Working paper #: Volume 17, No. 1
Author(s): Guy Harling, Katherine Ann Morris, Lenore Manderson, Jessica M. Perkins, Lisa F. Berkman
Objectives: We used data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI) study in rural South Africa to examine how age and gender interact to predict older adults’ social networks and receipt of social support in rural South Africa.
Method: We used regression analysis on data for 5059 adults aged over 40. We examined how network size, density, and communication and social support receipt were associated with gender and age, as well as with kin, gender and geographic composition.
Results: Older respondents reported fewer important social network ties, greater network density and less frequent communication than their middle-aged peers, largely due to fewer non-kin connections. Women had smaller networks, and difference in networks size was greater between older and younger women than among men. Older women had fewer non-kin ties living in the same village than younger women; older men’s lower levels of contact relative to middle-aged men in some spheres were offset by more female and co-resident ties.
Discussion: In contrast to the extant literature, older women in this study area had more limited social network and support than their male peers, and may thus benefit from targeted interventions.
Working paper #: Volume 17, No. 2
Author(s): Katherine Ann Morris, Clare Bambra, and Jason Beckfield
In the context of fiscal austerity in many European welfare states, policy innovation often takes the form of “social investment,” a contested set of policies aimed at strengthening labor markets and fostering gender equity. Social investment policies include employment subsidies, skills training, job-finding services, early childhood education and childcare, and public support for parental leave. Given that such policies can enhance gender equity in the labor market, we analyzed the possible effects of such policies on gender health equity. Using age- and sex-stratified data from the Global Burden of Disease Study on cardiovascular disease morbidity and mortality, and policy indicators on employment supports, childcare, and parental leave from multiple sources, we find mixed effects of social investment for men versus women. Government spending on public employment services and the percent of children in early childhood education or care are associated with lower mortality rates for men, but the associations are not significant for women. Government spending on employment training and the number of eligible weeks of paid parental leave are associated with lower mortality rates for women, but the associations are not significant for men. Government spending on paid parental leave is associated with lower mortality rates for both men and women, although with a stronger association for women. Finally, government spending on early childhood education and care is associated with lower mortality rates for both men and women equally. We discuss the implications of these effects for gender equity, and of these findings for the social investment policy turn and future research on gender health equity.
Working paper #: Volume 17, No. 3
Author(s): Onur Altındag, Ozan Bakis, and Sandra Rozo
We study the impact of more than 3 million Syrian refugees on Turkish businesses operating in an economy with a large informal sector. We use an instrumental variable design that relies on exogenous variations in refugee outflows from Syria and the geographic location of Arabic-speaking communities in Turkey before the conflict began. Using yearly censuses of firms, we find that refugee inflows had a positive impact on the intensive and extensive margins of production, which are highly concentrated in the informal economy. The effects are stronger for smaller firms and those that operate in the construction and hospitality industries.
Working paper #: Volume 17, No. 4
Author(s): Ludovico Carrino, Karen Glaser, and Mauricio Avendano
This paper examines the health impact of UK pension reforms that increased women’s State Pension age for up to six years since 2010. Exploiting an 11% increase in employment caused by the reforms, we show that rising the State Pension age reduces physical and mental health among women from routine-manual occupations. We show robust evidence that a larger increase in the State Pension age leads to larger negative health effects, resulting in a widening gap in health between women from different occupations. Our results are consistent with a 27% fall in individual incomes for women in routine-manual occupations.
Working paper #: Volume 18, No. 1
Author(s): Omar Karlsson, Rockli Kim, William Joe, and SV Subramanian
In India, excess female mortality, primarily concentrated in the postneonatal period, is well documented. Deaths in early childhood are also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal, and child mortality in India using repeated cross-sectional data from the Indian National Family Health Surveys conducted in 2005-06 and 2015-16. Overall, boys had greater neonatal mortality and the difference increased over time. Girls had greater postneonatal and child mortality, overall, but the difference decreased over time. A negative wealth gradient was found for all mortality outcomes for both boys and girls. Neonatal mortality was persistently greater for boys than girls over most of the household wealth distribution. Girls had greater child mortality at low levels of wealth and greater postneonatal mortality over much of the wealth distribution. The wealth gradient in neonatal mortality decreased for girls and increased for boys. Female child mortality had a substantially stronger wealth gradient but the difference decreased over the period. Not distinguishing between neonatal, postneonatal and child mortality masks important sex and socioeconomic disparities in under-5 mortality in India.
Working paper #: Volume 18, No. 2
Author(s): Rockli Kim, Yun Xu, William Joe, and SV Subramanian
In this brief report, and building on a previous study (6), for the first time, we present robust estimates on five indicators of child malnutrition (i.e., stunting, underweight, wasting, low birth weight, anaemia) for each PC in India. We provide ranking of the PCs both on the (i) average prevalence of the five indicators; and (ii) the degree of “Between-Village” inequality in the prevalence estimate on the five indicators. Thus, even if a PC is doing well on average, large inequalities within a PC (between its villages) suggests the need for further precision geo-targeting.
Working paper #: Volume 18, No. 3
Author(s): Sunil Rajpal, Rockli Kim, Rajan Sankar, Alok Kumar, William Joe and SV Subramanian
Nutritional well-being is central for achievement of several prominent national and international development goals. Despite considerable efforts and increasing policy commitments, India is yet to witness meaningful reductions in the burden of child undernutrition. We analyse the latest National Family Health Survey to develop critical policy insights to catalyse the reductions in child anthropometric failures in India. We describe that the POSHAN targets are far from modest and will require greater contribution from poor-performing states. The two fundamental concerns as reflected by this analysis are non-response of economic growth on nutritional well-being and greater burden among the poor. This calls for strengthening developmental finance for socioeconomic upliftment as well as enhanced programmatic support for nutritional interventions. The gaps in analytical inputs for programmatic purposes also deserves attention to unravel intricacies that otherwise remain obscured through customary enquiries. On one hand, this may serve well to improve policy targeting and on the other can help comprehend the nature and reasons of heterogeneities and inequities in nutritional outcomes across groups and geographies. In conclusion, we recommend strengthening analytical capacities of programme managers and health functionaries.
Working paper #: Volume 18, No. 4
Author(s): Rockli Kim, Akshay Swaminathan, Goutham Swaminathan, Rakesh Kumar, Sunil Rajpal, Jeffrey C. Blossom, William Joe, and SV Subramanian
In India, data on key developmental indicators that formulate policies and interventions are routinely available for the administrative units of districts but not for the political units of Parliamentary Constituencies (PC). Members of Parliament (MPs) in the Lok Sabha, each representing 543 PCs as per the 2014 India map, are the representatives with the most direct interaction with their constituents. The MPs are responsible for articulating the vision and the implementation of public policies at the national level and for their respective constituencies. In order for MPs to efficiently and effectively serve their people, and also for the constituents to understand the performance of their MPs, it is critical to produce the most accurate and up-to-date evidence on the state of health and well-being at the PC-level. However, absence of PC identifiers in nationally representative surveys or the Census has eluded an assessment of how a PC is doing with regards to key indicators of nutrition, health and development.
In this report, we present PC estimates for 100+ indicators of nutrition, health and development derived from two data sources.