The demand for health inputs and their impact on the black neonatal mortality rate in the U.S.

Relatively high birth rates among black adolescents and unmarried women as well as inadequate access to medical care are considered primary reasons why the black neonatal mortality rate is almost double that of whites. Using household production theory, this paper examines the determinants of input utilization and estimates the impact of utilization on the survival of black infants across large counties in the U.S. in 1977. The results indicate that expanding the availability of family planning clinics increases the number of teenagers served resulting in a lower neonatal mortality rate. Accessibility to abortion services operates in a similar manner. Moreover, the use of neonatal intensive care, which is strongly related to its availability, is an important determinant of newborn survivability whereas the initiation of early prenatal care is not. Overall, the results suggest that lowering the incidence of low-weight and preterm births among blacks by helping women to avoid an unwanted birth, may be the most cost-effective way of improving black infant health.