The Fertility Reduction Effects of the Colorado Family Planning Initiative by Age and Parity.

IF 2 3区 医学 Q2 ECONOMICS
Health economics Pub Date : 2026-08-08 DOI:10.1002/hec.70147
James Flynn, Amanda Stevenson, Sara Yeatman, Katie Genadek, Jane Menken, Stefanie Mollborn, Leslie Root
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Abstract

We use restricted-access birth records from the National Vital Statistics System (NVSS) to document the full age and parity fertility effects of the Colorado Family Planning Initiative (CFPI). The CFPI provided access to every FDA approved method of contraception for free to anyone living below approximately 200% of the federal poverty line from 2009 to 2015. Previous research has demonstrated important effects on fertility at ages 15-29. We estimate the statewide fertility effect of the CFPI for all age groups (15-44) and for all births and for first and non-first births using the synthetic control method. We find large and statistically significant reductions in birth rates for 15-24-year-olds that largely line up with other recent studies, but we find important heterogeneity across parity. For teenagers, we find reductions in first birth rates of about 9%, but much larger reductions in non-first birth rates of 17%-25%. We also find reductions in overall fertility for 20-24 and 25-29-year-olds, but these are entirely driven by reductions of 5%-9% in non-first birth rates, with no significant changes in first births. For 30-39-year-olds, we find small but statistically significant reductions in fertility of 3%-7% across parity levels, and we find a 6% reduction in fertility for 40-44-year-olds. We also conduct inference using synthetic difference-in-differences (SDID) and placebo-based methods. When we do this, our coefficient estimates are similar, though confidence intervals are wider, with specifications on older age groups no longer statistically significant.

按年龄和胎次划分的科罗拉多州计划生育倡议的生育率降低效果。
我们使用来自国家生命统计系统(NVSS)的限制访问出生记录来记录科罗拉多州计划生育倡议(CFPI)的全部年龄和胎次生育影响。从2009年到2015年,CFPI为生活在联邦贫困线以下的人免费提供了FDA批准的所有避孕方法。先前的研究已经证明了对15-29岁生育能力的重要影响。我们使用综合控制方法估计了CFPI在全州范围内对所有年龄组(15-44岁)、所有分娩以及第一胎和非第一胎的生育影响。我们发现,15-24岁人群的出生率大幅下降,在统计学上具有显著意义,这与最近的其他研究结果基本一致,但我们发现,在各胎次之间存在重要的异质性。对于青少年,我们发现第一次生育的比例下降了9%,但非第一次生育的比例下降了17%-25%。我们还发现,20-24岁和25-29岁人群的总体生育率有所下降,但这完全是由非第一胎生育率下降5%-9%造成的,而第一胎生育率没有显著变化。对于30-39岁的人,我们发现生育率在同等水平上下降了3%-7%,但在统计上有显著意义,我们发现40-44岁的人生育率下降了6%。我们还使用合成差异中的差异(SDID)和基于安慰剂的方法进行推理。当我们这样做时,我们的系数估计是相似的,尽管置信区间更宽,年龄较大的群体的规格不再具有统计意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health economics
Health economics 医学-卫生保健
CiteScore
3.60
自引率
4.80%
发文量
177
审稿时长
4-8 weeks
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.
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