Mothers and others: who invests in children's health?

We estimate the impact of family structure on investments made in children's health, using data from the 1988 National Health Interview Survey Child Health Supplement. Controlling for household size, income and characteristics, we find that children living with step-mothers are significantly less likely to have routine doctor and dentist visits, or to have a place for usual medical care, or for sick care. Who invests in children's health? It appears these investments are made, largely, by a child's mother, and that step-mothers are not substitutes for birth-mothers in this domain.