Jacob Klimek

Job market paper

The Dynamics of Health Behaviors, Pregnancies, and Birth Outcomes

Women who smoke, use marijuana, and binge drink during pregnancy are significantly more likely to experience poor birth outcomes than those who don't. However, little is known about how these behaviors prior to pregnancy impact birth outcomes. Using data that chronicles annual behaviors and pregnancies of women from adolescence through their fecund years, I jointly estimate a set of multiple dynamic equations to examine the causal impact of health behavior histories on birth outcomes. I use the estimated parameters to simulate counterfactual scenarios consisting of different histories of health behaviors to quantify resulting changes in pregnancy, live birth, gestation length, and birth weight. I find that a woman's history of smoking increases her likelihood of having a low birth weight child after accounting for multiple sources of endogeneity bias associated with selection, simultaneity, and habitual behavior. Conversely, I find no evidence of marijuana use or binge drinking histories impacting birth outcomes beyond the negative impacts of use during or immediately prior to pregnancy.