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Early Health Shocks, Intra-household Resource Allocation and Child Outcomes.

ABSTRACT: An open question in the literature is whether families compensate or reinforce the impact of child health shocks. Discussions usually focus on one dimension of child investment. This paper examines multiple dimensions using household survey data on Chinese child twins whose average age is 11. We find that, compared with a twin sibling who did not suffer from negative early health shocks at ages 0-3, the other twin sibling who did suffer negative health shocks received RMB 305 more in terms of health investments, but received RMB 182 less in terms of educational investments in the 12 months prior to the survey. In terms of financial transfers over all dimensions of investment, the family acts as a net equalizer in response to early health shocks for children. We estimate a human capital production function and establish that, for this sample, early health shocks negatively affect child human capital, including health, education, and socioemotional skills. Compensating investments in health as measured by BMI reduce the adverse effects of health shocks by 50%, but exacerbate the adverse impact of shocks on educational attainment by 30%.

SUBMITTER: Yi J

PROVIDER: S-EPMC4803089 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Early Health Shocks, Intra-household Resource Allocation and Child Outcomes.

Yi Junjian J Heckman James J JJ Zhang Junsen J Conti Gabriella G

Economic journal (London, England) 20151117 588

An open question in the literature is whether families compensate or reinforce the impact of child health shocks. Discussions usually focus on one dimension of child investment. This paper examines multiple dimensions using household survey data on Chinese child twins whose average age is 11. We find that, compared with a twin sibling who did not suffer from negative early health shocks at ages 0-3, the other twin sibling who did suffer negative health shocks received RMB 305 more in terms of he ...[more]

PMID: 27019517

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Project description:BackgroundSouth Africa has a dual system of healthcare model differentiated across socio-economic lines. While on the one hand there exists high quality private facilities that is expensive and accessible to the minority, on the other is the free but stretched and over-crowded public healthcare that the rest of the population relies on. Accessing private facilities requires private medical insurance or requires coping strategies that can lead to household vulnerability.ObjectiveThe objective of this study is to analyse the relationship between health shocks and household vulnerability in the South African context of high poverty and low medical insurance penetration rate.DataThe study employs data from waves three to five of South Africa's nationally representative National Income Dynamics Study (NIDS) conducted between the period 2012-2017 in approximately two-year intervals.MethodsUsing food expenditure shock as an indicator for vulnerability, the study utilises a range of econometric techniques from panel logit regression to quasi-experimental design based difference in difference regressions to assess the association between health shocks, medical insurance and household vulnerability.FindingsThe main finding of the study is that a significant proportion of households in the upper income quintile utilise private healthcare even when not covered by private medical insurance. This preference for private over public health facilities make them vulnerable to health shocks as they cope by sacrificing food consumption to incur additional health expenditure. In contrast, lower income households that are unable to access the high-cost private healthcare tend to rely on the strained public healthcare system. They are not able to use their constrained food expenditure as a coping strategy for private or out-of-pocket medical expenses because their food consumption is already at a bare minimum.ConclusionThe results confirm that access to quality healthcare is a privilege in South Africa, available only to the minority of the population. The study paints a grim picture of household vulnerability in South Africa and underlines the need for a National Health Insurance that would enable universal access to quality healthcare in the country.

Project description:International institutions provide well over US$10 billion in development assistance for health (DAH) annually and between 1990 and 2014, DAH disbursements totaled $458 billion but how do they decide who gets what, and for what purpose? In this article, we explore how allocation decisions were made by the nine convening agencies of the Equitable Access Initiative. We provide clear, plain language descriptions of the complete process from resource mobilization to allocation for the nine multilateral agencies with prominent agendas in global health. Then, through a comparative analysis we illuminate the choices and strategies employed in the nine international institutions. We find that resource allocation in all reviewed institutions follow a similar pattern, which we categorized in a framework of five steps: strategy definition, resource mobilization, eligibility of countries, support type and funds allocation. All the reviewed institutions generate resource allocation decisions through well-structured and fairly complex processes. Variations in those processes seem to reflect differences in institutional principles and goals. However, these processes have serious shortcomings. Technical problems include inadequate flexibility to account for or meet country needs. Although aid effectiveness and value for money are commonly referenced, we find that neither performance nor impact is a major criterion for allocating resources. We found very little formal consideration of the incentives generated by allocation choices. Political issues include non-transparent influence on allocation processes by donors and bureaucrats, and the common practice of earmarking funds to bypass the normal allocation process entirely. Ethical deficiencies include low accountability and transparency at international institutions, and limited participation by affected citizens or their representatives. We find that recipient countries have low influence on allocation processes themselves, although within these processes they have some influence in relatively narrow areas.

Project description:Despite the growing calls to integrate realistic human behavior in sustainability science models, the representative rational agent prevails. This is especially problematic for climate change adaptation that relies on actions at various scales: from governments to individuals. Empirical evidence on individual adaptation to climate-induced hazards reveals diverse behavioral and social factors affecting economic considerations. Yet, implications of replacing the rational optimizer by realistic human behavior in nature-society systems models are poorly understood. Using an innovative evolutionary economic agent-based model we explore different framings regarding household adaptation behavior to floods, leveraging on behavioral data from a household survey in Miami, USA. We find that a representative rational agent significantly overestimates household adaptation diffusion and underestimates damages compared to boundedly rational behavior revealed from our survey. This "adaptation deficit" exhibited by a population of empirically informed agents is explained primarily by diverse "soft" adaptation constraints-awareness, social influences-rather than heterogeneity in financial constraints. Besides initial inequality disproportionally impacting low/medium adaptive capacity households post-flood, our findings suggest that even under a nearly complete adaptation diffusion, adaptation benefits are uneven, with late or less-efficient actions locking households to a path of higher damages, further exacerbating inequalities. Our exploratory modeling reveals that behavioral assumptions shape the uncertainty of physical factors, like exposure and objective effectiveness of flood-proofing measures, traditionally considered crucial in risk assessments. This unique combination of methods facilitates the assessment of cumulative and distributional effects of boundedly rational behavior essential for designing tailored climate adaptation policies, and for equitable sustainability transitions in general.

Dataset Information

Early Health Shocks, Intra-household Resource Allocation and Child Outcomes.

Publications

Early Health Shocks, Intra-household Resource Allocation and Child Outcomes.

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