This dissertation consists of three essays on Health Economics. Chapter 1 analyzes the effects of abortion costs for minors on abortions, sexual behavior, and births. We exploit a 2015 change in parental involvement (PI) laws in Spain as a natural experiment in costs, together with rich population-level data on abortions and births. Using the exact date of teenager birth, we first document a decrease in abortions by 17-years-olds using a difference-in-difference comparison with 18-years-olds, consistent with the law that targeted Spanish minors. Using bunching methods from the Public Finance literature, we show evidence of temporal displacement. Some 17-years-old delayed their abortion and waited until they turned 18 and thereby avoided involving their parents. Second, we consider how the law change may have influenced health-related behaviors, finding implicitly that sexual behaviors changed so as to reduce the likelihood of becoming pregnant before turning 18 (and thereby internalized the cost of parental involvement). This is seen in the permanent shift in the number of abortions at age 18 that exists after removing the temporal displacement abortions around the age 18 threshold and an increase in the number of births to mothers who were pregnant at age 17. This paper finds that an important dimension of risky youth behavior responds to incentives contained in parental notification laws. Chapter 2 analyzes the effects of abortion costs on sex-selection by exploiting a 2010 abortion liberalization in Spain and the difference in son-preferences by nationality and child order documented in the literature. We show using a difference-in-difference comparison a significant increase in the fraction of boys for Chinese parents giving birth to their third child or above relative to children born of Spanish parents. Consistent with the literature, we do not find any effect on the fraction of boys for the first or the second child. Using the provincial number of abortion centers per person as a measure of access to abortion, we show, at the correlation level, that the effects come from those provinces with higher access to abortions. Finally, we find suggestive evidence that birth outcomes of Chinese girls who are the third children, and thus are now more likely to be ``wanted'' after the reform, improve. Gestational weeks increase, and the chance of being born prematurely decrease although our evidence suffers from lack of power. Finally, chapter 3 analyzes the effects of a universal, unconditional cash transfer announcement on birth outcomes by exploiting the 2007 cheque bebé policy in Spain that provided 2,500 euros per child to all mothers giving birth immediately after its announcement (Jul 2007). We use a difference-in-difference analysis comparing those born before and after the announcement. By exploiting the timing of the policy announcement we can avoid the composition effects caused by the incentives to have children generated by the policy. We show that the birth weight of those children born after the policy announcement (Sept-Dec) significantly improved relative to those born before (Apr-Jun) using previous years to control for the seasonal effects. Moreover, we provide suggestive evidence that those who are more vulnerable, as measured by the average municipality income level, parents' marital status, or parents' age, experience the most substantial improvements on birth weight.

Essay 2 uses Chinese adult twin data to investigate birth weight effect, the outcomes of which have been changed to long-term achievements. The OLS results suggest that birth weight has significant positive relationship with earnings, adult height, and health conditions. However, within-twin-pair results indicate that birth weight has significant positive influence only on adult height. Essay 2 also systematically interprets the pattern of bias directions of OLS relative to within-twins estimates across empirical studies on long-term outcomes. For health measures, OLS estimates are consistently biased upward relative to within-twins estimates across empirical studies, suggesting an overall positive correlation between omitted factors and birth weight. On the contrary, the bias direction of OLS relative to within-twins estimates fluctuates across empirical studies on ability-related outcomes, including educational attainment and earnings. This suggests that there are two main types of omitted variable (e.g., endowments and post-birth