Abortion and mental health: The role of selection

Janys, L.; and Siflinger, B.;

Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York

Abstract: Mental health consequences of abortions have recently been the subject of public discussions surrounding abortion legislation in several countries. Yet, it is unclear whether the positive association commonly found in the literature reflects a causal effect or whether the main driver is selection. Using administrative records from both in- and outpatient data among a population of Swedish women aged 16-35 in the region of Skane, we illustrate that there are substantial differences in the rate of diagnoses of mental health disorders and risky health behavior between women who experienced an abortion and those who did not. We show that there is a positive association between abortion and different mental health outcomes (as diagnosed by a medical provider), even when including various controls and individual fixed effects. To examine possible causality, we then use quasi-experimental control group- and event study methods and find no causal effect of abortion. We interpret the remaining association from the OLS specification as a selection effect and consequently are interested in characterizing what drives observed differences in mental health status between women with and without abortions. Recognizing that even small differences in innate mental health might drive risky health behaviors leading to abortions, we hypothesize that earlier abortions indicate different future mental health profiles. Our preliminary results suggest that there are slope differences depending on the age of abortion for future mental health curves. To formalize this notion we are planning on implementing an estimator using group-fixed effects first proposed by Bonhomme and Manresa (2015).

Date: 2019-07
New Economics Papers: this item is included in nep-hea
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