Contact Us

For Marketing, Sales and Subscriptions Inquiries
Rockefeller Center, 45 Rockefeller Plaza
20th Flr Unit #5, New York, NY 10111
United States

Conference List

Journal of Social Economics Research

June 2021, Volume 8, 1, pp 24-38

Child Support Enforcement and Infants Health Outcomes

Niraj Prasad Koirala

Niraj Prasad Koirala 1

  1. Texas Tech University, Department of Economics, Lubbock, TX, USA. 1

on Google Scholar
on PubMed

Pages: 24-38

DOI: 10.18488/journal.35.2021.81.24.38

Share :

Article History:

Received: 06 January, 2021
Revised: 25 January, 2021
Accepted: 08 February, 2021
Published: 22 February, 2021


This paper explores the potential externality of enforcements in child support policies on infants’ health outcomes. Exploiting the variations in child support policies across states and over the year and using the universe of birth records in the US (1975-2004), I document that the policies were effective in improving birth outcomes. Infants born to single mothers in states that fully adopt child support policies have on average 38 grams higher birth weight and 99 basis points lower likelihood of being born with low birth weight. These effects hold for a wide range of health outcomes. The marginal impacts are larger for mothers in states above-median changes in child support policies and for mothers who reside in poorer states. The results suggest that a higher quantity of prenatal care and better timing of prenatal care could be possible mechanisms of impact. This study contributes to the existing literature by providing the first evidence of health externality of child support policies for infants’ health outcomes.
Contribution/ Originality
This paper contributes to existing literature by exploring the potential externality of enforcements in child support policies on infants’ health outcomes.


Child support, Health, Fetal origin hypothesis, Birth outcomes, Panel data, Prenatal care.


Aizer, A., & McLanahan, S. (2006). The impact of child support enforcement on fertility, parental investments, and child well-being. Journal of Human Resources, 41(1), 28–45.Available at:

Almond, D., & Currie, J. (2011a). Human capital development before age five. Handbook of Labor Economics (Vol. 4, pp. 1315-1486). USA: Elsevier Press.

Almond, D., & Currie, J. (2011b). Killing me softly: The fetal origins hypothesis. Journal of Economic Perspectives, 25(3), 153–172.Available at:

Almond, D., & Mazumder, B. (2011). Health capital and the prenatal environment: The effect of Ramadan observance during pregnancy. American Economic Journal: Applied Economics, 3(4), 56–85.Available at:

Almond, D., Mazumder, B., & Van Ewijk, R. (2014). In utero Ramadan exposure and children's academic performance. The Economic Journal, 125(589), 1501–1533.

Almond, D., Mazumder, B., & van Ewijk, R. (2015). In Utero Ramadan exposure and children’s academic performance. The Economic Journal, 125(589), 1501–1533.Available at:

Argys, L. M., Peters, H. E., Brooks-Gunn, J., & Smith, J. R. (1998). The impact of child support on cognitive outcomes of young children. Demography, 35(2), 159-173.Available at:

Baird, S., Friedman, J., & Schady, N. (2011). Aggregate income shocks and infant mortality in the developing world. Review of Economics and statistics, 93(3), 847-856.Available at:

Baughman, R. A. (2017). The impact of child support on child health. Review of Economics of the Household, 15(1), 69–91.Available at:

Becker, C. M., Mirkasimov, B., & Steiner, S. (2017). Forced marriage and birth outcomes. Demography, 54(4), 1401–1423.Available at:

Beller, A. H., & Graham, J. W. (1991). The effect of child support enforcement on child support payments. Population Research and Policy Review, 10(2), 91–116.Available at:

Bozzoli, C., & Quintana-Domeque, C. (2014). The weight of the crisis: Evidence from newborns in Argentina. Review of Economics and Statistics, 96(3), 550–562.Available at:

Carlson, K. (2018). Red alert: Prenatal stress and plans to close military bases. American Journal of Health Economics, 4(3), 287-320.Available at:

Carlson, K. (2015). Fear itself: The effects of distressing economic news on birth outcomes. Journal of Health Economics, 41, 117–132.Available at:

Cole, N., & Currie, J. (1993). Welfare and child health: The link between AFDC participation and birth weight. American Economic Review, 83(4), 971–985.Available at:

Corman, H., Dave, D., Reichman, N. E., Corman, H., Dave, D., & Reichman, N. E. (2019). The effects of prenatal care on birth outcomes: Reconciling a messy literature. Oxford Research Encyclopedia of Economics and Finance. United Kingdom: Oxford University Press.

Currie, J., & Cole, N. (1993). Welfare and child health: The link between AFDC participation and birth weight. The American Economic Review, 83(4), 971-985.

