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Health Costs of a “Healthy Democracy”: The Impact of Peaceful Political Protests on Healthcare Utilization

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  • Tushar Bharati

    (Economics Department, Business School, The University of Western Australia)

  • Adnan M. S. Fakir

    (University of Sussex Business School)

Abstract

Peaceful protests are one of the most common and effective forms of political action worldwide. But they may have negative spillovers on health-seeking behavior. Using an instrumental variable approach that leverage variations in national sporting events and combining data on politically disruptive events from the Armed Conflict Location & Event Data (ACLED) project with information on healthcare utilization from the Bangladesh Demographic and Health Surveys (DHS), we show that peaceful protests reduce healthcare utilization among mothers with young children. Prenatal and postnatal care, vaccination rates, the likelihood of visiting a hospital facility if a child is unwell, and hospital deliveries all decrease in response to protests, while home deliveries increase. The effect is stronger for more elastic demands, like facility visits for minor illnesses and timely vaccinations. Security concerns and traffic congestion, which increases the time and costs of accessing health facilities, appear to be two potential mechanisms. The findings are not a criticism of peaceful protests, which we consider both an essential tenet and a by-product of a strong democracy, but instead seek to draw attention to an often ignored cost associated with it.

Suggested Citation

  • Tushar Bharati & Adnan M. S. Fakir, 2022. "Health Costs of a “Healthy Democracy”: The Impact of Peaceful Political Protests on Healthcare Utilization," Economics Discussion / Working Papers 22-15, The University of Western Australia, Department of Economics.
  • Handle: RePEc:uwa:wpaper:22-15
    Note: MD5 = 957168994ff0a088b40ee35a49268024
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    as
    1. Michael Ross, 2006. "Is Democracy Good for the Poor?," American Journal of Political Science, John Wiley & Sons, vol. 50(4), pages 860-874, October.
    2. David Card & Gordon B. Dahl, 2011. "Family Violence and Football: The Effect of Unexpected Emotional Cues on Violent Behavior," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(1), pages 103-143.
    3. Petra Persson & Maya Rossin-Slater, 2018. "Family Ruptures, Stress, and the Mental Health of the Next Generation," American Economic Review, American Economic Association, vol. 108(4-5), pages 1214-1252, April.
    4. Andreas Madestam & Daniel Shoag & Stan Veuger & David Yanagizawa-Drott, 2013. "Do Political Protests Matter? Evidence from the Tea Party Movement," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 128(4), pages 1633-1685.
    5. Arnab Roy Chowdhury & Ahmed Abid, 2019. "Emergent Protest Publics in India and Bangladesh: A Comparative Study of Anti-corruption and Shahbag Protests," Societies and Political Orders in Transition, in: Nina Belyaeva & Victor Albert & Dmitry G. Zaytsev (ed.), Protest Publics, pages 49-66, Springer.
    6. Amarasinghe, Ashani, 2022. "Diverting domestic turmoil," Journal of Public Economics, Elsevier, vol. 208(C).
    7. Metcalfe, Robert & Burgess, Simon & Proud, Steven, 2019. "Students' effort and educational achievement: Using the timing of the World Cup to vary the value of leisure," Journal of Public Economics, Elsevier, vol. 172(C), pages 111-126.
    8. Pal, Sarmistha, 2015. "Impact of hospital delivery on child mortality: An analysis of adolescent mothers in Bangladesh," Social Science & Medicine, Elsevier, vol. 143(C), pages 194-203.
    9. Petra Persson & Maya Rossin-Slater, 2018. "Family Ruptures, Stress, and the Mental Health of the Next Generation: Reply," American Economic Review, American Economic Association, vol. 108(4-5), pages 1256-1263, April.
    10. Adnan Fakir & M Khan, 2015. "Determinants of malnutrition among urban slum children in Bangladesh," Health Economics Review, Springer, vol. 5(1), pages 1-11, December.
    11. Jennifer Bair & Mark Anner & Jeremy Blasi, 2020. "The Political Economy of Private and Public Regulation in Post-Rana Plaza Bangladesh," ILR Review, Cornell University, ILR School, vol. 73(4), pages 969-994, August.
    12. Richard Akresh & Philip Verwimp & Tom Bundervoet, 2011. "Civil War, Crop Failure, and Child Stunting in Rwanda," Economic Development and Cultural Change, University of Chicago Press, vol. 59(4), pages 777-810.
