Parental Education and Child Health: Evidence from a Natural Experiment in Taiwan

1. Parental Education and Child Health: Evidence from a Natural Experiment in Taiwan Shin-Yi Chou Lehigh University & NBER Jin-Tan Liu (劉錦添) National Taiwan University & NBER Michael Grossman City University of New York Graduate Center & NBER Theodore Joyce Baruch College & NBER

2. 臺灣過去50年，兩大公共政策 • 1968年 九年國教 • 1995年 全民健保 Duflo (2001), “Schooling and Labor Market Consequences of School Construction in Indonesia:Evidence from an Unusual Policy Experiment,” American Economic Review, 91, 795-813. Currie and Moretti (2002),”Mother’s Education and the Intergenerational Transmission of Human Capital: Evidence from College Openings,” Quarterly Journal of Economics, 118, 1495-1532. Clark and Hsieh (2000), “Schooling and Labor Market Impact of the 1968 Nine-Year Education Program in Taiwan,” Working Paper, Department of Economics, Princeton University

3. Education and Health: • Michael Grossman (1972), “On the Concept of Health Capital and The Demand for Health,” Journal of Political Economy, 80, 223-255. • Michael Grossman (2000), “The Human Capital Model,” in Culyer and Newhouse eds. Handbook of Health Economics, Vol. 1. Elesevier Science B.V. • Michael Grossman and Robert Kaestner (1997), “Effects of Education on Health,” in Behrman and Stacery eds. The Social Benefits of Education, University of Michigan Press.

4. Education and Health • Michael Grossman, “Education and Nonmarket Outcomes,” in Hanushek and Welch eds. Handbook of the Economics of Education, Elsevier Science. • (NBER working papers No. 11582). • Conceptual Foundations: • 1. Productive efficiency • 2. Allocative efficiency • Causality? • Y = X B + U • “The third variable” may cause schooling and health to vary in the same direction. • “The time preference hypothesis”

5. Empirical Methods: • 1. Include past health measures in regressions • 2. Siblings or twins samples: • control for unmeasured third variables • differences in outcomes due to differences in • schooling between siblings or twins. • 3. Instrumental variables method (IV): • variables are correlated with schooling but not • correlated with omitted third variables, such as • ability, inherited genetic traits, and time • preference.

6. Instrumental Variable (IV) • Y = X B + U • OLS is biased when U is correlated with X • Use an IV Z for X • βIV = (Z’X)-1 (Z’Y) • βIV is consistent when Z satisfies two conditions: • 1) Z is uncorrelated with U • 2) Z is correlated with X

7. Instrumental Variable (IV) • Random encouragement designs: • 1. To test the effect of flu vaccine on flu: • The IV (the letter) is randomly assigned, • but not the treatment (flu vaccine). • 2. Distance to hospital with operating facilities • as an IV for surgery in heart attacks. • 3. Distance to school as an IV for schooling • 4. Policy Reforms

8. How to find IV? • 1.Lleras-Muney (2005), Compulsory Education • Laws from 1915 to 1939 • US Censuses of Population for 1960, 1970, 1980 • The effect of education on mortality • 2. Arendt (2005), Compulsory School Reform in • Denmark in 1958 and 1975 • The impact of schooling on self-rated health • 3. Spasojevic (2003), 1950 Swedish • Comprehensive School Reform.

9. Difference-in-Difference (DD)Estimators • “Natural Experiments” Actual policy changes to identify the effects of policies on outcomes • DD: to compare outcomes before and after a policy change for a group affected by the change (Treatment Group, T) to a group not affected by the change (Control Group, C). • DD = [E(Y1 ︳T) – E(Y0︳T)] – • [E(Y1 ︳C) – E(Y0︳C)] • Yi, t = α+ β2 Time + β3 Treatment • + β4 (Time* Treatment) + ui,t

10. DD: • Meyer, Bruce D. (1995), “Natural and Quasi-experiments in Economics,” Journal of Business and Economic Statistics, 13(2), 151-161. • Angrist, Joshua D. and Alan B. Krueger (1999), “Empirical Strategies in Labor Economics,” Handbook of Labor Economics. • MIT, Harvard: • Jonathon, Gruber • Duflo, Esther

11. 前言 • 探討主題:Does the parents’ attainment of education affect the health of their children? • 研究困難:Unobserved characteristics that affect both the parents’ education levels and the health of their children. • 本文實證方法:Compulsory schooling laws in Taiwan affects the levels of Parental education, but is uncorrelated with children’s health

12. ? 本文大綱 • 1968年臺灣九年國民義務教育 • Data and sample • Effect of 1968-Reform on Education • Effect of Parental Education on child health outcomes

13. 研究背景:1968年延長九年國民義務教育 • Extended from 6 years to 9 years • 140 new high schools were opened • Number of junior high schools per thousand primary school graduates increased from 0.8 (1967-1968 academic year) to 1.3 (1968-1969 academic year) • The percentage of primary school graduates who entered junior high school increased from 56% (1967-1968 academic year) to 77% (1968-1969 academic year) • Intensity of school construction varies across regions.