parental inputs) with each type having different correlation with birth weight. / Essay 3 uses data from the 2000 and 2005 censuses of China. It analyzes trends on the marital behavior of Chinese people during 1970-2004, and the impact of the one-child policy in terms of marriage age, marriage rate, and assortative mating on age. First, this essay finds that from 1990 onwards, more people have preferred to marry at and after their mid-twenties. Interestingly, up to the early 2000s, the prevailing marriage rates of men and women over 35 years old maintained at very high levels (over 90%) despite China becoming more prosperous. Moreover, the positive assortative mating on age was more or less the same from 1970 to 2004. In addition, this essay is the first to compare the marriages of Zhuang people relative to other non-Han people (excluding Man people) around 1989 to implement the difference-indifferences (DiD) estimation. Results from DiD estimations indicate that the one-child policy encourages more people to delay marriages. On the one hand, the policy favors more men at 30 years old or above to marry young women in their twenties. On the other hand, interestingly, it also induces more young men to marry older women. / The dissertation consists of three empirical studies on Chinese household behavior. Essay 1 uses Chinese child twin data to examine the effect of birth weight on performances during childhood and adolescent periods. Essay 1 has three main contributions to literature. First, this essay is the first to use twin data of an Asian developing country to study the birth weight impact. Within-twins results suggest that birth weight has significant effect on physical growth, but no significant effect on school performance, health conditions, and personality. Second, this study is the first to apply threshold regression on twin data to examine the non-linearity effect of birth weight. Overall, there is no evidence to support the argument that the effect is nonlinear on medium-term outcomes. Third, this study is the first to test directly whether birth weight effect operates through interaction with post-birth parental inputs. There is no evidence to support that this mechanism works in within-twins results. / Wong, Man Kit. / Adviser: Junsen Zhang. / Source: Dissertation Abstracts International, Volume: 73-01, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest dissertations and theses, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

本文通过研究自改革开放以来计划生育政策在广东省潮汕地区的执行情况，尝试回答一个理论问题，即在一个威权政体中，是什么因素削弱了国家对社会的控制能力，从而民间形成了对刚性国家政策的有效对抗，导致国家的一些政策指令无法在基层得到落实。上世纪八十年代，计划生育政策作为一项"基本国策"在中国大多数地区都得到了严格的执行，并基本完成预定的政策目标。然而，该政策在潮汕地区却遭遇到极大的阻力，无论是城镇还是农村都出现了普遍的严重的超生现象。 / 作者在对该地区进行了实地调研后，有三个主要发现：第一，随着改革开放政策的实行而迅速复兴的宗族文化对于潮汕地区的生育观念和生育行为的影响非常强烈。"多子多福"，"重男轻女"仍被绝大多数人视为理所应当，"儿孙满堂"更是许多农村人的追求。因此，虽然大部分的干部和群众经过计划生育的宣传都能理解该政策的必要性，但是由于生儿育女事关个人家庭和宗族的"兴衰"，所以明知抵触法规但仍会寻求各种可能的办法偷生。第二，在强大的传统文化作用下，基层政府、干部和群众形成了依赖利益和人情而建立起来的"乡规民约"，县镇村的干部群众都在这种民间自订的非正式制度下默契地规范约束自己的行为并且互动合作，因此上级的政策到了基层就遇到了无形的有弹性的成体系的抵抗，换言之，人们找到了实现"上有政策，下有对策"的软性抗争方式。第三，在这种强大的利益人情网络的软性对抗之下，上级的政府已经失去了对于基层计划生育的控制。一则他们没有足够的资源和能力去落实对下级的监管，二则上级官员自身也处在一定的利益关系网络中。因此，整体而言，市级乃至更上级政府在计生工作中也只能采取折中的策略，最后"容忍"了基层欺上瞒下的行为。因此，作者认为在潮汕地区县级以下的农村基层，依靠影响力极强的宗族文化而形成的"乡规民约"，作为一种软性非正式制度弱化了国家正式的行政体制，形成了一种对计划生育政策不成文的，富有弹性的，自成体系的非暴力抵抗，以及"上有政策，下有对策"的折中局面，使得计划生育政策在这一地区发挥了十分有限的作用。 / This study focuses on "Family Planning Program" ever since the "Opening-up Policy" in Teochew area, Guangdong. By doing so, it aims at answering one theoretical question: within an authoritarian regime, what sorts of factors can impair the state’s control over society, leading to effective resistance against the state’s rigid policies and ineffective implement of those policies at grass-roots level. In the 1980s, the "Family Planning Program", as a fundamental national policy, was strictly implemented in most parts of China, accomplishing its policy goals. However, this policy encountered enormous resistance in Teochew area, Guangdong. "Extra kids" have been widely observed in rural areas. / By carrying out on-site field research, the author has three main findings: / First, clan culture, reviving rapidly after the "Opening-up Policy", has been exerting significant impact over birth concepts and birth behaviors in Teochew area. Such thoughts as "the more sons, the more blessings" and "sons are better than daughters" are taken for granted. Having lots of children and grandchildren is considered the best luck possible. Therefore, even