Publication: Aggregate Economic Shocks and Infant Mortality: New Evidence for Middle-Income Countries
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Published
2010
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01651765
Date
2012-03-30
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We provide country-specific estimates of the effect of macroeconomic shocks on infant mortality for a sample of mainly middle-income countries. In most countries, infant mortality appears to be pro-cyclical or acyclical. Only when shocks to GDP are very deep, 15% or larger, are they consistently associated with higher mortality.
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Publication Aggregate Income Shocks and Infant Mortality in the Developing World(MIT Press, 2011-08)Health and income are strongly correlated both within and across countries, yet the extent to which improvements in income have a causal effect on health status remains controversial. We investigate whether short-term fluctuations in aggregate income affect infant mortality using an unusually large data set of 1.7 million births in 59 developing countries. We show a large, negative association between per capita GDP and infant mortality. Female infant mortality is more sensitive than male infant mortality to negative economic shocks, suggesting that policies that protect the health status of female infants may be especially important during economic downturns.Publication Aggregate Income Shocks and Infant Mortality in the Developing World(World Bank, Washington, DC, 2007-09)The diffusion of cost-effective life saving technologies has reduced infant mortality in much of the developing world. Income gains may also play a direct, protective role in ensuring child survival, although the empirical findings to date on this issue have been mixed. This paper assembles data from Demographic and Health Surveys (DHS) in 59 countries to analyze the relationship between changes in per capita GDP and infant mortality. The authors show that there is a strong, negative association between changes in per capita GDP and infant mortality- in a first-differenced specification the implied elasticity of infant mortality with respect to per capita GDP is approximately -0.56. In addition to this central result, two findings are noteworthy. First, although there is some evidence of changes in the composition of women giving birth during economic upturns and downturns, the observed changes in infant mortality are not a result of mothers with protective characteristics timing fertility to correspond with the business cycle. Second, the association between infant mortality and per capita GDP is particularly pronounced for periods of large contractions in GDP, suggesting the inability of developing country households or health systems (or both) to smooth resources. Simple back-of-the-envelope calculations using the estimates suggest that there may have been more than 1 million "excess" deaths in the developing world since 1980 as a result of large, negative contractions in per capita GDP.Publication The (Positive) Effect of Macroeconomic Crises on the Schooling and Employment Decisions of Children in a Middle-Income Country(World Bank, Washington, DC, 2002-01-31)The impact of macroeconomic crises on parents' investments in the human capital of their children is a widely contested issue. The author analyzes the effects of the profound macroeconomic crisis in Peru in 1988-92 on the schooling and employment decisions made by urban school-age children. He arrives at two basic findings: First, the crisis had no effect on the attendance rates of school-age children. But the share of children who were both employed and in school fell significantly during the crisis. Second, mean educational attainment was significantly higher for children who were exposed to the crisis than for those who were not. THe author argues that these findings may be related: children who are not employed have more time available and may therefore put more effort into school. He concludes with a discussion of the implications of his findings for the design of appropriate social protection policies.Publication Aggregate Economic Shocks, Child Schooling and Child Health(World Bank, Washington, DC, 2008-08)Do aggregate economic shocks, such as those caused by macroeconomic crises or droughts, reduce child human capital? The answer to this question has important implications for public policy. If shocks reduce investments in children, they may transmit poverty from one generation to the next. This paper uses a simple framework to analyze the effects of aggregate economic shocks on child schooling and health. It shows that the expected effects are ambiguous, because of a tension between income and substitution effects. The paper then reviews the recent empirical literature on the subject. In richer countries, like the United States, child health and education outcomes are counter-cyclical: they improve during recessions. In poorer countries, mostly in Africa and low-income Asia, the outcomes are pro-cyclical: infant mortality rises, and school enrollment and nutrition fall during recessions. In the middle-income countries of Latin America, the picture is more nuanced: health outcomes are generally pro-cyclical, and education outcomes counter-cyclical. Each of these findings is consistent with the simple conceptual framework. The paper discusses possible implications for expenditure allocation.Publication How Many Infants May Have Died in Low-Income and Middle-Income Countries in 2020 Due to the Economic Contraction Accompanying the COVID-19 Pandemic? Mortality Projections Based on Forecasted Declines in Economic Growth(BMJ Publishing Group, Ltd., 2021-08)While COVID-19 has a relatively small direct impact on infant mortality, the pandemic is expected to indirectly increase mortality of this vulnerable group in low-income and middle-income countries through its effects on the economy and health system performance. Previous studies projected indirect mortality by modelling how hypothesized disruptions in health services will affect health outcomes. We provide alternative projections, relying on modelling the relationship between aggregate income shocks and mortality. The findings underscore the vulnerability of infants to the negative income shocks such as those imposed by the COVID-19 pandemic. While efforts towards prevention and treatment of COVID-19 remain paramount, the global community should also strengthen social safety nets and assure continuity of essential health services.
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