Report on impact of early-life policies and interventions based on dynamic microsimulation models. Do specific fiscal policies reduce preterm births and childhood obesity? A study based on microsimulations and scenario evaluations
Task 10.2 aimed at implementing dynamic microsimulation models for scenario analyses on policy and intervention strategies focused on optimizing early-life stressors. In particular we decided to develop a microsimulation model for investigating the prospective effects of poverty alleviation fiscal policies on child health outcomes, simulating the effects of alternative fiscal policies on household income and forecast the impact of these income increases at the time of childbirth on child health. The microsimulation model, named Microsimulation for Income and Child Health (MICH), has been develop using Italy as the setting of interest and using childhood overweight and obesity as the outcome of interest. MICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the countryspecific EU-SILC data (for this study Italy EUSILC 2010 data). We considered four different fiscal policies to be compared with the baseline scenario (actual fiscal system of the country analysed): Basic Income, Poverty Reduction, New-born Benefit and Child Benefit. Secondly, module 2 (M2) exploits EU Child Cohort Network data and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages (for this study we used the data of the Italian NINFEA birth cohort). Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios. Our results show that fiscal policies, especially the focalised interventions, can have a strong impact on childhood health conditions. The MICH model, exploiting the cross-country comparative nature of EUROMOD and the comparability of birth cohort data member of the EU Child Cohort Network, can be applied to different settings both in term of populations and of the outcome of interest. The MICH model constitutes a useful tool to provide evidence of how fiscal policies could affect health outcomes in the population and thus could be used in fiscal and health policy-making.