    13. Seema Jayachandran & Ilyana Kuziemko, 2011. "Why Do Mothers Breastfeed Girls Less than Boys? Evidence and Implications for Child Health in India," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(3), pages 1485-1538.
    14. Sangnier, Marc & Zylberberg, Yanos, 2017. "Protests and trust in the state: Evidence from African countries," Journal of Public Economics, Elsevier, vol. 152(C), pages 55-67.
    15. Tanvir M Huda & Morseda Chowdhury & Shams El Arifeen & Michael J Dibley, 2019. "Individual and community level factors associated with health facility delivery: A cross sectional multilevel analysis in Bangladesh," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-13, February.
    16. Mark M. Pitt & Mark R. Rosenzweig & Mohammad Nazmul Hassan, 2012. "Human Capital Investment and the Gender Division of Labor in a Brawn-Based Economy," American Economic Review, American Economic Association, vol. 102(7), pages 3531-3560, December.
    17. Ge, Qi, 2018. "Sports sentiment and tipping behavior," Journal of Economic Behavior & Organization, Elsevier, vol. 145(C), pages 95-113.
    18. Davide Cantoni & David Y Yang & Noam Yuchtman & Y Jane Zhang, 2019. "Protests as Strategic Games: Experimental Evidence from Hong Kong's Antiauthoritarian Movement," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(2), pages 1021-1077.
    19. Bhalotra, Sonia & Valente, Christine & van Soest, Arthur, 2010. "The puzzle of Muslim advantage in child survival in India," Journal of Health Economics, Elsevier, vol. 29(2), pages 191-204, March.
    20. Francesco Passarelli & Guido Tabellini, 2017. "Emotions and Political Unrest," Journal of Political Economy, University of Chicago Press, vol. 125(3), pages 903-946.
    21. Sayedur Rahman & Aziz Ahmed Choudhury & Rasheda Khanam & Syed Mamun Ibne Moin & Salahuddin Ahmed & Nazma Begum & Nurun Naher Shoma & Md Abdul Quaiyum & Abdullah H Baqui & for the Projahnmo Study Group, 2017. "Effect of a package of integrated demand- and supply-side interventions on facility delivery rates in rural Bangladesh: Implications for large-scale programs," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-13, October.
    22. Asadullah, M. Niaz & Mansoor, Nazia & Randazzo, Teresa & Wahhaj, Zaki, 2021. "Is son preference disappearing from Bangladesh?," World Development, Elsevier, vol. 140(C).
    23. Tom Bundervoet & Philip Verwimp & Richard Akresh, 2009. "Health and Civil War in Rural Burundi," Journal of Human Resources, University of Wisconsin Press, vol. 44(2).
    24. A. Mushtaque R. Chowdhury & Abbas Bhuiya, 2004. "The wider impacts of BRAC poverty alleviation programme in Bangladesh," Journal of International Development, John Wiley & Sons, Ltd., vol. 16(3), pages 369-386.
    25. Gamlin, Jennie B., 2013. "Shame as a barrier to health seeking among indigenous Huichol migrant labourers: An interpretive approach of the “violence continuum” and “authoritative knowledge”," Social Science & Medicine, Elsevier, vol. 97(C), pages 75-81.
    26. Emilio Depetris-Chauvin & Ruben Durante & Filipe Campante, 2020. "Building Nations through Shared Experiences: Evidence from African Football," American Economic Review, American Economic Association, vol. 110(5), pages 1572-1602, May.
    27. Silvia Helena Barcellos & Leandro S. Carvalho & Adriana Lleras-Muney, 2014. "Child Gender and Parental Investments in India: Are Boys and Girls Treated Differently?," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 157-189, January.
    28. Mansour, Hani & Rees, Daniel I., 2012. "Armed conflict and birth weight: Evidence from the al-Aqsa Intifada," Journal of Development Economics, Elsevier, vol. 99(1), pages 190-199.
    29. Abay Asfaw & Francesca Lamanna & Stephan Klasen, 2010. "Gender gap in parents' financing strategy for hospitalization of their children: evidence from India," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 265-279, March.
    30. Gage, Anastasia J., 2007. "Barriers to the utilization of maternal health care in rural Mali," Social Science & Medicine, Elsevier, vol. 65(8), pages 1666-1682, October.
    31. El-Mallakh, Nelly, 2020. "How do protests affect electoral choices? Evidence from Egypt," Journal of Economic Behavior & Organization, Elsevier, vol. 179(C), pages 299-322.
    32. Beyer,Robert Carl Michael & Chhabra,Esha & Galdo,Virgilio & Rama,Martin G., 2018. "Measuring districts'monthly economic activity from outer space," Policy Research Working Paper Series 8523, The World Bank.
    33. Thomas Fujiwara, 2015. "Voting Technology, Political Responsiveness, and Infant Health: Evidence From Brazil," Econometrica, Econometric Society, vol. 83, pages 423-464, March.
