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This dissertation examines maternity leave policies, utilization and consequences in three separate, but related, papers. In the Introduction, I describe the ways state-level leave policies influence, but do not perfectly predict, utilization and then discuss the heterogeneity of women's experiences during pregnancy and post-partum, and how that heterogeneity informs interpretation of results in this field. In Chapter 2 ("Laboring until labor: the prevalence and correlates of antenatal maternity leave in the United States"), I use a national survey of English-speaking women to examine maternity leave taken in the final weeks of pregnancy. I describe individual-, employer-, and policy-level correlates of antenatal leave (ANL), focusing in particular on variation in state temporary disability insurance (TDI) laws. I find that two-thirds of women in this sample stopped working more than a week before their due date, and that state policies significantly influenced leave-taking, even after controlling for characteristics of women and their jobs. While certain individual-level characteristics of women's work were important, employer policies were not significantly associated with ANL use or duration. The literature does not yet include a national analysis of antenatal leave and its correlates. This paper fills that gap and sets up the following chapter on the consequences of taking ANL. In Chapter 3 ("Antenatal maternity leave and childbirth using the First Baby Study: a propensity score analysis"), I use survey data from a prospective cohort in Pennsylvania to test whether women who take maternity leave at the end of pregnancy have better labor and delivery outcomes. In this sample of women giving birth for the first time, fully half of the sample did not stop working before delivery. Using propensity score matching, I find that women who did stop working at least two days prior to delivery experienced more negative delivery outcomes, including an increased likelihood of unplanned Cesarean section. This paper highlights the strong selection into leave-taking, particularly in a context of limited leave availability. In Chapter 4 ("The impact of California's Paid Family Leave law on maternal time use"), I shift focus to postnatal maternity leave and use the American Time Use Survey, a nationally-representative dataset collected by the U.S. Census Bureau, to examine whether the country's first paid family leave (PFL) law increased the amount of time exposed women spent on childcare and decreased their time in paid work. Using a difference-in-difference-in-difference approach with variation in state, time, and age of youngest child, I find that after PFL, women in California significantly increased the time they spent with children in their care and slightly reduced their time spent working. Exploiting a natural experiment, I am able to avoid some of the selection concerns present in the previous chapter, but the daily diary nature of the data do not illuminate whether time use changed due to leave-taking, schedule changes, or some other factor. The results of these studies will inform future research on maternity leave and maternal health, and guide policymaking with regards to targeting and promoting maternity leave policies.
Many American families have a difficult time balancing their obligations at work with their responsibilities at home. This is especially the case when a member of the family needs an increased level of care giving, for instance after the birth of a child or when a family member is seriously ill. Governments around the world have passed legislation to make these difficult times easier for workers by mandating that employers provide paid family leave to their employees. However the US federal government mandates only 12 weeks of job-protected leave through the Family and Medical Leave Act of 1993, which only covers approximately 60% of US workers and is unpaid. The result is that US workers and families are often unable to take leave when they experience increased responsibilities at home. Proponents of expanding FMLA to include a wage replacement provision argue it would increase a worker's ability to stay home when there is an increase need for caregiving. It would also make the ability to take leave more equal across all workers. And while a number of political movements, on both the state and federal level, have sought to expand FMLA to include a paid provision, most have been unsuccessful due to the strong opposition it faces. Opponents argue that paid family leave mandates will place additional costs on employers, and therefore cause a decrease in employment and wages, especially for women who will be labeled as "risky" workers since they are more likely to take leave compared to their male counterparts. Up until recently it was impossible to test this "job killer" hypothesis, since no paid leave mandates existed in the US. However this changed in 2002 when California passed the first-of-its-kind paid maternity leave legislation. This provides us with a natural experiment to study how paid leave mandates would impact labor markets in the US, as well as study its impact on different family types. Chapter 2 uses establishment level employment data from the Equal Employment Opportunity Commission to study the impact California's policy has had on employment. Most model specifications revealed a positive and significant impact on CA employment, with the policy being correlated with an approximately 2% increase in establishment level employment. In other model specifications the law had a positive but insignificant effect. These findings would suggest that at worst CA's paid family leave mandate was a non-event for establishments in the state, and at best it had positive impact on employment. Chapter 3 examines how CA's policy impacted the wages of workers using data from the Current Population Survey. The analysis shows that the policy is correlated with a modest but positive increase in wages for all workers. It was also shown that women saw a more dramatic increase in their wages, which suggests that the policy has not lead to an increase in statistical discrimination as some opponents feared. Chapter 4 looks at the behavior of non-traditional households by analyzing the maternity leave behavior of women with different relationship statuses. Using both CPS data as well as NLSY97 data this analysis shows that new mothers in cohabiting household behave differently than their married counterparts when it comes to maternity leave, taking significantly shorter leaves and working more hours in the year of birth. The results suggest that their partner's income is not a significant factor in determining their incidence and length of leave. However having access to paid leave increases their willingness and ability to take leave.
