CrossRefGoogle Scholar
  22. Currie, J., & Moretti, E. (2002). Mother’s education and the intergenerational transmission of human capital: Evidence from college openings and longitudinal data (NBER Working Paper No. 9360). Cambridge, MA: National Bureau of Economic Research.Google Scholar
  23. Dahl, G. (2010). Early teen marriage and future poverty. Demography, 47, 689–718.CrossRefGoogle Scholar
  24. de Weerth, C., van Hees, Y., & Buitelaar, J. K. (2003). Prenatal maternal cortisol levels and infant behavior during the first 5 months. Early Human Development, 74, 139–151.CrossRefGoogle Scholar
  25. Dubay, L., Joyce, T., Kaestner, R., & Kenney, G. (2001). Changes in prenatal care timing and low birth weight by race and socioeconomic status: Implications for the Medicaid expansions for pregnant women. Health Services Research, 36, 373–398.Google Scholar
  26. Duncan, G., Wilkerson, B., & England, P. (2006). Cleaning up their act: The effects of marriage and cohabitation on licit and illicit drug use. Demography, 43, 691–710.CrossRefGoogle Scholar
  27. Edin, K. (2000). What do low-income single mothers say about marriage? Social Problems, 47, 112–133.CrossRefGoogle Scholar
  28. Evans, W., & Lien, D. (2005). The benefits of prenatal care: Evidence from the PAT bus strike. Journal of Econometrics, 125, 207–239.CrossRefGoogle Scholar
  29. Evans, W., & Ringel, J. (1999). Can higher cigarette taxes improve birth outcomes? Journal of Public Economics, 72, 135–154.CrossRefGoogle Scholar
  30. Finlay, K., & Neumark, D. (2010). Is marriage always good for children? Evidence from families affected by incarceration. Journal of Human Resources, 45, 1046–1088.CrossRefGoogle Scholar
  31. Gelbach, J. (2009). When do covariates matter? And which ones, and how much? (Working Paper 09-07). Tucson, AZ: Department of Economics, University of Arizona.Google Scholar
  32. Gelles, R. (1976). Abused wives: Why do they stay. Journal of Marriage and the Family, 38, 659–668.CrossRefGoogle Scholar
  33. Geronimus, A., & Korenman, S. (1993). Maternal youth or family background? On the health disadvantages of infants with teenage mothers. American Journal of Epidemiology, 137, 213–225.Google Scholar
  34. Hahn, B. (1993). Marital status and women’s health: The effect of economic marital acquisitions. Journal of Marriage and the Family, 55, 495–504.CrossRefGoogle Scholar
  35. Jacknowitz, A., & Schmidt, L. (2008). Does marriage really matter? Investments in prenatal care and birth outcomes. Unpublished manuscript, Department of Economics, Williams College.Google Scholar
  36. Jones, R., Darroch, J., & Henshaw, S. (2002). Patterns in the socioeconomic characteristics of women obtaining abortions in 2000–2001. Perspectives on Sexual and Reproductive Health, 34, 226–235.CrossRefGoogle Scholar
  37. Jones, R., Finer, L., & Singh, S. (2010). Characteristics of U.S. abortion patients, 2008. Washington, DC: Guttmacher Institute.Google Scholar
  38. Jones, R., Kost, K., Singh, S., Henshaw, S., & Finer, L. (2009). Trends in abortion in the United States. Clinical Obstetrics and Gynecology, 52, 119–129.CrossRefGoogle Scholar
  39. Joyce, T. (1999). Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City. Journal of Health Economics, 18, 31–67.CrossRefGoogle Scholar
  40. Laub, J., Nagin, D., & Sampson, R. (1998). Trajectories of change in criminal offending: Good marriages and the desistance process. American Sociological Review, 63, 225–238.CrossRefGoogle Scholar
  41. Miles, M., Funk, S., & Kasper, M. A. (1991). The neonatal intensive care unit environment: Sources of stress for parents. AACN Clinical issues in Critical Care Nursing, 2, 346–354.Google Scholar
  42. Miles, M., Funk, S., & Kasper, M. A. (2007). The stress response of mothers and fathers of preterm infants. Research in Nursing and Health, 15, 261–269.CrossRefGoogle Scholar
