Cash Payments and Infant Health: A Natural Experiment

Project Summary

The project team is investigating whether cash transfers can prevent infant deaths in the first year of life, reduce maternal morbidities, and promote racial and ethnic equity. In order to provide evidence of the effects of cash support on infant health, the team will evaluate the effects of the 2021 American Rescue Plan (ARP)’s version of the Child Tax Credit (CTC), which provided significant cash transfers to all families earning less than $400,000 with documented children. 

Research Question(s)

  1. Are children whose parents receive an additional $5,000 lump-sum payment during their first months of life less likely to die before their first birthday relative to similar children who did not receive such a payment? 
  2. Do monthly cash transfers to parents during pregnancy improve children’s health at birth, relative to children whose families did not receive monthly cash transfers because the child was not yet born and there were no older, qualifying siblings?


  • Share rigorous research on the impacts of the child tax credit and cash assistance with individuals in social science, social work, public health, advocacy organizations, and legislative staff in local, state, and federal government to drive policy change.

Racial Equity Implications

Black individuals and those of Indigenous descent bear the unjust burden of our country’s high infant mortality rate. Like their infants, Black birthing people die at more than double the rate of their white counterparts, while Indigenous birthing people face substantially elevated risks of severe birth-related morbidity and mortality. Systemic racism and implicit bias lead to a disproportionate lack of financial security for BlPOC families and represent an important pathway to racial disparities in survival rates for infants and birthing people. Beyond pushing non-white households towards the bottom of the income and wealth distributions, systemic racism and implicit bias also permeate the political structures that could otherwise mitigate the health consequences of economic disadvantage. 


Health and wellbeing: infant mortality, adverse birth outcomes including low birthweight (<2,500g), small for gestational age (<10th pctl. weight-for-age), preterm birth (<37 weeks), congenital anomalies, and health outcomes for birthing people, including gestational diabetes and preeclampsia.


The project team will conduct this analysis using birth records from the U.S. National Vital Statistics System (NVSS), which allows results to be fully generalizable to the U.S. population. However, the team will not need to generalize groups such as Indigenous and Asian populations because the analyses can be conducted separately for population subgroups by socio-economic status and race. The team will begin with a Regression Discontinuity design to evaluate the effects of cash receipt after birth by comparing outcomes of first-born children born in November-December 2021 to those born in January-February 2022. Then, to evaluate the effects of payments received in utero, first-born children will be compared to higher-order children born in January-February 2022 to assess birth outcomes for higher-order versus first-borns relative to comparable groups of children born in the same period in 2021 using a difference-in-differences design. Linked birth-infant mortality data will allow for analysis of death through the first year of life.

Close up of Black infant holding a Black person's thumb
Grantee and Partner organizations

University of California, Los Angeles
Columbia University 
Morehouse School of Medicine
University of Wisconsin-Madison
Room to Grow

Grant status
In Progress
Principal investigators
Naomi Zewde, PhD
Start date
Award amount
24 months

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