During the past several decades, paid family leave has emerged as a policy issue at the intersection of work and life, which is affecting many working families, particularly during the period of childbirth. According to U.S. Census Bureau data, 56 percent of women worked full-time during pregnancy from 2006 to 2008, and among women who worked during pregnancy, 64 percent were actively working less than one month before childbirth and 59 percent returned to work less than three months after childbirth. As the number of single parent households and the number of women participating in the labor force increased over the last three decades, the demand for paid family leave from employers or government has grown. Researchers have found that paid family leave has a number of health and economic benefits. This dissertation builds upon on an existing body of research by examining whether paid family leave improves two measures related to quality of life: child health and mothers' employment and work schedules. Further, this study examines a potential political precursor to the passage of paid family leave laws, namely the proportion of female legislative representation. Together, these studies enhance our understanding of how paid family leave affects the well-being of working families and the factors that predict its passage into law. One of the unique aspects of this research is that is that the effects of paid paternity leave are examined, which has not received adequate attention in the existing literature. The overarching theme and motivation of this dissertation is the availability of paid family leave and is introduced in Chapter 1. Chapter 2 examines the effects of the availability of paid family leave on the health outcomes of children. This study uses country-level balanced panel data from the 35 OECD countries from 1990 to 2016. Using an event study design, the study finds an approximately 1.9 to 5.2 percent decrease in country-level infant, neonatal, and under-five mortality rates following the adoption of paid maternity leave. However, the impact of the implementation of paid paternity leave was not as apparent as that of paid maternity leave, which may be attributed to its recency and amount that is much smaller than that of the more common maternity leave. An increase in the length of paid paternity leave was found to have a measurable impact on the health outcomes of children. An important finding of this study is that it takes at least two years for paid family leave to have an effect on the health outcomes of children, indicating that there is a delayed impact after the enactment of paid family leave legislation.Chapter 3 examines the impact of the paid family leave on female labor market outcomes, including being employed, working full-time, number of hours worked, and whether mothers actually utilized the paid family leave program. The study uses individual-level, cross-sectional data in the United States from the 2000 to 2019 waves of the Current Population Survey's Annual Social and Economic Supplement (ASEC) and a triple difference-in-difference estimator. The results show that the adoption of state paid family leave improves the labor market outcomes for mothers with an infant. Mothers with infants in states with paid family leave are 0.6 percent more likely to be employed, 0.6 percent more likely to work full-time, and work 0.8 more hours compared to mothers with infants in states without paid family leave. However, the results also show that the adoption of state paid family leave decreases the labor market outcomes for mothers with both an infant and child. When mothers with both an infant and a child live in states with paid family leave, they are 3 percent less likely to be employed, 2.2 percent less likely to work full-time, and work 1.3 fewer hours compared to mothers with both an infant and a child in states without paid family leave. This may suggest that paid family leave is inadvertently worsening the labor market outcomes for mothers with multiple children. From the results on the utilization of paid family leave, it appears that some mothers may be hesitant to use such leave, which may be attributed to fears associated with taking paid family leave.Chapter 4 examines whether the female legislative representation has a measurable effect on the likelihood of whether a U.S. state adopts friendly work-family policies. The study examines 50 U.S. states from 2000 to 2016 using a linear probability model with data from the Michigan State University's Correlates of State Policy Project. The study finds that when states have more than 25 percent females in the state legislature and the governor is a female, they do not experience a statistically significant increase in the likelihood of passing friendly work-family laws. The results may suggest that an increase in the passive representation of women does not always result in active representation. According to representation theories in the literature, passive representation leading to active representation only occurs when three conditions are met: 1) the policy area needs to be salient for women; 2) women need to be the direct beneficiary of the policy; and 3) policy area needs to be gender-related. Two of these three conditions were not met in this study, which may explain the null findings. Another explanation is the extremely partisan political culture in the United States where even women-related issues are supported or opposed on party lines, regardless of the number of female legislators in any party. A number of common and interrelated policy implications emerge from the studies included in chapters 2 through 4, which are presented in Chapter 5, Summary and Conclusion. The lagged impact of paid family leave suggests that both the employees and employers need to be educated with the availability of and access to paid family leave and both should be aware of their rights and responsibilities. Compliance of the employers with paid family leave has been an issue with the Family and Medical Leave Act (FMLA), which is on a non-paid basis, and it can be expected to be even worse for paid family leave. Thus, the government would need to come up with better and effective enforcement mechanisms. Fears associated with the utilization of paid family leave, which include impediment to career advancement or even losing job, would need to be mitigated in order to realize the benefits of paid family leave. Finally, the lack of a linkage between female legislative representation and the adoption of friendly work-family legislation may indicate that merely large female legislative representation is not sufficient and the success of such legislation may depend on the buy-in of the public. It needs to be better communicated that paid family leave is beneficial to both employees and employer alike, and paid family leave is a value proposition to businesses and employers.Overall, the findings of this research can be used to educate stakeholders on the need, justification, challenges, benefits, and a general framework for the development and implementation of paid family leave.
