104 research outputs found

    Sex-selective Abortion Bans are Not Associated with Changes in Sex Ratios at Birth among Asian Populations in Illinois and Pennsylvania

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    Legal prohibitions on sex-selective abortions are proliferating in the United States. Eight state legislatures have banned abortions sought on the basis of the sex of the fetus, 21 states have considered such laws since 2009, and a similar bill is pending in U.S. Congress. These laws have been introduced and enacted without any empirical data about their impact or effectiveness. Prior studies of U.S. Census data found sex ratios among foreign-born Chinese, Korean and Indian immigrants were skewed in favor of boys, but only in families where there were already one or two girls. Using the variation in the timing of bans in Illinois and Pennsylvania as natural experiments, we compare the pre-ban and post-ban sex ratios of certain Asian newborn children in these states over 12-year periods. We then compare these ratios with the sex ratios of Asian newborn children in neighboring states during the same period. We find that the bans in Illinois and Pennsylvania are not associated with any changes in sex ratios at birth among Asians. In Illinois and its neighboring states, the sex ratio at birth of Asian children was not male-biased during our study period. On the other hand, the sex ratio at birth among Asians in Pennsylvania and its neighboring states was skewed slightly in favor of boys, but the enactment of the ban did not normalize the sex ratio. This strongly suggests that sex-selective abortion bans have had no impact on the practice of sex selection, to the extent that it occurs, in these states. This finding is highly relevant to legislative and policy debates in the U.S. Congress and state legislatures where sex-selective abortion laws are being considered

    Socioeconomic Differences in the Impact of Smoking Tobacco and Alcohol Prices on Smoking in India

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    The threat posed by smoking to health in India is severe. Already 1 in 5 of all adult male deaths and 1 in 20 of all adult female deaths at ages 30-69 are due to smoking and India will soon have 1 million smoking deaths a year. Increasing tobacco prices has been found to be the single most effective method to reduce smoking. Yet, bidis, the most common form of smoked tobacco in India, are largely untaxed, while cigarettes are taxed at about 40% of retail price, well below the 65–80% rate noted by the World Bank in countries with effective tobacco control policies. Moreover, low and stagnant tax rates have occurred in a period in which all tobacco products have become more affordable with income growth. First, we use data from the most recent three consecutive quinquennial National Sample Survey (NSS) rounds (NSS 50, 55 and 61 conducted in 1993/94, 1999/00 and 200/05) and a two-equation system of budget shares and unit values that attempts to correct for quality and measurement error. Second, we pool data from the most recent nine rounds of NSS (NSS 55-57, 59-64, conducted between 1999/00 to 2007/08). Our analyses of single and repeated cross-sections yield own-price elasticity for bidis that are roughly in keeping with existing evidence. We find that a 10% increase in bidi prices would reduce the demand for bidis by about 6 to 9.5%. We find, however, that own-price elasticity for cigarettes in India is substantially larger than previously thought. Our estimates suggest that cigarette users are at least as responsive as bidi users to price changes. On the whole, our analyses suggest that low SES households are likely more responsive to price changes than high SES households. Our analyses also uncovers important and policy-relevant cross-prices effects. Findings from this study provide additional evidence of the effectiveness of tobacco prices at reducing tobacco use.

    Reduced burden of childhood diarrheal diseases through increased access to water and sanitation in India : a modeling analysis

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    Each year, more than 300,000 children in India under the age of five years die from diarrheal diseases. Clean piped water and improved sanitation are known to be effective in reducing the mortality and morbidity burden of diarrhea but are not yet available to close to half of the Indian population. In this paper, we estimate the health benefits (reduced cases of diarrheal incidence and deaths averted) and economic benefits (measured by out-of-pocket treatment expenditure averted and value of insurance gained) of scaling up the coverage of piped water and improved sanitation among Indian households to a near-universal 95% level. We use IndiaSim, a previously validated, agent-based microsimulation platform to model disease progression and individual demographic and healthcare-seeking behavior in India, and use an iterative, stochastic procedure to simulate health and economic outcomes over time. We find that scaling up access to piped water and improved sanitation could avert 43,352 (95% uncertainty range [UR] 42,201-44,504) diarrheal episodes and 68 (95% UR 62-74) diarrheal deaths per 100,000 under-5 children per year, compared with the baseline. We estimate a saving of (in 2013 US)) 357,788 (95% 345,509−345,509-370,067) in out-of-pocket diarrhea treatment expenditure, and 1646(951646 (95% UR 1603-$1689) in incremental value of insurance per 100,000 under-5 children per year over baseline. The health and financial benefits are highly progressive, i.e. they reach poorer households more. Thus, scaling up access to piped water and improved sanitation can lead to large and equitable reductions in the burden of childhood diarrheal diseases in India

    Halftime for SDGs: Maternal and Newborn Health—Best Investment Paper

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    Each year, 295,000 women die during and just after pregnancy, and 2.4 million babies die in the first month of their lives. In 2019, 2,160,000 neonatal deaths and 275,000 maternal deaths occurred in low- income and lower-middle income countries alone, translating to a welfare loss equivalent to 426billionand426 billion and 36 billion for neonatal and maternal deaths respectively. The total loss was 462billionoralmost6462 billion or almost 6% of these countries’ combined GDP.In the Sustainable Development Goals (SDGs) pledge, the world promised to reduce maternal deaths to 0.07% and neonatal mortality to below 1.2%, saving about 200,000 women and 1.2 million children from dying annually. However, on the current trajectory, maternal mortality is expected to decline to only 0.16% and neonatal deaths to only 1.5% by 2030.This paper analyses the most cost-effective way to reduce maternal and neonatal deaths - Increase coverage of Basic Emergency Obstetric and Newborn Care (BEmONC) from 68% to 90% combined with increased family planning services in 55 low-income and lower-middle income countries which account for around 90% of the burden of maternal and neonatal mortality globally.The proposed package will require 3.2 billion per year more investment and will deliver benefits worth 278billionperyearinavoideddeathsandhighereconomicgrowth.Itwillalsoyieldademographicdividendbenefitequivalentto278 billion per year in avoided deaths and higher economic growth. It will also yield a demographic dividend benefit equivalent to 25bn annually. For every 1invested,thesocialandeconomicbenefitsareestimatedtobe1 invested, the social and economic benefits are estimated to be 87. The benefit-cost ratio (BCR) is 87

    Gender Gaps in Cognitive and Noncognitive Skills: Roles of SES and Gender Attitudes

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    Gender gaps in skills exist around the world but differ remarkably among the high and low-and-middle income countries. This paper uses a unique data set with more than 20,000 adolescents in rural India to examine whether socioeconomic status and gender attitudes predict gender gaps in cognitive and noncognitive skills. We find steep socioeconomic and attitude gradients in both cognitive and noncognitive skills, with bigger effect sizes for the socioeconomic status (SES) gradients. Our results suggest that a sizable improvement in gender attitudes would yield important gains for females, but substantial gains would come only from large improvements in household socioeconomic status. Overall, the household socioeconomic and cultural environment is significantly associated with the gender gaps in both cognitive and noncognitive skills
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