Revealed comparative disadvantage of infants: Exposure to NAFTA and birth outcomes

Abstract

This paper investigates the relationship between regional exposure to trade liberalization under the North American Free Trade Agreement (NAFTA) and infant health outcomes in the U.S., focusing on differences in impact across areas with varying levels of import competition. I explore this question by implementing event studies and difference-in-difference regressions that compare birth outcomes of infants born in different years relative to NAFTA and localities with differential exposure to import competition. Using more than 88 M birth records of Natality data, I find significant negative effects on a wide range of birth outcomes. The adverse effects are much larger for infants at the lower tails of birth weight and gestational age distribution. Additional analyses using a wide range of alternative data sources suggest several potential pathways, including reductions in income-employment, decreases in housing wealth, lower health care utilization, lower health insurance use, and lower-quality health insurance.