Why Did Reproductive Health Improve in Washington DC in the 1990s? The Role of Demographic and Socioeconomic Changes

Sanders Korenman, City University of New York at Baruch
Danielle H. Ferry, National Bureau of Economic Research

Washington DC experienced astounding improvements in reproductive health in the 1990s: the infant mortality dropped by one half; mean birth weight climbed 73 grams; LBW fell by 30 percent, VLBW fell by one third; the proportion preterm fell by one quarter; and the proportion full-term, low weight fell by 30 percent. The prevalence of socio-demographic risk-factors such as unwed and teen motherhood also declined. Results indicate that changes in marital status and age account for none of the improvements in reproductive health. Improvement in health was restricted to black mothers and infants, yet there was little trend in marital status among blacks. Changes in the maternal age distribution had, if anything, an adverse impact on maternal and infant health in the district because, among DC blacks, rates of (e.g.) LBW rise with age. Increased education improved health, and a 50% decline in black births boosted “compositionally” DC reproductive health indicators.