Child Health in Elementary School Following California's Paid Family Leave Program

Abstract

We evaluate changes in elementary school children health outcomes following the introduction of California’s Paid Family Leave (PFL) program, which provided parents with paid time off following the birth of a child. Our health outcomes--overweight, ADHD, and hearing-related problems--are characterized by diagnosis rates that only pick up during early elementary school. Moreover, our health outcomes have been found to be negatively linked with many potential implications of extended maternity leave--increased breastfeeding, prompt medical checkups at infancy, reduced prenatal stress, and reduced non-parental care during infancy. Using the Early Childhood Longitudinal Studies (ECLS) within a difference-in-differences framework, our results suggest improvements in health outcomes among California elementary school children following PFL’s introduction. Furthermore, the improvements are driven by children from less advantaged backgrounds, which is consistent with the notion that California’s PFL had the greatest effect on leave-taking duration after childbirth mostly for less advantaged mothers who previously could not afford to take unpaid leave.

Does Paid Family Leave Reduce Nursing Home Use? The California Experience

“…More generally, our situation is analogous to that faced in several program‐evaluation efforts. For example, Lichtman‐Sadot and Bell () propose that California's PFL law improves health outcomes among elementary school children through breastfeeding, greater parental care during infancy, and reduced prenatal stress; however these mechanisms are unobserved in their data and the authors rely on existing studies to propose these channels. Detailed individual‐ (and family‐) level data on elderly people with care needs, and the employment status and caregiving behavior of their family members, would be needed to investigate these connections more directly.…”

“…Clustering techniques are widely used in applications such as taxonomy, market research, genetic analysis, and the targeting of medical and health‐service interventions, and have also been used to select comparison groups for purposes of estimating treatment effects with nonexperimental data (e.g., Peck, ; Weitzman, Silver, & Dillman, ). While previous studies on the effect of PFL have used observations from all states other than California (Bartel et al., ; Lichtman‐Sadot & Bell ), or the three next‐largest states, to define the comparison group (Rossin‐Slater, Ruhm, & Waldfogel, ), cluster analysis allows for the creation of a comparison group based on empirical similarity criteria, thus making it less reliant on subjective choices.…”

“…Stearns () found that paid maternity leave policy led to a reduction in low‐weight births. Similarly, Lichtman‐Sadot and Bell () demonstrated improvements in health outcomes among California's elementary school children following the introduction of PFL. Gimm and Yang () examined the effect of California's PFL law on mental and physical health outcomes of family caregivers but found no effect of the policy change.…”

Did California Paid Family Leave Impact Infant Health?

“…In particular, parent‐reported measures of child health may be influenced by their attitudes about working. Recent work by Lichtman‐Sadot and Bell () looks at the impact of PFL on the health of older children (aged five to six) and finds improvements along a broad range of outcomes. Stearns () studies the effects of the precursor to PFL (California Temporary Disability Leave or TDI) on birth outcomes in the late 1970s, finding a reduction in pre‐term and low birth weight births.…”

“…Overall, we do not find systematic evidence that women responded to the policy change by changing their fertility, potentially changing the composition of babies born after July 2004. However, the different result in Lichtman‐Sadot () is still concerning, so as a robustness check, we implement a correction suggested in Lichtman‐Sadot and Bell () by removing babies born between February and November 2004 from equation . This exercise, detailed further in the Appendix, shows that the magnitude and significance levels of our main findings are maintained .…”