Fetal health shocks and early inequalities in healthcapital accumulation

Abstract

Several stu dies report socioeconomic inequalities in c hild health and consequence s of ea rly disease. However, not muchis known about inequalities in health capital accumulation in the womb in response to fetal health shocks, which isessential for finding the earliest sensitive periods for interventions to reduce inequalities. We identify inequalities in birthweight accumulation as a result of fetal health shocks from the occurrence of one of the most common birth defects, oral clefts,within the first 9 weeks of pregnancy, using quantile regression and two datasets from South America and the USA. Infants bornat lower birth weight quantiles are significantly more adversely affected by the health shock compared with those born at higherbirth weight quantiles, with overall comparable results between the South American and US samples. These results suggest thatfetal health shocks increase child health disparities by widening the spread of the birth weight distribution and that healthinequalities begin in the womb, requiring interventions before pregnancy.