    34. Fredrick Manang & Chikako Yamauchi, 2020. "The Impact of Access to Health Facilities on Maternal Care Use, Travel Patterns, and Health Status: Evidence from Longitudinal Data from Uganda," Economic Development and Cultural Change, University of Chicago Press, vol. 69(1), pages 405-451.
    35. Chamarbagwala, Rubiana & Morán, Hilcías E., 2011. "The human capital consequences of civil war: Evidence from Guatemala," Journal of Development Economics, Elsevier, vol. 94(1), pages 41-61, January.
    36. Matthew A. Masten & Alexandre Poirier, 2021. "Salvaging Falsified Instrumental Variable Models," Econometrica, Econometric Society, vol. 89(3), pages 1449-1469, May.
    37. Casey B. Mulligan & Ricard Gil & Xavier Sala-i-Martin, 2004. "Do Democracies Have Different Public Policies than Nondemocracies?," Journal of Economic Perspectives, American Economic Association, vol. 18(1), pages 51-74, Winter.
    38. Imbens, Guido W & Angrist, Joshua D, 1994. "Identification and Estimation of Local Average Treatment Effects," Econometrica, Econometric Society, vol. 62(2), pages 467-475, March.
    39. Bhan, Gautam & Bhandari, Nita & Taneja, Sunita & Mazumder, Sarmila & Bahl, Rajiv, 2005. "The effect of maternal education on gender bias in care-seeking for common childhood illnesses," Social Science & Medicine, Elsevier, vol. 60(4), pages 715-724, February.
    40. repec:ehl:lserod:100316 is not listed on IDEAS
    41. Choi, Jin Young & Lee, Sang-Hyop, 2006. "Does prenatal care increase access to child immunization? Gender bias among children in India," Social Science & Medicine, Elsevier, vol. 63(1), pages 107-117, July.
    42. Teresa Molina, 2020. "Health Seeking amid Violence: Evidence from the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 69(1), pages 173-212.
    43. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May.
    44. Naila Kabeer & Lopita Huq & Simeen Mahmud, 2014. "Diverging Stories of “Missing Women” in South Asia: Is Son Preference Weakening in Bangladesh?," Feminist Economics, Taylor & Francis Journals, vol. 20(4), pages 138-163, October.
    45. Ahmed, Syed Masud & Petzold, Max & Kabir, Zarina Nahar & Tomson, Göran, 2006. "Targeted intervention for the ultra poor in rural Bangladesh: Does it make any difference in their health-seeking behaviour?," Social Science & Medicine, Elsevier, vol. 63(11), pages 2899-2911, December.
    46. Acemoglu,Daron & Robinson,James A., 2009. "Economic Origins of Dictatorship and Democracy," Cambridge Books, Cambridge University Press, number 9780521671422, September.
    47. Seema Jayachandran & Rohini Pande, 2017. "Why Are Indian Children So Short? The Role of Birth Order and Son Preference," American Economic Review, American Economic Association, vol. 107(9), pages 2600-2629, September.
    48. Bharati, Tushar, 2022. "The long shadow of the Kargil War: The effect of early-life stress on education," Economics & Human Biology, Elsevier, vol. 44(C).
    49. Shemyakina, Olga N., 2021. "Political violence and child health: Results from Zimbabwe," Economics & Human Biology, Elsevier, vol. 42(C).
    50. Lucia Corno, 2014. "Learning (or Not) in Health-Seeking Behavior: Evidence from Rural Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 63(1), pages 27-72.
    51. Salma Nasrin & Md. Mashiur Rahman, 2019. "Politicization of Student Politics in Bangladesh: Historical Experiences and Contemporary Trends," Journal of Social Science Studies, Macrothink Institute, vol. 6(2), pages 17-42, December.
    52. Eli Berman & Mitch Downey & Joseph Felter, 2016. "Expanding Governance as Development: Evidence on Child Nutrition in the Philippines," NBER Working Papers 21849, National Bureau of Economic Research, Inc.
    53. Robin Thompson & Nigel Miller & Sophie Witter, 2003. "Health‐seeking behaviour and rural/urban variation in Kazakhstan," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 553-564, July.
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    More about this item

    Keywords

    health-seeking; political violence; protests; non-violence; cricket; Bangladesh;
    All these keywords.

    JEL classification:

    • D74 - Microeconomics - - Analysis of Collective Decision-Making - - - Conflict; Conflict Resolution; Alliances; Revolutions
    • H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • P16 - Political Economy and Comparative Economic Systems - - Capitalist Economies - - - Capitalist Institutions; Welfare State

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