IDEAS home Printed from https://ideas.repec.org/p/inq/inqwps/ecineq2023-645.html
   My bibliography  Save this paper

Decomposing changes in child health inequality in Sub-Saharan Africa: new approach and new evidence

Author

Listed:
  • David Pérez-Mesa

    (University of La Laguna)

  • Gustavo A. Marrero

    (University of La Laguna)

  • Sara Darias-Curvo

    (University of La Laguna)

Abstract

We analyze recent changes in child health inequality in 15 Sub-Saharan Africa (SSA) countries, characterize the features (observed and unobserved) contributing to these within-country changes, and investigate the existence of trade-offs between changes in child health inequality and changes in mean child health. We propose a methodology for estimating the contribution of a group of factors to the changes in child health inequality, which is perfectly comparable with existing decomposition approaches for mean child health. Among the observed features, we consider between-regional aspects (regional and rural/urban fixed effects) and within-regional factors including family background, mother’s demography, family structure and home infrastructures. Total child health inequality is falling in most countries, but the part of inequality explained by our set of observed features is increasing. While the unobserved and between-regional features have reduced child health inequality, the within-regional factors related to mother’s demography and family background have pushed inequality in the opposite direction. These two sets of features are precisely the ones behind the observed trade-off between child health inequality and mean child health: while their changes are harming child health inequality, they are benefiting mean child health.

Suggested Citation

  • David Pérez-Mesa & Gustavo A. Marrero & Sara Darias-Curvo, 2023. "Decomposing changes in child health inequality in Sub-Saharan Africa: new approach and new evidence," Working Papers 645, ECINEQ, Society for the Study of Economic Inequality.
  • Handle: RePEc:inq:inqwps:ecineq2023-645
    as

