{"title":"The brother's penalty: Boy preference and girls' health in rural China","authors":"Yuli Ye, Qinying He, Qiang Li, Lian An","doi":"10.1002/hec.4833","DOIUrl":null,"url":null,"abstract":"<p>This paper identifies the health penalty experienced by girls due to having a brother from endogenous sibling gender composition. We propose a girls-to-girls comparison strategy and rule out the confounding effect from the sibship size, birth interval, and birth order. Employing an instrumental variable approach and data from the Chinese Family Panel Studies, we find that girls with a brother are demonstrably shorter and report poorer health. This “brother's penalty” manifests even prenatally. Alternative explanations, such as birth order disadvantages, are carefully addressed and ruled out. The results hold even after excluding gender-neutral ethnic minorities. This observed penalty is likely attributed to unequal resource allocation within families and potential parental neglect. This penalty is amplified in families with lower income and maternal education, implying resource constraints contribute to gender discrimination. Our findings highlight the importance of addressing intrafamily gender bias for ensuring equal opportunities and health outcomes.</p><p><b>Clinical trial registration</b>: Not applicable.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 8","pages":"1748-1771"},"PeriodicalIF":2.0000,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health economics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hec.4833","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
This paper identifies the health penalty experienced by girls due to having a brother from endogenous sibling gender composition. We propose a girls-to-girls comparison strategy and rule out the confounding effect from the sibship size, birth interval, and birth order. Employing an instrumental variable approach and data from the Chinese Family Panel Studies, we find that girls with a brother are demonstrably shorter and report poorer health. This “brother's penalty” manifests even prenatally. Alternative explanations, such as birth order disadvantages, are carefully addressed and ruled out. The results hold even after excluding gender-neutral ethnic minorities. This observed penalty is likely attributed to unequal resource allocation within families and potential parental neglect. This penalty is amplified in families with lower income and maternal education, implying resource constraints contribute to gender discrimination. Our findings highlight the importance of addressing intrafamily gender bias for ensuring equal opportunities and health outcomes.
期刊介绍:
This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems.
Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses.
Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.