Romina Tomé

Research Papers

Happier Hours? The Impact of Closing Bars Earlier on Fetal Health*

(Job Market Paper)

Alcohol-related policies have the potential to address not only medical consequences of substance abuse but also related negative behaviors, including driving under the influence, violent conduct, and risky sexual decisions. Such policies may, therefore, influence the social and intra-household environments surrounding pregnant women and children in their wombs. However, little is known about the broader consequences of alcohol-related policies on this portion of the population. This paper helps to fill that gap by analyzing the staggered adoption of laws that restrict the hours of operation of bars and restaurants in a major metropolitan area in Brazil. Capitalizing on confidential vital registration data, I account for selective fertility and migration to assess morbidity, exploiting within-family variation in prenatal exposure to the laws. My fixed-effects difference-in-differences estimates show that reducing alcohol trading hours increases the probability of having a male child and does not have a statistically significant impact on the incidence of low birth weight and preterm birth. Taken together, these results are compatible with a reduction in fetal deaths. Consistent with this hypothesis, I show that the laws caused increased survival rates of less healthy male fetuses, which helps to explain the null effects on birth outcomes. Results are shown robust to the choice of specification regarding seasonality and time effects. I provide extensive auxiliary evidence detailing potential mechanisms behind my main results.

*An earlier version of this paper has been circulated under the title "Curtailing Access to Alcohol: Evidence on the Impact over Infant Health in Brazil.'"

Blog coverage: World Bank

Health and the City: Urban Congestion and Air Pollution in Brazil

Congestion of urbanized centers is a trademark accompanies of economic development across the globe. These economic forces pose a challenge with respect to environmental conditions and, therefore, welfare for populations in those areas. Nevertheless, the evidence to inform policy-makers in the developing world is still scarce. In this paper, we take advantage of the meteorological phenomenon of thermal inversion which in urban areas arguably exogenously lock pollutants closer to the ground to estimate the causal effects on pollution on infant health at birth. We employ detailed data from birth records around the metropolitan area of São Paulo, Brazil, between 2002 and 2009. Our preliminary results confirm a positive relationship between thermal inversions and several air pollutants and suggest that exposure during the last three months of pregnancy to thermal inversions has a negative effect on health at birth. Specifically, a 1 SD in the number of thermal inversions per week leads to a decrease in birth weight by 14 grans, an increase of 7 percent in the incidence of low birth weight (less than 2,500 grams), and a raise of 12 percent in the incidence of very low birth weight (less than 1,500 grams). These effects on birth weight are partly explained by a reduction in gestational length.

Heightened immigration enforcement impacts U.S. citizens' birth outcomes

with Marcos A. Rangel, Christina Gibson-Davis, and Laura Bellows

We examine how increased Immigration and Customs Enforcement (ICE) activities im- pact the health of pregnant mothers and their infants in North Carolina around the time Section 287(g) of the Immigration and Nationality Act was first being implemented in the state. Fo- cusing on administrative data between 2001 and 2006, we conduct difference-in-differences and triple-differences case-control regression analysis. Pregnancies are classified by levels of potential exposure to immigration enforcement depending on parental country of birth and reported maternal education level. Contrast groups are foreign-born parents residing in non- adopting counties and all U.S.-born non-Hispanics. We find that the introduction of the policy increased the incidence of low birth-weight babies by 3.5 percentage points (p-value<0.001) six to eight months after policy implementation with intra-uterine growth effects also mani- festing themselves within the first three months of the new regime. These results coexist with a worsening in the timing of initiation and frequency of pre-natal care received. Overall qual-ty of care received goes down accordingly (10.6 p.p., p-value<0.001). Our findings inform policies that address disadvantages generated before birth and quantify the impact of policies targeting unauthorized populations over their U.S. born children.

Work in progress

"Replacement Income During Family Leave and Women’s Labor Market Outcomes"

with Aleksandra Holod, Krishna Winfrey, Sami Kitmitto, and Erica Gunderson

"The Hidden Consequences of Soccer Games: Violence and Children's Outcomes in Brazil”

“Prenatal Care, Birth and Educational Outcomes: evidence from a Brazilian megacity”


How is childcare measured? A Toolkit. Inter-American Development Bank - Book (2016)

with Florencia Lopez Boo and Maria Caridad Araujo

Los primeros años de vida de los niños peruanos. Una fotografía sobre el bienestar y el desarrollo

de los niños del Programa Nacional Cuna Más. Inter-American Development Bank Technical Note (2016)

with Marta Rubio-Codina and Maria Caridad Araujo


The quality of the Centros Infantiles del Buen Vivir in Ecuador. Inter-American Development Bank Policy Brief (2015)

with Maria Caridad Araujo, Florencia Lopez Boo, Rafael Novella, and Sara Schodt