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Sanitation, Disease Externalities, and Anemia: Evidence From Nepal

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  • Diane Coffey
  • Michael Geruso
  • Dean Spears

Abstract

Anemia impairs physical and cognitive development in children and reduces human capital accumulation. The prior economics literature has focused on the role of inadequate nutrition in causing anemia. This paper is the first to show that sanitation, a public good, significantly contributes to preventing anemia. We identify effects by exploiting rapid and differential improvement in sanitation across regions of Nepal between 2006 and 2011. Within regions over time, cohorts of children exposed to better community sanitation developed higher hemoglobin levels. Our results highlight a previously undocumented externality of open defecation, which is today practiced by over a billion people worldwide.

Suggested Citation

  • Diane Coffey & Michael Geruso & Dean Spears, 2016. "Sanitation, Disease Externalities, and Anemia: Evidence From Nepal," NBER Working Papers 22940, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:22940
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    Cited by:

    1. Kresch, Evan Plous & Walker, Mark & Best, Michael Carlos & Gerard, François & Naritomi, Joana, 2023. "Sanitation and property tax compliance: Analyzing the social contract in Brazil," Journal of Development Economics, Elsevier, vol. 160(C).
    2. Gelli, Aulo & Headey, Derek D. & Ngure, Francis & Becquey, Elodie & Ganaba, Rasmané & Huybregts, Lieven & Pedehombga, Abdoulaye & Sanou, Armande & Traore, Abdoulaye & Zongo, Florence & Zongrone, Aman, 2017. "Assessing the health and nutrition risks of smallholder poultry production in Burkina Faso: Insights from formative research," IFPRI discussion papers 1665, International Food Policy Research Institute (IFPRI).
    3. Derek Headey & Giordano Palloni, 2019. "Water, Sanitation, and Child Health: Evidence From Subnational Panel Data in 59 Countries," Demography, Springer;Population Association of America (PAA), vol. 56(2), pages 729-752, April.
    4. Kristensen, Frederikke Frehr & Sharp, Paul, 2021. "Disease Surveillance, Mortality and Race: The Case of HIV/AIDS in the United States," CAGE Online Working Paper Series 553, Competitive Advantage in the Global Economy (CAGE).
    5. repec:rre:publsh:v:51:y:2021:i:1 is not listed on IDEAS
    6. Gautam, Sanghmitra, 2023. "Quantifying welfare effects in the presence of externalities: An ex-ante evaluation of sanitation interventions," Journal of Development Economics, Elsevier, vol. 164(C).
    7. Johann Caro-Burnett & Ahmed Mushfiq Mobarak & Judith A. Chevalier, 2021. "Is Habit a Powerful Policy Instrument to Induce Prosocial Behavioral Change?," Cowles Foundation Discussion Papers 2275, Cowles Foundation for Research in Economics, Yale University.
    8. Ray, Rita & Datta, Rajlakshmi, 2017. "Do separate female toilets in primary and upper primary schools improve female enrollment? A case study from India," Children and Youth Services Review, Elsevier, vol. 79(C), pages 263-273.
    9. Spears, Dean, 2020. "Exposure to open defecation can account for the Indian enigma of child height," Journal of Development Economics, Elsevier, vol. 146(C).
    10. Gupta, Soumya & Seth, Payal & Pingali, Prabhu L., 2023. "Addressing child anemia in India – the case for convergence of nutritional and sanitation interventions," 2023 Annual Meeting, July 23-25, Washington D.C. 335640, Agricultural and Applied Economics Association.
    11. Ray, Rita, 2020. "Mother’s autonomy and child anemia: A case study from India," Children and Youth Services Review, Elsevier, vol. 112(C).

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    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • J1 - Labor and Demographic Economics - - Demographic Economics
    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development

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