Search

An analysis of child height-for-age using the newly released data from the National Family Health Survey-4 indicates that the average child height increased by about four-tenths of a height-for-age standard deviation between 2005 and 2015. Although important, this increase is small relative to India's overall height deficit, and relative to economic progress; children in India remain among the shortest in the world. It is unsurprising that the increase in height-for-age has been modest because none of the principal factors responsible for India's poor child height outcomes have substantially improved over the last decade. Familiar patterns of regional, sex, and caste disadvantage are reflected in child height in 2015.

Anaemia impairs physical and cognitive development in children and reduces human capital accumulation. The prior economics literature has focused on the role of inadequate nutrition in causing anaemia. This article is the first to show that sanitation, a public good, significantly contributes to preventing anaemia. We identify effects by exploiting rapid and differential improvement in sanitation across regions of Nepal between 2006 and 2011. Within regions over time, cohorts of children exposed to better community sanitation developed higher haemoglobin levels. Our results highlight a previously undocumented externality of open defaecation, which is today practiced by over a billion people worldwide.

In this paper, we shed new light on a long-standing puzzle: in India, Muslim children are substantially more likely than Hindu children to survive to their first birthday, even though Indian Muslims have lower wealth, consumption, educational attainment, and access to state services. Contrary to the prior literature, we show that the observed mortality advantage accrues not to Muslim households themselves but rather to their neighbors, who are also likely to be Muslim. Investigating mechanisms, we provide a collage of evidence suggesting externalities due to poor sanitation are a channel linking the religious composition of neighborhoods to infant mortality.

A large literature considers the optimal size and growth rate of the human population, trading off the utility value of additional people with the costs of a larger population. In this literature, an important parameter is the social weight placed on population size; a standard result is that a planner with a larger weight on population chooses larger population levels and growth rates. We demonstrate that this result is conditionally overturned when an exhaustible resource constraint is introduced: if the discount rate is small enough, the optimal population today decreases with the welfare weight on population size. That is, a more total-utilitarian social planner could prefer a smaller population today than a more average-utilitarian social planner. We also present a numerical illustration applied to the case of climate change, where we show that under plausible real-world parameter values, our result matters for the direction and magnitude of optimal population policy., Competing Interests: The authors declare that they have no conflict of interest.

India's experience presents a puzzle at odds with a basic fact of household economics: amidst unprecedented economic growth, average per capita daily calorie consumption has declined in recent decades. Does an improving disease environment explain the calorie decline? A diminished burden of infectious disease could lower energy needs by increasing absorption and effective use of calories. We document a robust effect of disease exposure - measured as infant mortality and as poor sanitation - on calorie consumption. Similar effects are found using multiple datasets and empirical strategies. Disease can account for an important fraction (one-fifth or more) of India's calorie decline., (© 2016 The Authors.)

Coal power generation is expanding rapidly in India and other developing countries. In addition to consequences for climate change, present-day health externalities may also substantially increase the social cost of coal. Health consequences of air pollution have proven important in studies of developed countries, but, despite clear importance, similarly well-identified estimates are less available for developing countries, and no estimates exist for the important case of coal in India. We exploit panel data on Indian households, matched to local changes in exposure to coal plants. Increased exposure to coal plants is associated with worse respiratory health. Consistent with a causal mechanism, the effect is specific: no effect is seen on diarrhea or fever, and no effect on respiratory health is seen of new non-coal plants. Our result is not due to endogenous avoidance behavior, or to differential trends in determinants of respiratory health, either before the period studied or simultaneously.