Currie, J., & Grogger, J. (2002). Medicaid expansions and welfare contractions: Offsetting effects on prenatal care and infant health? Journal of Health Economics, 21(2), 313–335.Available at:

Dooley, D., & Prause, J. (2002). Mental health and welfare transitions: Depression and alcohol abuse in AFDC women. American Journal of Community Psychology, 30(6), 787-813.Available at:

Duncan, B., Mansour, H., & Rees, D. I. (2017). It’s just a game: The super bowl and low birth weight. Journal of Human Resources, 52(4), 946-978.Available at:

Farré, L., & González, L. (2019). Does paternity leave reduce fertility? Journal of Public Economics, 172, 52–66.Available at:

FBI. (2018). Uniform crime reporting program data: Police employee (LEOKA) data: Inter-University Consortium for Political and Social Research. USA: Federal Bureau of Investigation.

Fertig, A. R., & Watson, T. (2009). Minimum drinking age laws and infant health outcomes. Journal of Health Economics, 28(3), 737–747.Available at:

Ga, Y., & Feng, L. (2012). Effects of federal nutrition program on birth outcomes. Atlantic Economic Journal, 40(1), 61–83.Available at:

Güneş, P. M. (2015). The role of maternal education in child health: Evidence from a compulsory schooling law. Economics of Education Review, 47, 1–16.Available at:

Haeck, C., & Lefebvre, P. (2016). A simple recipe: The effect of a prenatal nutrition program on child health at birth. Labour Economics, 41, 77–89.Available at:

Hofferth, S. L., & Pinzon, A. M. (2011). Do nonresidential fathers’ financial support and contact improve children’s health? Journal of Family and Economic Issues, 32(2), 280-295.Available at:

Hoynes, H., Miller, D., & Simon, D. (2015). Income, the earned income tax credit, and infant health. American Economic Journal: Economic Policy, 7(1), 172–211.Available at:

Hoynes, H., Page, M., & Stevens, A. H. (2011). Can targeted transfers improve birth outcomes? Evidence from the introduction of the WIC program. Journal of Public Economics, 95(7–8), 813–827.Available at:

Hu, W. Y. (1999). Child support, welfare dependency, and women’s labor supply. Journal of Human Resources, 34(1), 71–103.Available at:

Istvan, J. (1986). Stress, anxiety, and birth outcomes: A critical review of the evidence. Psychological Bulletin, 100(3), 331-348.Available at:

Joyce, T. (1999). Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City. Journal of Health Economics, 18(1), 31–67.Available at:

Jürges, H. (2015). Ramadan fasting, sex-ratio at birth, and birth weight: No effects on Muslim infants born in Germany. Economics Letters, 137, 13-16.Available at:

Kaplan, E. K., Collins, C. A., & Tylavsky, F. A. (2017). Cyclical unemployment and infant health. Economics and Human Biology, 27, 281–288.Available at:

Knox, V. W. (1996). The effects of child support payments on developmental outcomes for elementary school-age children. Journal of Human Resources, 31(4), 816–840.Available at:

Kuka, E. (2018). Quantifying the benefits of social insurance: Unemployment insurance and health. Review of Economics and Statistics, 102(3), 490-505.

Leonard, J., & Mas, A. (2008). Welfare reform, time limits, and infant health. Journal of Health Economics, 27(6), 1551–1566.Available at:

Lindo, J. M. (2011). Parental job loss and infant health. Journal of Health Economics, 30(5), 869–879.Available at:

Majid, M. F. (2015). The persistent effects of in utero nutrition shocks over the life cycle: Evidence from Ramadan fasting. Journal of Development Economics, 117, 48–57.Available at:

Mocan, N., Raschke, C., & Unel, B. (2015). The impact of mothers’ earnings on health inputs and infant health. Economics and Human Biology, 19, 204–223.Available at:

Myrskylä, M. (2010). The effects of shocks in early life mortality on later life expectancy and mortality compression: A cohort analysis. Demographic Research, 22, 289–320.Available at:

Neelakantan, U. (2009). The impact of changes in child support policy. Journal of Population Economics, 22(3), 641–663.Available at:

Nixon, L. A. (1997). The effect of child support enforcement on marital dissolution. Journal of Human Resources, 32(1), 159–181.Available at:

NoghaniBehambari, H., Noghani, F., & Tavassoli, N. (2020). Early-life income shocks and old-age cause-specific mortality. Economic Analysis, 53(2), 1-19.

NoghaniBehambari, H., Noghani, F., & Tavassoli, N. (2021). Child support enforcement and child mortality. Applied Economics Letters, 1-12.

Noghanibehambari, H., & Salari, M. (2020). Health benefits of social insurance. Health Economics, 29(12), 1813-1822.