  43. O’Connell, M., & Rogers, C. C. (1984). Out-of-wedlock births, premarital pregnancies and their effect on family formation and dissolution. Family Planning Perspectives, 16, 157–162.CrossRefGoogle Scholar
  44. Oreopoulos, P., Stabile, M., Walld, R., & Roos, L. L. (2008). Short-, medium-, and long-term consequences of poor infant health: An analysis using siblings and twins. Journal of Human Resources, 43, 88–138.CrossRefGoogle Scholar
  45. Peacock, J. L., Bland, J. M., & Anderson, H. R. (1995). Preterm delivery: Effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine. British Medical Journal, 311, 531–535.CrossRefGoogle Scholar
  46. Ponirakis, A., Susman, E., & Stifter, C. (1997). Negative emotionality and cortisol during adolescent pregnancy and its effects on infant health and autonomic nervous system reactivity. Developmental Psychobiology, 33, 163–174.CrossRefGoogle Scholar
  47. Raatikainen, K., Heiskanen, N., & Heinonen, S. (2005). Marriage still protects pregnancy. BJOG: An International Journal of Obstetrics and Gynaecology, 112, 1411–1416.CrossRefGoogle Scholar
  48. Raley, R. K. (2001). Increasing fertility in cohabiting unions: Evidence for the second demographic transition in the United States? Demography, 38, 59–66.CrossRefGoogle Scholar
  49. Ribar, D. (2004). What do social scientists know about the benefits of marriage? A review of quantitative methodologies (IZA Discussion Paper No. 998). Bonn, Germany: Institute for the Study of Labor.Google Scholar
  50. Royer, H. (2004). What all women (and some men) want to know: Does maternal age affect infant health? (Working Paper No. 68). Berkeley: Center for Labor Economics, University of California.Google Scholar
  51. Shah, P. S., Jamie, Z., & Samana, A. (2011). Maternal marital status and birth outcomes: A systematic review and meta-analyses. Maternal and Child Health Journal, 15, 1097–1109.CrossRefGoogle Scholar
  52. Smith, L. J., van Asperen, P. P., McKay, K. O., Selvadurai, H., & Fitzgerald, D. A. (2008). Reduced exercise capacity in children born very preterm. Pediatrics, 122, e287–e293.CrossRefGoogle Scholar
  53. Stack, S., & Eshleman, J. R. (1998). Marital status and happiness: A 17-nation study. Journal of Marriage and the Family, 60, 527–536.CrossRefGoogle Scholar
  54. Strube, M., & Barbour, L. (1983). The decision to leave an abusive relationship: Economic dependence and psychological commitment. Journal of Marriage and the Family, 45, 785–793.CrossRefGoogle Scholar
  55. Umberson, D. (1992). Gender, marital status and the social control of health behavior. Social Science & Medicine, 34, 907–917.CrossRefGoogle Scholar
  56. Waite, L. (1995). Does marriage matter? Demography, 4, 483–507.CrossRefGoogle Scholar
  57. Ward, C., Lewis, S., & Coleman, T. (2007). Prevalence of maternal smoking and environmental tobacco smoke exposure during pregnancy and impact on birth weight: Retrospective study using Millennium Cohort. BMC Public Health, 7, 81.CrossRefGoogle Scholar
  58. Weiss, Y., & Willis, R. J. (1985). Children as collective goods and divorce settlements. Journal of Labor Economics, 3, 268–292.CrossRefGoogle Scholar
  59. Wu, Z., & Hart, R. (2002) The effects of marital and nonmarital union transition on health. Journal of Marriage and Family, 64, 420–432.CrossRefGoogle Scholar
  60. Wu, Z., Penning, M. J., Pollard, M. S., & Hart, R. (2003). “In sickness and in health”: Does cohabitation count? Journal of Family Issues, 24, 811–838.CrossRefGoogle Scholar

Copyright information

© Population Association of America 2013

Authors and Affiliations

  1. 1.Department of EconomicsUniversity of Notre DameNotre DameUSA
  2. 2.Department of EconomicsBrigham Young UniversityProvoUSA

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