2018-2019
Lecture 1
Look at child health: nutritional status.
These components were the basis of the program they developed.
The program was ruled out in some areas and then in other areas, a bit later (randomly chosen).
Height under 5years of age: predictor of future indicators.
Why economists are interested in studying health issues?
Health and illness are a major concern in social equity and justice.
• health is the basis of economic productivity
• health interacts with other inputs
• the healthier the better!
Why study health and development?
Health tends to be poor in developing countries
Diseases are widespread
— Geoclimatic
— Institutions, colonial legacy, war
Children and young adults most affected
— Shaky basis for development
Vicious circle of underdevelopment and bad health
Work is more physical in low income countries —> good health and nutrition is even more important
Health as investment in better future
Health in Development Economics: common questions in the field
· health production and determinants
· macro and micro effects of health and income
· micro and macro consequences of bad health on income
· how can we boost health efficiently?
Health and Economics:
Health is multifaceted and complex — important for worker productivity
Variables of interest:
— Nutrition (quality and quantity)
— Morbidity and mortality (statistics from hospitals…)
— Sickness spell
— Disease environment
— Health infrastructures
Health capital accumulation (i.e. height)
Health inputs and flows (nutrition)
Health shocks (diarrhea)
Lifecycle approach
Example of what Stunting leads to:
· small adult stature
· lower wages
· worse cognition skills
· chronic diseases
,Aggregate Health Measures:
— LE
— Mortality (infant and maternal) // data quality is a problem too, if you want to study this long term
— Morbidity
— Data quality
— Between cross-country vs. within country changes
All Cause of Mortality under 5
,Nutritional patterns are changing very rapidly, incomes change and junk food coming from other countries. Nutrition
value goes down.
Some survey measures:
• biomarkers
• anthropometric indicators
• nutrition inputs
• health expenditures
• self-reported health
• medical history
• maternal mortality (to expand sample size: ask about dead siblings during labour/pregnancy)
Morbidity measures:
WHO growth standards:
— Height for age (stunting)
— Weight for age
— Weight for height (wasting)
, Z-scores: standardization of anthropometric indicators (formula for measure x for a child with age in months a) take
the median to avoid the extremes
-2 and -3 is ok, anything above: severe stunting.
Child nutrition: genetic and behavioural (favour male first child)
22% under 5yo were stunted (too short for their age)
Normal distribution: polygamy and monogamy mothers — centred around -2 points
Height and weight across age groups:
After 20 months the score drops
Macro Evidence – Micro foundations (Jack and Lewis, 2009)
• how did we get so healthy?
Nutrition
Public health
Education
Vaccination
Spread of health and medical knowledge (WHO)
Lifestyle changes matter more than healthcare?
Health care spending