Land reform and health endowments at birth

Abstract

This study examines the impact of China's Household Responsibility System (HRS) reform—a significant land reform that boosted labor productivity in rural areas—on birth outcomes. Leveraging the staggered rollout of the reform across counties and data from the earliest available fertility surveys in China, we provide evidence that prenatal exposure to the reform leads to an average increase in birth weight of about 55 grams. Further analyses suggest that this improvement is most likely driven by better nutrition during gestation, rather than improved access to prenatal health care or an increase in selective births. Moreover, this effect is more pronounced in areas where women have a comparative advantage in agricultural production, underscoring the critical role of women's economic standing in shaping child health outcomes.