Does Participation in Multiple Welfare Programs Improve Birth Outcomes?

Year: 2000

Research Center: Joint Center for Poverty Research, University of Chicago and Northwestern University

Investigator: Brien, Michael J., and Christopher A. Swann

Institution: University of Virginia

Project Contact:
Michael J. Brien
Department of Economics
University of Virginia
Charlottesville, VA 22901
Phone: 804-924-6750


The United States has relatively high rates of low-weight births, preterm births, and infant mortality compared with other Western industrial countries. A number of Federal programs—WIC, Food Stamp, Medicaid, and AFDC—have provided benefits to help improve birth outcomes. In spite of the fact that many women participate in more than one of these programs, previous research has only considered the effect of participation in one program at a time. Such analysis may lead to misleading conclusions if women participate in multiple programs and if some programs are effective while others are not. It also ignores the possibility of synergies among programs. In this paper, Brien and Swann consider whether participation in more than one program improves birth outcomes. They allow for possible synergies among programs in their analysis, and attempt to control for nonrandom selection into the programs.

Brien and Swann used data from the National Maternal and Infant Health Survey, conducted in 1988. The survey includes information about welfare program participation, birth outcomes, and sociodemographic characteristics of mothers and families for almost 19,000 women. The authors restrict their analysis to 3,451 low-income, single women for whom the dataset contained complete information on all the relevant variables.

The authors use a number of techniques to evaluate the impact of program participation on birth outcomes, including simple descriptive statistics comparing average birth outcomes of women who participate in different combinations of programs; ordinary least squares regressions controlling for observed characteristics but not for the selection of women into the various programs; and a more complex model of the decision to participate in each of the four programs and the resulting birth outcome. Highlights of their findings include the following:

  • The descriptive analysis shows that WIC recipients can expect better birth outcomes than nonrecipients. Women who participate in the other programs can generally expect worse birth outcomes than nonparticipants, suggesting possible adverse selection into these programs.
  • After controlling for observed characteristics such as age and education, WIC participation continues to improve birth weights by approximately 230 grams, on average.
  • When allowing for synergies among programs, WIC continues to be effective. Though there appear to be some synergies, there is no consistent pattern across all bundles of choices.
  • The positive effect of WIC participation on birth weights is statistically insignificant after controlling for nonrandom selection into the programs.

In future work, Brien and Swann plan to refine their method of determining program eligibility and attempt to better understand the participation decisions for the possible bundles of programs.