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Public Health Investments and the Infant Mortality Gap: Evidence from Federal Sanitation Interventions on U.S. Indian Reservations

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    To what extent do differential levels of investment in public health inputs explain observed differences in health outcomes across socioeconomic and racial groups? This study investigates the impact of 3,700 projects that were part of a widespread Federal initiative to improve sanitation infrastructure on U.S. Indian reservations starting in 1960. Sanitation investment substantially reduced the cost of clean water for households, leading to sharp reductions in both waterborne gastrointestinal disease and infectious respiratory disease among Native American infants. The sanitation program was quite cost-effective, in part because improvements in the overall disease environment also reduced infectious respiratory disease among nearby white infants. Despite the health externalities, Federal sanitation interventions explain almost forty percent of the convergence in Native American and white infant mortality rates in reservation counties since 1970.

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    File URL: http://web.williams.edu/Economics/wp/watson0805san.pdf
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    Paper provided by Department of Economics, Williams College in its series Department of Economics Working Papers with number 2005-02.

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    Length: 46 pages
    Date of creation: Aug 2005
    Date of revision:
    Publication status: Published in Journal of Public Economics, September 2006, v. 90, iss. 8-9, pp. 1537-60.
    Handle: RePEc:wil:wileco:2005-02
    Contact details of provider: Postal: Williamstown, MA 01267
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    Fax: 413 597 4045
    Web page: http://econ.williams.edu
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