On the Determinants of Mortality Reductions in the Developing World

This paper presents and critically discusses a vast array of evidence on the determinants of mortality reductions in developing countries. We argue that increases in life expectancy between 1960 and 2000 were largely independent from improvements in income and nutrition. We then characterize the age and cause of death profile of changes in mortality and ask what can be learned about the determinants of these changes from the international evidence and from country-specific studies. Public health infrastructure, immunization, targeted programs, and the spread of less palpable forms of knowledge all seem to have been important factors. Much of the recent debate has revolved around antagonistic approaches, which are not supported by the evidence discussed here. Finally, the paper suggests that the evolution of health inequality across and within countries is intrinsically related to the process of diffusion of new technologies and to the nature of these new technologies (public or private).

Health and the Evolution of Welfare across Brazilian Municipalities

This paper describes the pattern of reductions in mortality across Brazilian municipalities between 1970 and 2000, and analyzes its causes and consequences. It shows that, as in the international context, the relationship between income and life expectancy has shifted consistently in the recent past. But reductions in mortality within Brazil have been more homogeneously distributed than across countries. We use a compensating differentials approach to estimate the value of the observed reductions in mortality. The results suggest that gains in life expectancy had a welfare value equivalent to 39% of the growth in income per capita, being therefore responsible for 28% of the overall improvement in welfare. We then use a dynamic panel to conduct a preliminary assessment of the potential determinants of these gains. We show that improvements in education, access to water, and sanitation seem to be important determinants of the dimension of changes in life expectancy not correlated with income.

Access to justice and entrepreneurship: evidence from Brazil’s Special Civil Tribunals

Entrepreneurship is usually indentified as an important determinant of aggregate productivity and long-term growth. The determinants of entrepreneurship, nevertheless, are not entirely understood. A recent literature has linked entrepreneurship to the development of the justice system. This paper contributes to this literature by evaluating the role of access to justice in determining the incidence of entrepreneurship. We explore the creation of Special Civil Tribunals in the Brazilian state of São Paulo during the 1990s. Special Civil Tribunals increased the geographic presence of the justice system, simplified judicial procedures, and increased the speed of adjudication of disputes. Using census data, and difference-in-differences and instrumental variable strategies, we find that implementation of Special Civil Tribunals led to increased entrepreneurship, defined as the probability that individuals are employers or selfemployed. Results are particularly strong and robust for the case of self-employment, and do not seem to be related to other changes in infrastructure or public good provision at the local level, or to pre-existing trends in entrepreneurship.access to justice, courts, entrepreneurship, institutions, Brazil Jel Codes: K1, K41, K42, H41, O12, O17, O54

Evaluating the Impact of Community-Based Health Interventions: Evidence from Brazil's Family Health Program

This paper analyzes the direct and indirect impacts of Brazil's Family Health Program. We estimate the effects of the program on mortality and on household behavior related to child labor and schooling, employment of adults, and fertility. We find consistent effects of the program on reductions in mortality throughout the age distribution, but mainly at earlier ages. Municipalities in the poorest regions of the country benefit particularly from the program. For these regions, implementation of the program is also robustly associated with increased labor supply of adults, reduced fertility, and increased schooling. Evidence suggests that the Family Health Program is a highly cost-effective tool for improving health in poor areas.family health program, mortality, household behavior, impact evaluation, Brazil

Organization and Information in the Fight against Crime: An Evaluation of the Integration of Police Forces in the State of Minas Gerais, Brazil

This paper explores the experience of information sharing, coordination, and integration of actions of the Civil and Military Polices in the state of Minas Gerais, Brazil, in the context of the IGESP program. The IGESP is based on the introduction of information management systems and organizational changes akin to those associated with COMPSTAT. All the evidence presented points to a causal effect of the IGESP on crime. The most conservative estimates indicate a reduction of 24% in property crimes and 13% in personal crimes. There is also evidence that the IGESP is associated with improved police response, measured by apprehension of weapons and clearance rates. We present one of the first set of causal estimates – with a clear identification strategy – of the impact of COMPSTAT-like programs. The results suggest that the coordination and informational gains represented by the program may constitute a first-order factor in a successful policy for fighting crime.crime, police, Brazil, COMPSTAT, impact evaluation

Altruism, Fertility, and the Value of Children: Health Policy Evaluation and Intergenerational Welfare

This paper accounts for the value of children and future generations in the evaluation of health policies. This is achieved through the incorporation of altruism and fertility in "value of life" type of framework. We are able to express adults' willingness to pay for changes in child mortality and also to incorporate the welfare of future generations in the evaluation of current policies. Our model clarifies a series of puzzles from the literature on the "value of life" and on intergenerational welfare comparisons. We show that, by incorporating altruism and fertility into the analysis, the estimated welfare gain from recent reductions in mortality in the U.S. easily doubles.