Dissertation Defense: “Essays in the Economics of Infant and Child Health”, Shuhei Kaneko, University of California, Santa Barbara
Speaker
Shuhei Kaneko, University of California, Santa Barbara
Biography
His research lies at the intersection of health economics, labor economics, and applied econometrics, with a focus on how early-life conditions and healthcare environments shape human capital and inequality across the life course.
Title
“Essays in the Economics of Infant and Child Health”
Abstract
This dissertation consists of three essays on the economic analysis of the determinants of health of infants and children. A growing body of evidence demonstrates that early-life health is a critical input into human capital formation, with lasting consequences for later-life health, educational attainment, labor market outcomes, and well- being. This dissertation contributes to this literature by examining three distinct determinants of infant and child health: fluoride in drinking water, cesarean section delivery practices, and heating fuel affordability.
In the first chapter, we focus on the role of fluoride in drinking water. While the effects of fluoride in drinking water on dental health and human capital remain central to public health debates, most existing evidence focuses on high dosages from community fluoridation. We estimate the causal impacts of childhood exposure to lower fluoride levels, exploiting quasi-exogenous variation in naturally occurring concentrations shaped by regional geology in Japan. Combining this variation with longitudinal survey data, nationally representative medical claims, and patient surveys, we provide comprehensive evidence on fluoride's effects. Even at low concentrations, fluoride substantially improves dental health in childhood and adolescence.
Importantly, fluoride exposure also enhances self-esteem among adolescent girls, operating through improved appearance: fewer cavities reduce the likelihood of visible dental problems, and these improvements in dental aesthetics foster their confidence. We find no adverse effects on cognitive performance or educational attainment, in contrast to concerns raised by studies of higher exposures. Taken together, our results show that fluoride remains effective even within a well-developed health system such as Japan's and indicate a conservative lower bound for concentrations that yield dental and psychosocial benefits without cognitive risks.
In the second chapter, we delve into the cesarean deliveries. Cesarean section rates vary widely across U.S. counties, yet it remains unclear how much this variation reflects demand-side factors, such as patient risk or preferences, versus supply-side forces like physician practices or hospital incentives. We develop a new empirical strategy to isolate the role of providers. Exploiting obstetric unit closures from 1989 to 2019 that reallocate mothers to counties with different C-section rates, we find that a one percentage point increase in the delivery county’s rate raises an actual mother’s likelihood of a C-section by roughly one percentage point, and that effect is potentially driven by low-risk mothers. This is exactly the group for whom unnecessary C-sections are most concerning and where policy efforts have focused. The findings highlight provider behavior as a key driver of geographic variation in C-section use and suggest that targeting provider practices may be key to improving maternal and infant health and reducing avoidable medical interventions.
In the final chapter, I show how the price of home heating can affect adverse birth outcomes when mothers are exposed to cold temperatures. To this end, I leverage geographical variation in the type of energy for home heating, temporal variation in natural gas prices triggered by the fracking boom, and seasonal variation in exposure to cold temperatures. Using U.S. birth records for 2001–2015, I find that higher home-heating prices increase the risk of serious conditions such as very preterm birth and very low birthweight when pregnant women are exposed to cold weather. A back-of-the-envelope calculation suggests that roughly 2\% of births with such severe conditions were avoided as a result of the decline in heating costs during the late-2000s fracking boom. As a potential mechanism, I examine how rising heating prices force households to reallocate spending. Although families may reduce heating use, the inelastic demand for heating implies that total energy expenditures still increase, leaving fewer resources for other goods. Consistent with this hypothesis, I find that higher energy prices raise household energy spending while reducing healthcare expenditures.
JEL Codes: I10, I12, I18, I38, J08, J13, J16, J18, J24, Q54
Event Details
Join us for Shuhei’s dissertation defense, where he will present his research titled “Essays in the Economics of Infant and Child Health” We invite you to attend this important academic milestone and learn more about her work in the field. To access a copy of the dissertation here, you must have an active UCSB NetID and password.
