The Lancet Commission on Investing in Health has focused the world's attention on eliminating global health disparities as reflected in their title, Global health 2035: a world converging within a generation (Jamison et al., 2013). Although health technologies (especially safe water, antibiotics and vaccinations) are thought responsible for average gains in life expectancy over the last half century; research on the role of such technologies on reducing health disparities across population sub-groups is much more limited. Important unanswered questions in the literature include: which specific technologies are most important for reducing health disparities/promoting mortality convergence? How do technologies interact in the production of health? What explains the low rate of technology adoption among some population sub-groups? This K01 Career Development application will combine demographic methods with rigorous micro-econometric analyses 1) to assess the role of technology on infant and child mortality convergence by constructing novel data sets using demographic techniques 2) to analyze the independent and combined impact of four health technologies (sewerage and waters infrastructure, immunization and antibiotics) on infant and child mortality convergence using quasirandom variation from natural experiments and 3) to examine the relative importance of socioeconomic, environmental and cultural factors on the adoption of efficacious health technologies across sub-groups using econometric techniques. The Candidate, Marcella Alsan, is an infectious-disease trained physician-economist and an Assistant Professor of Medicine at Stanford Medical School. She will benefit from the mentorship of investigators with extensive expertise in demographic methods, economics and health policy. The Candidate will gain experience in indirect methods of mortality analysis, population projection and demographic approaches to measuring health inequalities through coursework at Stanford University and University of California, Berkeley. The proposed training and research experience will provide the foundation for her career as an independent investigator.

Public Health Relevance

Reducing the burden of preventable disease for all is a global public health imperative. I propose to use demographic and econometric analyses to assess the impact of technologies purportedly responsible for the greatest declines in infectious disease (e.g. sewerage/water infrastructure, antibiotics and immunization) on mortality convergence. I will explore how these technologies interact in the production of health and the role of culture in health technology adoption. This information is critically important to optimally allocate resources across health technologies for the purpose of eliminating mortality disparities.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Scientist Development Award - Research & Training (K01)
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Pediatrics Subcommittee (CHHD)
Program Officer
King, Rosalind B
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Stanford University
Internal Medicine/Medicine
Schools of Medicine
United States
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Alsan, Marcella; Xing, Anlu; Wise, Paul et al. (2017) Childhood Illness and the Gender Gap in Adolescent Education in Low- and Middle-Income Countries. Pediatrics 140: