Three essays in health economics
Date
2022-08
Authors
Kim, Min Kyong
Major Professor
Advisor
Bhattacharya, Joydeep
Kreider, Brent
Bunzel, Helle
DePaula, Guilherme
Dorius, Shawn
Committee Member
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Abstract
Over the past century, there has been a remarkable decline in mortality. The decrease in mortality during early infancy and childhood has been particularly significant in the developing countries. Because it offers valuable information about the general state of maternal and infant health, infant mortality is important. Furthermore, infant mortality is sensitive to factors that have an impact on everyone's health, making it essential to comprehend a society's general state of health. As a result, infant mortality is an important variable in understanding health improvements in developing countries. Furthermore, given its significant impact on future economic outcomes, understanding infant mortality is critical.
In this dissertation, I first investigate a policy in India that may have a negative impact on neonatal mortality. Nutritional intake during pregnancy, especially protein and iron found abundantly in beef, strongly affects babies' birth outcomes and survival. While most upper-caste Hindus in India traditionally eschew beef consumption, minority groups such as Muslims, Christians, and Dalits, also often poor, do not. Recently, many Indian states in secular India, especially those governed by the Hindu-nationalist BJP party, have passed laws promoting the protection of cows, effectively making beef unavailable. In this paper, I study the impact of such laws on neonatal mortality using cattle-slaughter and beef bans as a natural experiment. Using a difference-in-differences design, I find neonatal mortality increases by five per 1,000 live births among beef consumers suggesting India's cattle-slaughter bans intended to promote bovine welfare have deleterious collateral consequences on humans.
In another chapter of this dissertation, I (with my co-authors) ask whether increases in child survival bring down fertility and incentivize couples to switch from traditional to modern methods of contraception. Our parsimonious model predicts the answer in each case is yes. We test these connections using household-level Demographic and Health Surveys from recent fertility transitions using arguably exogenous variation in child survival at the regional level to estimate subsequent drops in household fertility. We find an increase in ambient child survival leads to a fertility drop and raises the chance of using modern contraception methods. Our findings suggest that, along the trajectory of contemporary fertility transitions, the need and potency of family planning programs rises with improvements in child survival.
In the last chapter, I (along with my co-author) investigate whether income inequality has a first-order direct effect on health. We narrow the focus of this question substantially by focusing on health outcomes that are impacted by disease, specifically communicable or infectious disease. We explore the hypothesis that the income-inequality link is in part mediated by infectious disease: in locations with greater income inequality and residence-work integration, infectious disease spreads more easily. We investigate this association by examining whether countries with elevated levels of income inequality have higher rates of Tuberculosis (TB) incidence per capita. There is a well-studied and documented direct connection between income and health - high-income people and countries are likely to be healthier. Poor people are significantly more prone to catching and harboring latent infections from an infectious disease, such as tuberculosis (TB). As a result, the more income-unequal a society, the higher the chance a random mixing of people from different income strata brings the infected and uninfected closer, thereby raising disease spread. We find Gini coefficients a mere 10% apart would likely see a 5% difference in tuberculosis prevalence. A correction for “aggregation bias” using data on anemia prevalence (a non-communicable disease) is also applied.
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Economics
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article