This project will study the impact of natural disasters on childhood mortality, childhood morbidity, and early-life health investments. First, the study will estimate the immediate effect of natural disasters on child mortality, lagged effects of natural disasters on child mortality, and immediate and lagged effects on child morbidity. Differences in these relationships by child age will be explored. Second, the project will test whether natural disasters affect health investments in children such as immunizations, breastfeeding, and prenatal care. This project will examine each of several aspects of the relationship between natural disasters and these health investments: the relative impact of natural disasters on infrastructure-dependent health investments (e.g., immunizations, prenatal care) compared to other investments that do not rely on health infrastructure (e.g., breastfeeding);the effects of disasters that are likely to damage infrastructure (e.g., earthquakes) versus those that primarily lead to income shocks (e.g., droughts);the impact of various types of natural disasters on income (measured using a household wealth index);and how increased mortality risk in the wake of a disaster affects parent incentives to make health investments. The data to estimate these relationships will include (1) household data from Demographic and Health Surveys (DHS) from 39 countries and (2) an international natural disaster database (Emergency Events Database, EMDAT) containing detailed information on the date, location, death toll and other details for a variety of natural disasters such as droughts, earthquakes, epidemics, wind storms and many others. The DHS include information on children born within the past five years, as well as information on child mortality, morbidity, and health investments. These two data sets will be merged at the state/province or finer level within each country. We will employ two estimation strategies. The unit of analysis will be a child born in the past five years. The first strategy will employ the most recent wave of DHS data (and data on disasters in the years previous) from each country to estimate country fixed-effect models. However, these models do not control for unobserved area-level differences within countries that may be correlated with child mortality and morbidity as well as disaster occurrence. In order to control for such unobserved differences, our second estimation strategy will use multiple waves of DHS data for countries to estimate models that will include area and time fixed effects.

Public Health Relevance

This work will provide new knowledge concerning the relationships between natural disasters and public health. It will provide a more comprehensive overview of the impact of disasters on mortality and morbidity, focusing on children across 39 countries and many disasters rather than a single case study. It will also yield estimates in a heretofore unexplored but essential area: the impact of disasters on health investments which have long-term implications for children's health.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Research Grants (R03)
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Pediatrics Subcommittee (CHHD)
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Bures, Regina M
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Rand Corporation
Santa Monica
United States
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Datar, Ashlesha; Liu, Jenny; Linnemayr, Sebastian et al. (2013) The impact of natural disasters on child health and investments in rural India. Soc Sci Med 76:83-91