This dissertation centers on two themes. First: how do public policies affect the incentives of mothers to participate in the labor market? And second: how do these maternal employment incentives and economic opportunities impact the health of children? In the first chapter, I focus on the first theme, and identify the impact of a large means-tested preschool program, Head Start, on the labor supply of mothers. This chapter uses a discontinuity in grant writing assistance in the first year of the Head Start program to identify impacts on the work and welfare usage of mothers. Using restricted Decennial Census and administrative AFDC data I find that Head Start decreases employment rates and hours worked per week for single mothers. I also find a suggestive increase in welfare receipt for single mothers which is confirmed by an increase in the share of administrative welfare case-files that are single mother households. For all mothers combined there are no significant changes in work or welfare use. I also estimate long-run impacts, 10 years after a woman's child was eligible for Head Start. I find large and persistent declines in work for both non- white mothers and single mothers, accompanied by increase in public assistance income and return to school. I argue that this is consistent with the 1960's era Head Start program's focus on encouraging quality parenting, parent participation and helping families access all benefits for which they were eligible. In the second chapter, my coauthor, Gaetano Basso, and I examine the impacts of California's Paid Family Leave program on the health of infants. One goal of the policy was to make it easier for working mothers to take maternity leave, and encourage their return to work. Pervious research has confirmed that the policy resulted in longer maternity leave durations, which we theorize may impact infant health. We measure health using the full census of child hospitalizations in California. The potential policy implications are of great interest both because of the high costs of health care in the U.S., and to better evaluate a potential benefit of the family leave policy overlooked by the existing literature. Our results suggest a decline in infant admissions, which is concentrated among those causes that are potentially affected by closer childcare (and to a lesser extent breastfeeding). Other admissions that are unlikely to be affected by parental leave do not exhibit the same pattern. In the third chapter, I examine the mechanisms through which the business cycle influences child health and development. There is a growing literature which finds large consequences of conditions in utero for health and success. Using a large survey of births covering the period 1990-2014, I use a state-year panel fixed effects model to examine the relationship between the business cycle and breastfeeding, stress while in-utero, and cigarette and alcohol consumption before, during and after pregnancy. I find suggestive evidence that the share of births that are unplanned rise with the unemployment rate. I also find that pregnant women are more likely to experience economic stress in times of high unemployment - but that this is primarily through an increase in the probability that their husband or partner loses their job. The pregnant woman's own employment is unaffected. Breastfeeding shows mixed results, but for the sample of states that appear most frequently in the data, both initiation and duration increases with the unemployment rate.
This dissertation consists of three essays in health economics. The first chapter, "The Built Environment and Obesity in Philadelphia: The Use of Satellite Imagery and Transfer Learning," investigates the relationship between the built environment and health outcomes, specifically obesity prevalence in Philadelphia. The built environment can affect obesity prevalence through the physical activity environment and the food environment. The main innovation of this paper is to use a pre-trained convolutional neural network (CNN) to extract data representing the features of the built environment from high-resolution satellite imagery. Because of the lack of information on the food environment in satellite images, I combined a proxy variable for food access together with the feature variables to represent the characteristics of the built environment. I then employed the Elastic Net model to test the relationship between the feature variables of the built environment and obesity prevalence in Philadelphia. The results show that the built environment is highly associated with obesity prevalence. This study also provides some evidence that the features of the built environment that have been extracted from satellite imagery can reduce the role of food access in estimating obesity, as well as that adding these features can explain more variance of obesity. The second chapter, "Paid Maternity Leave and Child Health: Evidence from Urban China," uses the China Health and Nutrition Survey data to study whether the extension of paid maternity leave affects children's health outcomes in urban China. This paper uses the time variation of the implementation of a maternity leave policy across different provinces from 1987 to 1991 in China to estimate a two-way fixed-effects model. The results suggest that the expansion of paid maternity leave has no impact on children's health in urban China. The last chapter, titled "The Association between Paid Maternity Leave and Mothers' Health and Labor Outcomes in Urban China," studies whether the extension of paid maternity leave in 1987-1991 would affect the labor and health outcomes of mothers in urban China by using the China Health and Nutrition Survey data. Based on the variation in the implementation time of a paid maternity leave policy across different provinces, this paper employs a two-way fixed-effects model to estimate the policy impact on mothers' health and labor outcomes in China. The findings indicate that extending the duration of paid maternity leave is associated with an increased likelihood of mothers remaining employed after childbirth. However, the study also reveals a negative relationship between the extension of paid maternity leave and mothers' wage rates.
This report examines the laws that govern parental leave in five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) from a historical perspective, as well as from the experiences of individuals and the findings of a literature review, in order to identify best practices and remaining challenges to help secure a more gender-equal society. Topics discussed include: women's labour market participation, job security and maternity leave; fathers as parents; flexibility and shortcomings in parental leave laws; the use of parental leave and factors that influence its use by men.
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