Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

Gabriel Picone, Ph.D.

Committee Member

Bradley Kamp, Ph.D.

Committee Member

Troy Quast, Ph.D.

Committee Member

Xin Jin, Ph.D.


early-life health, birth outcomes, antimalarial interventions, medical marijuana laws


Over the past two decades, a growing body of literature within health economics has provided evidence of the impact of fetal conditions on individual’s health and economic outcomes over the entire life course. This dissertation contributes to the field of health economics by investigating the effects of two distinct types of public policies, antimalarial interventions in sub-Saharan Africa and medical marijuana laws in the United States, on early-life health.

Chapter 1 adds to the increased understanding of the impact of in utero exposure to large-scale interventions to combat endemic diseases by examining the effects of antimalarial interventions aimed at preventing and controlling malaria in pregnancy on birth outcomes. Since the year 2000, a coordinated international effort against malaria has led to a significant scale-up of intervention coverage across sub-Saharan Africa. One of the objectives of this undertaking was to improve maternal and early-life health. This chapter investigates the effect of access to malaria prevention and control measures, including insecticide-treated nets, intermittent preventive treatment in pregnancy, indoor residual spraying, and artemisinin-based combination therapy, on birth weight. I exploit the geographic and time variation in the rollout of antimalarial interventions in sub-Saharan Africa across regions with different levels of initial malaria prevalence to analyze 277,245 live births in 22 countries from 2000 to 2013 in a continuous difference-in-differences estimation framework and find that the diffusion of intermittent preventive treatment among pregnant women contributed to the reduction of low birth weight incidence in sub-Saharan Africa. I do not find other antimalarial interventions to be associated with significant improvements in birth outcomes.

Chapter 2 provides an investigation focused on examining the impact of medical marijuana laws in the United States on birth outcomes. As of June 2017, medical marijuana laws which liberalize the cultivation, possession, and use of cannabis for allowable medical purposes have been adopted by 29 states and the District of Columbia. The expansion of state-level legislation allowing for medical marijuana use has fueled an ongoing debate regarding drug policy. Despite a growing interest in investigating and quantifying both direct and indirect effects of marijuana liberalization policies, little is known about how they affect early-life health. Using data on the entire universe of births in the U.S. between 1990 and 2013 and a difference-in-differences research design, I find no evidence to support the hypothesis that medical marijuana laws have a negative impact on birth weight and gestation, however I also find that medical marijuana laws are associated with reductions in Apgar scores.

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Economics Commons