Open defecation, which is still practiced by about a billion people worldwide, is one of the most compelling examples of how place influences health in developing countries. Efforts by governments and development organizations to address the world's remaining open defecation would be greatly supported by a better understanding of why some people adopt latrines and others do not. We analyze the 2005 and 2012 rounds of the India Human Development Survey (IHDS), a nationally representative panel of households in India, the country which is home to 60% of the people worldwide who defecate in the open. Among rural households that defecated in the open in 2005, we investigate what baseline properties and what changes over time are associated with switching to latrine use between 2005 and 2012. We find that households that are richer or better educated, that have certain demographic properties, or that improved their homes over this period were more likely to switch to using a latrine or toilet. However, each of these effect sizes is small; overall switching to latrine use from open defecation is low; and no ready household-level mechanisms are available for sanitation programs to widely influence these factors. Our research adds to a growing consensus in the literature that the social context should not be overlooked when trying to understand and bring about change in sanitation behavior., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Is a larger population of people living good lives a better population, all else equal? This question is central to population issues in social welfare, ethics, and policy. Many answers in the philosophical literature argue that if a policy choice results in the birth of additional people living good lives, these extra lives are irrelevant to any evaluation of the policy. This paper applies the questionnaire-experimental method of empirical studies of social choice to investigate participants' policy choices and social orderings with respect to population size and average well-being. In general, heterogeneous responses depended on the quantitative and qualitative properties of the question. In particular, an experimentally manipulated increase in population size caused an option to be more likely to be selected, on average. Overall, responses suggest that population size is not neutral to social welfare. Many participants, although not all, reported that a larger population of people living good lives could be strictly preferable, at small or no costs to average well-being.

India has far higher open defecation rates than other developing regions where people are poorer, literacy rates are lower, and water is relatively more scarce. In practice, government programmes in rural India have paid little attention in understanding why so many rural Indians defecate in the open rather than use affordable pit latrines. Drawing on new data, a study points out that widespread open defecation in rural India is on account of beliefs, values, and norms about purity, pollution, caste, and untouchability that cause people to reject affordable latrines. Future rural sanitation programmes must address villagers' ideas about pollution, pit-emptying, and untouchability, and should do so in ways that accelerate progress towards social equality for Dalits rather than delay it.

Child height is an important indicator of human capital and human development, in large part because early life health and net nutrition shape both child height and adult economic productivity and health. Between 2005 and 2010, the average height of children under 5 in Cambodia significantly increased. What contributed to this improvement? Recent evidence suggests that exposure to poor sanitation - and specifically to widespread open defecation - can pose a critical threat to child growth. We closely analyze the sanitation height gradient in Cambodia in these two years. Decomposition analysis, in the spirit of Blinder-Oaxaca, suggests that the reduction in children's exposure to open defecation can statistically account for much or all of the increase in average child height between 2005 and 2010. In particular, we see evidence of externalities, indicating an important role for public policy: it is the sanitation behavior of a child's neighbors that matters more for child height rather than the household's sanitation behavior by itself. Moving from an area in which 100% of households defecate in the open to an area in which no households defecate in the open is associated with an average increase in height-for-age z-score of between 0.3 and 0.5. Our estimates are quantitatively robust and comparable with other estimates in the literature., (Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.)

Over a billion people worldwide defecate in the open, with important consequences for early-life health and human capital accumulation in developing countries. We report a cluster randomized controlled trial of a village sanitation intervention conducted in rural Maharashtra, India designed to identify an effect of village sanitation on average child height, an outcome of increasing importance to economists. We find an effect of approximately 0.3 height-for-age standard deviations, which is consistent with observations and hypotheses in economic and health literatures. We further exploit details of the planning and implementation of the experiment to study treatment heterogeneity and external validity., (Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.)

A growing literature indicates that effects of early-life health on adult economic outcomes could be substantial in developing countries, but the magnitude of this effect is debated. We document a robust gradient between the early-life mortality environment to which men in India were locally exposed in their district and year of birth and the wages that they earn as adults. A 1 percentage point reduction in infant mortality (or 10 point reduction in IMR) in an infant's district and year of birth is associated with an approximately 2 percent increase in his subsequent adult wages. Consistent with theories and evidence in the literature, we find that the level of schooling chosen for a child does not mediate this association. Because of its consequences for subsequent wages, early-life health could also have considerable fiscal externalities; if so, public health investments could come at very low net present cost., (Copyright © 2015 Elsevier B.V. All rights reserved.)