Olafsson, A. (2016). Household financial distress and initial endowments: Evidence from the 2008 financial crisis. Health Economics, 25, 43-56.Available at:

Pierson, K., Hand, M. L., & Thompson, F. (2015). The government finance database: A common resource for quantitative research in public financial analysis. PloS one, 10(6), e0130119.Available at:

Reichman, N. E., & Florio, M. J. (1996). The effects of enriched prenatal care services on Medicaid birth outcomes in New Jersey. Journal of Health Economics, 15(4), 455–476.Available at:

Robins, P., & Robins, P. (1986). Child support, welfare dependency, and poverty. American Economic Review, 76(4), 768–788.Available at:

Robinson, T., & Raisler, J. (2005). Each one is a doctor for herself": Ramadan fasting among pregnant Muslim women in the United States. Ethnicity & Disease, 15(1 Suppl 1), S1-99.

Roff, J. (2008). A Stackelberg model of child support and welfare. International Economic Review, 49(2), 515-546.Available at:

Rossin-Slater, M. (2017). Signing up new fathers: Do paternity establishment initiatives increase marriage, parental investment, and child well- being? American Economic Journal: Applied Economics, 9(2), 93–130.Available at:

Ruggles, S., Flood, S., Goeken, R., Grover, J., & Meyer, E. (2019). Jose Pacas, and Matthew Sobek. 2019. IPUMS USA: Version 9.0. Minneapolis, MN: IPUMS.

SEER. (2019). Surveillance, epidemiology, and end results (SEER) program National Cancer Institute, DCCPS, Surveillance Research Program. Retrieved from .

Sonchak, L. (2016). The impact of WIC on birth outcomes: New evidence from South Carolina. Maternal and Child Health Journal, 20(7), 1518-1525.Available at:

Sonchak, L. (2015). Medicaid reimbursement, prenatal care and infant health. Journal of Health Economics, 44, 10–24.Available at:

Sorensen, E., & Hill, A. (2004). Single mothers and their child-support receipt how well is child-support enforcement doing? Journal of Human Resources, 39(1), 135-154.Available at:

Tavassoli, N., Noghanibehambari, H., Noghani, F., & Toranji, M. (2020). Upswing in industrial activity and infant mortality during late 19th century US. Journal of Environments, 6(1), 1–13.Available at:

Torche, F. (2011). The effect of maternal stress on birth outcomes: Exploiting a natural experiment. Demography, 48(4), 1473-1491.Available at:

Van Ewijk, R. (2011). Long-term health effects on the next generation of Ramadan fasting during pregnancy. Journal of Health Economics, 30(6), 1246–1260.Available at:

Walker, I., & Zhu, Y. (2006). Child support and partnership dissolution. The Economic Journal, 116(510), C93–C109.Available at:


Google Scholor ideas Microsoft Academic Search bing Google Scholor


This study received no specific financial support.

Competing Interests:

The author declares that there are no conflicts of interests regarding the publication of this paper.


Related Article

( 1 ) Opinion of Parents about Child Labour and Their Education – A Study
( 2 ) Child Support Enforcement and Infants Health Outcomes
( 3 ) Income Shocks and Child Mortality Rates: Evidence from Fluctuations in Oil Prices
( 4 ) Innovations Dissemination Approaches among Government Co-Operative Supporting Organisations in Tanzania
( 5 ) Ethical Context of Organization and Turnover Intention of Women Employees: The Mediating Role of Perceived Organizational Support
( 9 ) A Theoretical Analysis Upon the Environmental Health and Justice Issue: A Case Study for a Comparison Between G20s Unitary and Federal Members
( 10 ) Measuring the Quality of Health Services in Lattakia Province Patients' Perspective (Field Study of Health Centers in Jableh City)
( 11 ) The Nexus between Urbanization, Energy Demand and Healthcare in Bangladesh
( 12 ) Public Health Expenditure, Economic Growth and Health Outcomes in Nigeria
( 13 ) Health Care Outcomes, Malnutrition and Food Security in Southern Africa Development Community: A Quantile Regression Approach
( 14 ) Effects of Socio-Cultural Diversity on the Performance of Private Health Care Organizations in Kogi State
( 15 ) The Effectiveness of the Production of Healthy Rice in Comparison with other Rice Varieties in the Upper Northern Region of Thailand
( 16 ) A Process Model for Conformance of Health Information Systems: Towards National Interoperability
( 17 ) The Effect of Disruptive Factors on Inventory Control as a Mediator and Organizational Performance in Health Department of Punjab, Pakistan
( 18 ) Analysis of Demographic Factors on Perceptions of Inventory Managers towards Healthcare Performance
( 19 ) Assessment of Mental Health of Undergraduate Students Based on Age: A Bayesian Ordinal Quantile Regression Approach
( 20 ) Assessing Access to Comprehensive HIV Treatment Services for Men Who Have Sex with Men and Female Sex Workers in the Bamenda Health District
( 21 ) The Promise and Reality of Public Sector Reform – A Case Study of the Implementation of Trinidad and Tobagos Health Sector Reform