The Demand for Health Inputs and Their Impact on the Black Neonatal Mortality Rate in the U.S.
Theodore J. Joyce
Relatively high birth rates among black adolescents and
unmarried women as well as inadequate access to medical care are
considered primary reasons why the black neonatal mortality rate
is almost double that of whites. Using household production
theory, this paper examines the determinants of input utilization
and estimates the impact of utilization on the survival of black
infants across large counties in the U.S. in 1977. The results
indicate that expanding the availability of family planning
clinics increases the number of teenagers served resulting in a
lower neonatal mortality rate. Accessibility to abortion services
operates in a similar manner. Moreover, the use of neonatal
intensive care, which is strongly related to its availability, is
an important determinant of newborn survivability whereas the
initiation of early prenatal care is not. Overall, the results
suggest that lowering the incidence of low weight and preterm
births among blacks by helping women to avoid an unwanted birth,
may be the moat cost-effective way of improving black infant
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