Project Summary
The project team is leveraging unique U.S. Department of Defense (DoD) policies and the DoD’s robust administrative records to examine whether parental support policies, such as maternity and paternity leave and subsidized childcare improve parents’ health outcomes. To study whether these policies can improve parental health, the team is taking advantage of changes to DoD parental supports available to active duty parents. For parents, access to maternity and paternity leave changed at different times, while childcare access depended on location, allowing researchers to interact these policies with one another to estimate if any benefits are multiplicative – or if they offset each other.
Research Question(s)
- Do parental leave and subsidized childcare support parent health immediately post-birth and do such policies speed up parents’ recovery back to their original health?
Actionability
- Contribute to state and federal debates about whether and how supporting working families by providing information about parental benefits, if any, from paid family and/or subsidized childcare.
Outcomes
Inpatient & outpatient medical care*,PDE
Evaluates whether illness and medical care needs change based on health care records for all inpatient and outpatient visits to military health facilities or paid for by military health insurance (TRICARE). Using ICD-9 codes and following prior research (17), we create indicator variables for any visits to inpatient or outpatient care; conditions related to pregnancy, childbirth, and the puerperium period (mothers only); mental disorders; and factors influencing health status and contact with health services.
Substance usePDE
Evaluates whether alcohol and tobacco use changes. Army and Navy members are screened annually in their birth month to assess individual medical needs. Annual screenings include questions about frequency of substance use
Mental healthPDE
Evaluates whether emotional stability and psychiatric diseases (e.g., depression) change. Annual Army/Navy health screenings include questions about feelings of depression, numbness, tiredness, and other indicators of mental condition. Combining several indicators generates a "psychiatric score” that captures the mental health of service members. Along with five other health performance domains, scores generate a factor that determines job eligibility based on health.
Basic physical healthPDE
Evaluates whether Body Mass Index or blood pressure change. Weight and blood pressure are measured at annual Army/Navy health screenings and twice-annual Army/Navy/Marine Corps physical fitness assessments.
Physical abilityPDE, TFDW
Evaluates physical health from standardized health performance (run times, upper body strength, core strength) measured from twice-annual physical health assessments for the Army/Navy/Marine Corps.
Job limitsTFDW
Evaluates whether a service member had limited duty for health reasons.
* indicates primary outcome. PDE=Data from the Person-Event Data Environment for the Army/Navy. TFDW= Data from the Total Force Data Warehouse for the Marines
Methodology
The researchers are using a comparative interrupted time series, assessing inpatient and outpatient medical care received, substance use, and mental/physical health for first-time parents and non-parents over time before and after the childbirth event. To control for differences between parents and non-parents, machine learning techniques will be used to create a set of matched control individuals who are similar to new parents.
Naval Postgraduate School
Northwestern University