14. (每1000位國小畢業生中國中的數目) Junior High Schools per Thousand Primary School Graduates Source: Ministry of Education, Educational Statistics of Republic of China.

15. (每位國小畢業生進入國中的比例) Number of First Year JH Students to Number of Primary School Graduates Source: Ministry of Education, Educational Statistics of Republic of China.

16. ProgramIntensity in 1968 (1968年新設國中數目佔1967年每1000 位12歲至14歲學童的比率) * Program intensity is defined as number of new junior high schools in 1968 per thousand children ages 12-14 in 1967.

17. Econometric Method: • 控制組/對照組: children over/under the age of 11 in 1968 • Validation of our strategy: • The higher the program intensity is, the larger the effect of education reform • Program intensity was independent with initial schooling levels

18. Enrollment Rate Program Enrollment Rate in 1966 vs. Program Intensity Source: Ministry of Education, Educational Statistics of Republic of China.

19. Program Percentage of Workers in Agriculture in 1967 vs. Program Intensity Source: The data on percentage of workers in agriculture are from the Taiwan Agricultural Yearbook.

20. Data and Sample • Birth and death certificates, 1978-1999, total 22 years • Sample Size: 5,576,868~6,099,832. • Child Health outcomes include the probabilities of:low/very low birth weight(less than 2500 grams/1500 grams), pre-maturity, mortality,etc. • Sample: women or men satisfying these: • Between 1- and 20-years old in 1968 • Between 22- and 45-years old when they or their wives gave birth in 1978-1999

21. Effect of 1968 Education Reform on Education • Basic approach: • Sijt is the number of years of formal schooling completed by mother (or father) i born in city/county j with her/his child born in year t. • Indices: i: mother (or father), j: city/county, t: year • C: cohort dummies, • P: program intensity, • T: treatment group dummy, • R: region of birth(city/county), • Y: year dummies, 1978 is an omitted year 19 19 1979 l =1979

22. β ( ) ) β ( Effects of Education Reform on Parents’ Educational Attainment (Basic Approach)

23. 1968年九年國教對個人教育成就的影響: • Education reform not only has a positive impact on the educational attainment of the treatment groups, but also has a larger impact for the younger women. • The 12-14 year-olds may not be a pure control group. • Education reform has a bigger impact on father’s educational attainment than on mother’s. • Education reform had a larger impact on the education of younger fathers.

24. 1968年九年國教對個人教育成就的影響(續): • Full specification: replace P x T by P x C(Program Intensity) • Coefficient series {bk}: • decreases sharply when k=13 (13 years old in year 1968) • fluctuates near 0 when k=14 ~ 19 • all positive for k=0 ~ 11, and decreases from 0 to 11 1999 19 k=1979 l=1979

25. Mothers Fathers Coefficients of the Interactions between the Age in 1968 and Program Intensity in the Years of Schooling Regression

26. 1968年九年國教對教育成就的影響 • Restricted Estimation: assume bk=0 when k ³15. • We delete the cohort aged 12-14 from our sample. • The F-ratios are 15.73 and 16.96 for mother’s and father’s samples, respectively, when the enrollment rate and the percentage of agricultural share are employed as regressors. • for every junior high school constructed per 1000 children between the ages of 12 and 14, • Mothers 0-5, 6-11: receive 1.0 and 0.72 additional years • Fathers 0-5, 6-11: receive 0.84 and 0.77 additional years

27. Effect of Parental Education on Child Health Outcome • Basic approach in the first stage • Under OLS estimation, higher parental educational attainments significantly reduce the risk of all adverse health outcomes (prematurity, etc.) • Under the 2SLS estimation, mother’s years of schooling shows significant impacts only on low and very low birthweight and prematurity. • Under the OLS estimation, father’s years of schooling has similar effect as mother’s. • Under 2SLS, father’s years of schooling has smaller effect as mother’s.

28. Effects of Parental Schooling on Child Health Outcomes: OLS and TSLS (Basic Approach in the First Stage)

29. Effect of Parental Education on Child Health Outcome • Restricted estimation in the first stage • Similar to previous results except that father’s years of schooling reduces infant and postneonatal mortality.

30. Effects of Parental Schooling on Child Health Outcomes: OLS and TSLS (Restricted Estimation in the First Stage)

31. Further questions: • 1. Control group, treatment group • Age: • 2. Clustering • 3. Group data regression • Weights? • 4. Mother’s education vs. Father’s education

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