Intergenerational Economics: Marianne Page

By Griselda Jarquin – How do we end the cycle of poverty in the United States? How can children’s health and nutrition services reduce destitution among minors? What are the long-term benefits of safety net programs? On the eve of her Bacon Public Lectureship at UC Center Sacramento, Professor of Economics Marianne Page explains.

Page’s research focuses on inequality and intergenerational mobility—how families, the economy, and social policies affect children’s likelihood of achieving economic success in adulthood. Working with the Center for Poverty Research prompted Page to consider “the extent to which safety net programs can break the cycle of poverty that transmits across generations.”

The interdisciplinary environment of Center for Poverty Research inspired Page to consider outcomes not traditionally measured by economists “When you think about economic disadvantage in the context of broader disciplines, you realize how other factors, like health or socio-emotional skills, which track one’s ability to succeed but may not be picked up by a test score, are really important to understanding larger economic processes.”

Page’s paper “The Intergenerational Transmission of Poverty and the Long Reach of Child Health and Nutrition Programs” examines the long-term impacts of social safety net programs, particularly those such as Medicaid that provide disadvantaged children with health and nutrition services.

Poor children are more likely than other children to be unhealthy. They are also more likely to enter adulthood having missed more days of school, with worse health and a greater susceptibility to chronic diseases. “Inferior health may in turn compromise low-income children’s chances for future economic success,” says Page. 

Quasi-experimental methods 

Her research builds upon the groundbreaking work of James J. Heckman. Heckman showed that the quality of the environment in which early childhood development takes place heavily influences health, economic, and social outcomes for individuals and society at large. More specifically, Page’s paper contributes to an emerging area of research that examines health and nutrition programs targeting low-income children and families in the United States—programs such as Medicaid; the Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program); the Supplemental Nutrition Program for Women, Infants and Children (WIC); National School Lunch Program (NSLP); and the School Breakfast Program (SBP).

Unlike most studies, which make deductions based on correlational studies, Page’s research pays attention to the careful establishment of causal relationships. Her quasi-experimental methods strive to emulate experimental settings by comparing outcomes among otherwise-similar individuals whose exposure to a program varies. Such variation is attributable to: differences in the timing of a program’s implementation or structure; geographic variation in determinants of program eligibility; or rules that create differential access among otherwise-similar individuals.

This method allows researchers to differentiate between true program effects and effects related to other family background characteristics. That differentiation is crucial to evaluating whether or not a program generates meaningful changes in its recipients’ lives.

Crucial levers

Page’s conclusion is emphatic. “Providing children with these basic health and nutrition services makes a significant difference in their long-term well-being, whether that is measured by later life earnings or health.” Furthermore, “from a policy perspective, the magnitudes of these effects are substantive.”

Still, not all policymakers believe the high costs incurred by these programs are worth sustaining. But Page insists that current cost-benefit analysis does not adequately consider the full range of benefits that these programs may generate. 

For example, early childhood investments are likely to reduce future health expenditures. They may also “translate into improved earnings potential, which could reduce welfare participation and increase tax revenues.” Although these studies demonstrate that nutrition and health programs “increase educational attainment, adult health, earnings and overall self- sufficiency,” Page goes one step further, demonstrating that they “are crucial levers towards reducing the intergenerational transmission of poverty.”

From one generation to the next

“The Intergenerational Transmission of Poverty and the Long Reach of Child Health and Nutrition Programs” also provides early results from an investigation of the multigenerational effects of the Medicaid program.

These programs make a meaningful and economically substantive difference in children’s lives. 


Page uses data on infant health outcomes from the 1996-2013 U.S. Vital Statistics Natality files, which contain information on a variety of markers of health at birth for every person born in the United States, as well as information about the infant’s mother. She then examines differences across states “in the timing and generosity of Medicaid expansions to create treatment and control groups who had differential access to Medicaid.” She also analyzes differences within the state as eligibility rules have changed over time.

All of which allows Page to examine Medicaid’s wide-ranging impact. Her preliminary findings suggest that the “positive impacts of the Medicaid program may extend even further than previously realized by spilling over onto the next generation’s health.”

Towards evidence-based policymaking

What makes Page’s work innovative is her acknowledgement that there may be complex biological and economic mechanisms generating these spillovers. She points to studies in both economics and biology suggesting that the effects of individual’s early life health environments may endure to the next generation. Biological literature, she explains, provides an accumulation of evidence, based on animal experiments, suggesting that the prenatal and early life health environment has trans-generational effects. “We know that in utero, even in the prenatal period, the fetus’ development is setting up its later reproductive system.”

She also points to various economic findings that access to public health and nutrition programs during childhood may break the cycle of poverty through their effect on the first generation’s economic wellbeing. The benefits of these economic improvements may then transmit to the next generation. She insists that “these programs make a meaningful and economically substantive difference in children’s lives.” As such, policy should be developed based on evidence-based studies. 

Ongoing commitment

And yet public health and nutrition programs have recently come under attack. Recent discussions highlight the high costs associated with such programs, or focus on individuals who abuse the system. Acknowledging that some abuse is inevitable, Page insists that poor children are not disadvantaged because of their own behavior or bad choices. She hopes that her research encourages people to see nutrition and health programs as important tools in the fight to break the cycle of poverty. 

Page’s commitment to documenting the long-term benefits of social policies—particularly those aimed at kids—is ongoing. “I have multiple early-stage projects on the multigenerational effects of safety net programs,” she says. She is also beginning a project that parallels her research on Medicaid, using related methods to analyze SNAP and the multi-generational linkages it generates.

Marianne Page is Deputy Director of the Center for Poverty Research. Her recent research received funding from UC Davis Interdisciplinary Frontiers in the Humanities and Arts, the Center for Poverty Research, and the National Science Foundation.

Professor Page will present the Bacon Public Lectureship at UC Center Sacramento at noon on Wednesday, March 1, 2017.