CAREER: Family Behavior, Health Technologies, and Government Policy: Research and Training

Assisted reproductive technologies (ARTs) are transforming couples' ability to conceive, and prenatal screening technologies allow parents to gain precise information about fetal health during pregnancy. These technologies have the potential to fundamentally alter family structure and family wellbeing. However, because these technologies are expensive, their arrival may introduce new health inequities, which underscores the role of public policies that regulate their accessibility and affordability.

Understanding the consequences of ARTs and prenatal screening technologies for family decisions, family outcomes, and inequality is essential for informing public fertility-related policies, and thereby advancing national health, prosperity, and welfare. This CAREER research program combines population-wide administrative data, with uniquely detailed information on individual-level use of these technologies, and experimental and theoretical research methods to better understand their effects on families.

The research project will study how ARTs and prenatal screening technologies affect family reproductive decisions, as well as whether these technologies affect inequalities across families. This proposal's education plan focuses on training students in how to access and use big administrative data for research - knowledge that is often passed through personal connections - to help level the playing field in the profession for the next generation of researchers.

The results of this research project will have major influence on the conduct of public fertility policy, and health care policy generally. The results could help improve the health of Americans as well as help establish the US a global leader in reproductive health care policy.

This CAREER research project has four components. The first project is motivated by sharp differences in utilization of assisted reproductive technologies (ARTs) across socioeconomic groups. It exploits age thresholds in public health insurance coverage of ARTs to investigate the role of affordability in driving this inequality; further, it examines the long-run consequences of ARTs uptake on the health and well-being of women who use them and their families.

The second project will study the arrival of a new and superior - but expensive - screening technology for identifying chromosomal abnormalities. It will combine reduced-form evidence leveraging insurance eligibility thresholds with a theoretical model of parents' prenatal testing decisions to examine the implications of the superior technology on parents' testing choices, birth outcomes, and measures of aggregate population health.

The third project focuses on a particular type of ARTs, In Vitro Fertilization (IVF). The project is based on the observation that IVF with donated gametes (sperm and oocytes) decouples a baby's environment in utero from the baby's genetic material. Using data containing information about IVF children born with donated gametes, this project will bring novel evidence to the debate on the importance of "nature" versus "nurture" in the association between parents' socioeconomic standing and children's health.

The fourth component is a mentoring workshop that aims to reduce inequality among students in access to information about the use of large-scale administrative data in research. The results could help improve the health of Americans as well as help establish the US a global leader in reproductive health care policy.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.