    Download full text from publisher

    File URL: http://www.ecineq.org/milano/WP/ECINEQ2023-645.pdf
    File Function: First version, 2023
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Choudhuri, Pallavi & Desai, Sonalde, 2021. "Lack of access to clean fuel and piped water and children’s educational outcomes in rural India," World Development, Elsevier, vol. 145(C).
    2. Facundo Alvaredo & Thomas Piketty & Emmanuel Saez & Lucas Chancel & Gabriel Zucman, 2018. "World Inequality Report 2018," PSE-Ecole d'économie de Paris (Postprint) halshs-01885458, HAL.
    3. Frank Cowell & Carlo Fiorio, 2011. "Inequality decompositions—a reconciliation," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 509-528, December.
    4. François Bourguignon & Francisco Ferreira & Phillippe Leite, 2008. "Beyond Oaxaca–Blinder: Accounting for differences in household income distributions," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 6(2), pages 117-148, June.
    5. repec:hal:pseose:halshs-01109086 is not listed on IDEAS
    6. Janet Currie & Tom Vogl, 2013. "Early-Life Health and Adult Circumstance in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 1-36, May.
    7. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    8. Arndt, Channing & McKay, Andy & Tarp, Finn (ed.), 2016. "Growth and Poverty in Sub-Saharan Africa," OUP Catalogue, Oxford University Press, number 9780198744795.
    9. Douglas Almond & Janet Currie & Valentina Duque, 2018. "Childhood Circumstances and Adult Outcomes: Act II," Journal of Economic Literature, American Economic Association, vol. 56(4), pages 1360-1446, December.
    10. repec:pri:rpdevs:case_and_paxson_early_life_health_w15637 is not listed on IDEAS
    11. repec:pri:cheawb:case_and_paxson_early_life_health_w15637 is not listed on IDEAS
    12. Anne Case & Christina Paxson, 2010. "Causes and consequences of early-life health," Demography, Springer;Population Association of America (PAA), vol. 47(1), pages 65-85, March.
    13. Janet Currie, 2011. "Inequality at Birth: Some Causes and Consequences," American Economic Review, American Economic Association, vol. 101(3), pages 1-22, May.
    14. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    15. Cogneau, Denis & Moradi, Alexander, 2014. "Borders That Divide: Education and Religion in Ghana and Togo Since Colonial Times," The Journal of Economic History, Cambridge University Press, vol. 74(3), pages 694-729, September.
    16. Ragui Assaad & Caroline Krafft & Nadia Belhaj Hassine & Djavad Salehi-Isfahani, 2012. "Inequality Of Opportunity In Child Health In The Arab World And Turkey," Middle East Development Journal (MEDJ), World Scientific Publishing Co. Pte. Ltd., vol. 4(02), pages 1-37.
    17. Aizawa, Toshiaki, 2019. "Ex-ante Inequality of Opportunity in Child Malnutrition: New Evidence from Ten Developing Countries in Asia," Economics & Human Biology, Elsevier, vol. 35(C), pages 144-161.
    18. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    19. repec:pri:cheawb:case_and_paxson_early_life_health_w15637.pdf is not listed on IDEAS
    20. Davillas, Apostolos & M. Jones, Andrew, 2018. "Ex ante inequality of opportunity in health, decomposition and distributional analysis of biomarkers," ISER Working Paper Series 2018-13, Institute for Social and Economic Research.
    21. Davillas, Apostolos & Jones, Andrew M, 2020. "Ex ante inequality of opportunity in health, decomposition and distributional analysis of biomarkers," Journal of Health Economics, Elsevier, vol. 69(C).
    22. Kathleen Beegle & Luc Christiaensen & Andrew Dabalen & Isis Gaddis, 2016. "Poverty in a Rising Africa," World Bank Publications - Books, The World Bank Group, number 22575.
    23. Alan S. Blinder, 1973. "Wage Discrimination: Reduced Form and Structural Estimates," Journal of Human Resources, University of Wisconsin Press, vol. 8(4), pages 436-455.
    24. Bleichrodt, Han & van Doorslaer, Eddy, 2006. "A welfare economics foundation for health inequality measurement," Journal of Health Economics, Elsevier, vol. 25(5), pages 945-957, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pérez-Mesa, David & Marrero, Gustavo A. & Darias-Curvo, Sara, 2021. "Child health inequality in Sub-Saharan Africa," MPRA Paper 108801, University Library of Munich, Germany.
    2. Aizawa, Toshiaki, 2021. "Inequality of opportunity in infant mortality in South Asia: A decomposition analysis of survival data," Economics & Human Biology, Elsevier, vol. 43(C).
    3. David Pérez-Mesa & Gustavo A. Marrero & Sara Darias-Curvo, 2020. "Child health inequality and opportunities in Sub-Saharan Africa," Working Papers 557, ECINEQ, Society for the Study of Economic Inequality.
    4. Mkupete Jaah Mkupete & Dieter Von Fintel & Ronelle Burger, 2022. "Decomposing inequality of opportunity in child health in Tanzania: The role of access to water and sanitation," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2465-2480, November.
    5. Toshiaki Aizawa, 2020. "Trajectory of inequality of opportunity in child height growth: Evidence from the Young Lives study," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 42(7), pages 165-202.
    6. Prakash, Kushneel & Kumar, Sanjesh, 2021. "“Smoking your child’s job away”: Parental smoking during one’s childhood and the probability of being employed in adulthood," Journal of Business Research, Elsevier, vol. 136(C), pages 86-98.
    7. David Pérez-Mesa & à ngel S. Marrero, 2024. "Adult health and inequality of opportunity in Spain," Working Papers 671, ECINEQ, Society for the Study of Economic Inequality.
    8. Bermudez, Bladimir Carrillo & Santos Branco, Danyelle Karine & Trujillo, Juan Carlos & de Lima, Joao Eustaquio, 2015. "Deforestation and Infant Health: Evidence from an Environmental Conservation Policy in Brazil," 2015 Conference, August 9-14, 2015, Milan, Italy 229064, International Association of Agricultural Economists.
    9. Francisco J. Cabrera-Hernández & Pedro P. Orraca-Romano, 2023. "Inequality in the Household: How Parental Income Matters for the Long-Term Treatment of Healthy and Unhealthy Siblings," Journal of Family and Economic Issues, Springer, vol. 44(3), pages 674-692, September.
    10. Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2023. "Multigenerational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation's Health," American Economic Review, American Economic Association, vol. 113(1), pages 98-135, January.
    11. Gabriella Conti, 2013. "The Developmental Origins of Health Inequality," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 285-309, Emerald Group Publishing Limited.
    12. Eskander, Shaikh M.S.U. & Barbier, Edward B., 2022. "Long-term impacts of the 1970 cyclone in Bangladesh," World Development, Elsevier, vol. 152(C).
    13. Jabłoński Łukasz, 2019. "Inequality in Economics: The Concept, Perception, Types, and Driving Forces," Journal of Management and Business Administration. Central Europe, Sciendo, vol. 27(1), pages 17-43, March.
    14. Brunori, Paolo & Davillas, Apostolos & Jones, Andrew M. & Scarchilli, Giovanna, 2022. "Model-based Recursive Partitioning to Estimate Unfair Health Inequalities in the United Kingdom Household Longitudinal Study," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 543-565.
    15. Agar Brugiavini & Raluca Elena Buia & Matija Kovacic & Cristina Elisa Orso, 2020. "Adverse childhood experiences and risk behaviours later in life: Evidence from SHARE countries," Working Papers 2020:08, Department of Economics, University of Venice "Ca' Foscari".
    16. Lin, Ming-Jen & Liu, Elaine M., 2014. "Does in utero exposure to Illness matter? The 1918 influenza epidemic in Taiwan as a natural experiment," Journal of Health Economics, Elsevier, vol. 37(C), pages 152-163.
    17. Alexander, Diane & Currie, Janet, 2017. "Is it who you are or where you live? Residential segregation and racial gaps in childhood asthma," Journal of Health Economics, Elsevier, vol. 55(C), pages 186-200.
    18. Aizawa, Toshiaki, 2019. "Ex-ante Inequality of Opportunity in Child Malnutrition: New Evidence from Ten Developing Countries in Asia," Economics & Human Biology, Elsevier, vol. 35(C), pages 144-161.
    19. Weil, David N., 2014. "Health and Economic Growth," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 2, chapter 3, pages 623-682, Elsevier.
    20. Eriksson, Tor & Pan, Jay & Qin, Xuezheng, 2014. "The intergenerational inequality of health in China," China Economic Review, Elsevier, vol. 31(C), pages 392-409.

    More about this item

    Keywords

    Child health inequality; Inequality decomposition; Mean health; Sub-Saharan Africa;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O10 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - General
    • P52 - Political Economy and Comparative Economic Systems - - Comparative Economic Systems - - - Comparative Studies of Particular Economies

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inq:inqwps:ecineq2023-645. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Maria Ana Lugo (email available below). General contact details of provider: https://edirc.repec.org/data/ecineea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.