Work Under Attack: When Economies Fluctuate: Infant Survival in the Developing World

Despite substantial improvements in global health, millions of infants continue to die before reaching their first birthday. Using a dataset of 11.5 million births in 78 developing countries, we examine the consequences of aggregate economic fluctuations for infant survival. We exploit oil price shocks and find that, at the sample mean of net oil exposure, a 50% increase in international oil prices corresponds to an increase in infant mortality of approximately 3 deaths per 1,000 live births, or 4% relative to the sample mean. Infant survival is particularly sensitive to economic fluctuations in poorer countries, rural areas, among first-born children, and among children of older mothers, with little evidence that the effects differ systematically with the direction of the oil price shock. Investigating potential mechanisms, we find that, at the sample mean of net oil exposure, the same change in international oil prices corresponds to reductions in vaccination rates of 0.15-0.31 percentage points and increases in the incidence of low and very low birth weight of approximately 4-5% relative to their respective sample means, while having little effect on maternal healthcare utilization, household resources, or childhood morbidity. The results are robust to alternative specifications and identification strategies, including within-mother comparisons. These findings demonstrate that aggregate economic fluctuations have important implications for early-life health and point to preventive child health investments and birth endowments as potential margins linking economic fluctuations to infant survival in developing countries.