Malnutrition, infectious disease and economic development

This dissertation consists of three essays in the field of health and development economics. The broad theme is whether and to what extent do improvements in the health or disease environment have a causal impact on human capital accumulation and economic development. Chapter I studies the effect of early childhood malnutrition on adult obesity, drawing evidence from the 1959-61 China Famine. Studying the health outcomes and health behaviors of adult men and women who were born around the time of the famine, I find that women who as infants were exposed to famine have on average a higher body mass index (BMI) and are more likely to be obese than women who were not exposed to famine. I do not find significant effects on obesity for men. I also find no evidence that the increase in BMI is differentially greater for the famine cohorts who are exposed to a food-rich environment in adult life than for the famine cohorts who are not. Using detailed individual-level data on food intake and physical activities, I show that the increase in BMI for famine-exposed women is not due to higher caloric or fat intakes nor to more sedentary lifestyles. Chapter II, which is joint work with Wei Ha, studies the intergenerational effects of the 1959-61 China Famine. We first show that individuals born during the famine experience stunting, have a higher BMI, have fewer years of schooling, and are less likely to have completed primary school. We then show that children born to these famine cohorts also experience significant negative effects, even though they were born some 15 to 40 years after the famine. These children have a lower height-for-age and weight-for-age compared to those born to parents who have not been exposed to famine. The negative effects do not disappear even after controlling for parents' health and education. We point out that understanding the intergenerational transmission of health capital is important for understanding the intergenerational transmission of poverty. Chapter III, which is joint work with David Cutler, Michael Kremer, Monica Singhal, and Tom Vogl, examines the effects of early life exposure to malaria on the educational attainment and economic status in adulthood by exploiting geographic variation in malaria prevalence in India prior to a nationwide eradication program in the 1950s. We find that the malaria eradication program led to modest increases in household per capita consumption for prime age men, and the effects for men are larger than those for women in most specifications. We find no evidence of increased educational attainment for men, and mixed evidence for women.