though most cadres and citizens understand very well the necessity of the "Family Planning Program", since having children is a serious matter of family’s and clan’s prosperity, people are striving to have more kids, disregarding the laws and policies. / Second, under the big umbrella of traditional culture, governments at grass-roots level, cadres and masses have formulated so-called "village regulations and folk rules", which are based on mutual interests and relationship, and they behave and cooperate consciously according to these informal institutions. As a result, policies from upper levels have met invisible, flexible and systematic resistance at grass-roots level. In other words, people have found a way to use soft countermeasures to resist rigid institutions. / Third, impacted by these soft resistance, governments from upper levels have lost control over the implementation of family planning at grass-root level. Partially because they do not have enough resource and capability to enforce supervision, partially because they themselves are nested heavily in this interest network. Thus, by and large, governments at prefecture or upper levels can only compromise in family planning related issues, leading to the toleration of grass-roots cheating behaviors. / In sum, the author believes that in rural Teochew area, "village regulations and folk rules", which are based on a strong clan culture, as soft informal institutions, have impaired the state’s formal administrative system, generated unspoken, flexible, systematic and nonviolent resistance against "Family Planning Program", and led to a compromising predicament. Therefore, "Family Planning Program", as a national policy, has generated limited impact in Teochew area. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / 庄棟杰. / Parallel title from added title page. / Thesis (M.Phil.) Chinese University of Hong Kong, 2015. / Includes bibliographical references (leaves 88-91). / Abstracts also in English. / Zhuang Dongjie.

Indiana University-Purdue University Indianapolis (IUPUI) / The Catholic Church is widely known for its opposition to birth control. Yet statistics show that the vast majority of American Catholics use birth control. While multiple studies have been conducted on a larger quantitative scale about the use or attitudes of American Catholics toward birth control, there have not been qualitative studies to understand the experiences of Catholics who use contraception. This study is particularly timely given the recent Catholic opposition to the Affordable Care Act’s mandate of employee healthcare provided birth control as well as, the extraordinary synod of bishops to discuss pastoral challenges to family life in October 2015. Fourteen married Catholic women were interviewed about their religious identities and experiences using contraception. Analysis demonstrated how these women constructed a religious identity by maximizing certain aspects, such as prayer and service, while minimizing other aspects, such as individual autonomy and denominational distinctions, of their religious identity. However in order to cope with the tension between their salient religious identity and their contraceptive decision making women utilizing multiple mechanisms. Specifically, they made boundaries around which types of contraception were acceptable and limits to church or individual authority; they justified their decisions based on medical necessity or betrayal they felt from the church; they legitimated their decisions by discussing God’s control and their husband’s perceptions of NFP; and they normalized their decisions through their desire to care for their children and be sexually intimate with their husbands. This research illuminates unique challenges that religious women face in their sexual decision making and sexual health practices that can help sex educators and health care providers care for women. Additionally, the Catholic Church and American Catholics make up huge forces in education, health care, charity, politics, and employment. However, not all Catholics follow the rules of the church. Those members who remain an active part of the Catholic Church, such as the practicing Catholics in this study can influence the way the church changes. By better understanding the experience of these dissenters, social researchers may be able to better understand the future of the Catholic Church.

Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)