# Health at Birth and Later Life Outcomes: Evaluating the Returns to Policy-Driven Early Health Investments

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $292,563

## Abstract

ABSTRACT
Not only do children from disadvantaged families have significantly worse health at birth and poorer adult outcomes, but
the effects of poor health at birth appear to extend across generations. Given these patterns, it has been posited that
interventions that improve early life health could yield high returns and help to break the intergenerational cycle of
disadvantage. Despite the clear public health importance of this topic, little research exists to help us understand the long-
reaching effects of health at birth and the role for early intervention in the United States. This project proposes to provide
new evidence on this front using a novel dataset that links birth records for all individuals born in California between
1960 and 2014 to large-scale, federal survey and administrative data with information on later life mortality, disability,
educational attainment, earnings and income, and reliance on public assistance. To our knowledge, this will be the first
such dataset in the U.S. and will be unprecedented both in terms of its coverage and scope. Using this new dataset, we will
estimate the long-term effects of health at birth on adult disability, mortality, and economic outcomes by comparing
outcomes among twins born with different birth weights (Aim 1). This estimation strategy adjusts for any unobserved
family-specific characteristics that might confound estimates of the causal impact of health at birth on outcomes later in
life. Using a similar identification technique, we propose the first analysis of the intergenerational effects of health at birth
on long-term health and economic outcomes (Aim 2). We will estimate the impact of a mother's birth weight on the
outcomes of her children, both at the time of birth and later in life. This will provide new information on the effects on her
child's mortality risk, disability, and achievement throughout life. We will also explore the different mechanisms driving
the intergenerational effects of mother's health at birth. For both Aims 1 and 2, we will obtain estimates for the overall
population and for subgroups defined by race, ethnicity, and socioeconomic status. The scope and size of our dataset will
allow us to generate precise estimates across these subgroups and will provide important new information on the role of
early life health in explaining persistent health and socioeconomic disparities for certain disadvantaged groups. Finally,
we will examine the potential role for early intervention in altering health at birth and long-term outcomes using a case
study of a large-scale, enhanced prenatal care program. We propose to evaluate the short- and long-term effects of a
statewide intervention targeted to low-income pregnant women in California for the children who benefit from this
intervention while in utero (Aim 3). To identify the effects of this intervention, we will use a natural experiment approach
that takes advantage of the program's staggered implementation across cou...

## Key facts

- **NIH application ID:** 9895598
- **Project number:** 5R01AG059731-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Laura R Wherry
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $292,563
- **Award type:** 5
- **Project period:** 2018-08-15 → 2020-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9895598

## Citation

> US National Institutes of Health, RePORTER application 9895598, Health at Birth and Later Life Outcomes: Evaluating the Returns to Policy-Driven Early Health Investments (5R01AG059731-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9895598. Licensed CC0.

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