The impact of alcohol bans on birth weight in South Africa
1
Department of Economics, Stellenbosch University, Stellenbosch, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2260
ABSTRACT
ABSTRACT:
Alcohol consumption remains a significant global challenge, contributing to 2.6 million deaths in 2019 and causing negative externalities, including accidental trauma, violent crimes, and health risks. While considerable research has focused on alcohol control policies' impact on adult health outcomes, there is limited evidence of their effects on neonatal health, despite the long-term implications on future well-being and socioeconomic success. This study addresses this gap by investigating the impact of alcohol restrictions on birth weight in South Africa. We leverage the sudden nationwide alcohol ban implemented from 27 March 2020 to 31 May 2020 in response to COVID-19. The universal ban on alcohol sales and transportation, enforced with strict intensity, provides a natural experiment to estimate causal impacts on neonatal health. We use birth records from 2017 to 2024 of women and children participating in the Building Healthier Communities study in the Western Cape, South Africa. We compare birth weight outcomes of neonates born to mothers who experienced the alcohol ban during pregnancy with those of neonates unexposed to the ban. By natural design, there is no selection into pregnancy during the ban, allowing us to estimate causal impacts using Ordinary Least Squares regressions. We find that intrauterine exposure to the alcohol ban significantly improved birth weight. Specifically, exposure in the first trimester increased birth weight by 0.229 kilograms. Heterogeneity analysis of a second ban implemented six weeks later indicates persistent effects through the second trimester, increasing birth weight by 0.252 kilograms. The substantial impact reflects the Western Cape's status as having the world's highest Fetal Alcohol Spectrum Disorders prevalence. These findings suggest interventions reducing alcohol consumption can improve neonatal health outcomes. Considering the long-term effects on human capital outcomes, including education, productivity, and earnings, these results underscore broader societal benefits of strict alcohol policies and their potential intergenerational benefits.
Alcohol consumption remains a significant global challenge, contributing to 2.6 million deaths in 2019 and causing negative externalities, including accidental trauma, violent crimes, and health risks. While considerable research has focused on alcohol control policies' impact on adult health outcomes, there is limited evidence of their effects on neonatal health, despite the long-term implications on future well-being and socioeconomic success. This study addresses this gap by investigating the impact of alcohol restrictions on birth weight in South Africa. We leverage the sudden nationwide alcohol ban implemented from 27 March 2020 to 31 May 2020 in response to COVID-19. The universal ban on alcohol sales and transportation, enforced with strict intensity, provides a natural experiment to estimate causal impacts on neonatal health. We use birth records from 2017 to 2024 of women and children participating in the Building Healthier Communities study in the Western Cape, South Africa. We compare birth weight outcomes of neonates born to mothers who experienced the alcohol ban during pregnancy with those of neonates unexposed to the ban. By natural design, there is no selection into pregnancy during the ban, allowing us to estimate causal impacts using Ordinary Least Squares regressions. We find that intrauterine exposure to the alcohol ban significantly improved birth weight. Specifically, exposure in the first trimester increased birth weight by 0.229 kilograms. Heterogeneity analysis of a second ban implemented six weeks later indicates persistent effects through the second trimester, increasing birth weight by 0.252 kilograms. The substantial impact reflects the Western Cape's status as having the world's highest Fetal Alcohol Spectrum Disorders prevalence. These findings suggest interventions reducing alcohol consumption can improve neonatal health outcomes. Considering the long-term effects on human capital outcomes, including education, productivity, and earnings, these results underscore broader societal benefits of strict alcohol policies and their potential intergenerational benefits.
| eISSN: | 2654-1459 |
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