Sanitation, Disease, and Anemia: Evidence From Nepal

by Dan Campbell on August 13, 2015

Sanitation, Disease, and Anemia: Evidence From Nepal, July 2015.

Authors: Diane Coffey, Michael Geruso.

Anemia is a health problem with significant economic consequences. In children, it impairs physical and cognitive development and reduces human capital accumulation. In adults, it reduces productivity. Globally, more than 40% of all children under five have hemoglobin levels below the threshold for anemia. Previous literature has focused on the role of poor nutritional intake in causing anemia. This paper is the first to propose the hypothesis that poor sanitation, a public good with other well-documented health externalities, significantly contributes to hemoglobin deficiency via its role in creating a poor disease environment.

We investigate a causal relationship between sanitation and hemoglobin by exploiting rapid differential improvement in sanitation across regions of Nepal between 2006 and 2011. We show that within regions over time, cohorts of children exposed to worse community sanitation developed lower hemoglobin levels and displayed higher anemia incidence. The results contribute to the basic science of anemia’s causes and suggest the possibility of new policy tools for reducing anemia in the developing world.

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