title: Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries.
abstract: A long literature in demography has debated the importance of place for health, especially children's health. In this study, we assess whether the importance of dense settlement for infant mortality and child height is moderated by exposure to local sanitation behavior. Is open defecation (i.e., without a toilet or latrine) worse for infant mortality and child height where population density is greater? Is poor sanitation is an important mechanism by which population density influences child health outcomes? We present two complementary analyses using newly assembled data sets, which represent two points in a trade-off between external and internal validity. First, we concentrate on external validity by studying infant mortality and child height in a large, international child-level data set of 172 Demographic and Health Surveys, matched to census population density data for 1,800 subnational regions. Second, we concentrate on internal validity by studying child height in Bangladeshi districts, using a new data set constructed with GIS techniques that allows us to control for fixed effects at a high level of geographic resolution. We find a statistically robust and quantitatively comparable interaction between sanitation and population density with both approaches: open defecation externalities are more important for child health outcomes where people live more closely together.
authors.affiliation: r.i.c.e., a research institute for compassionate economics, New Delhi, India.
authors.forename: Payal
authors.initials: P
authors.lastname: Hathi
authors.affiliation: World Bank Water and Sanitation Program, Washington, DC, USA.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Haque
authors.affiliation: r.i.c.e., a research institute for compassionate economics, New Delhi, India.
authors.forename: Lovey
authors.initials: L
authors.lastname: Pant
authors.affiliation: r.i.c.e., a research institute for compassionate economics, New Delhi, India. coffey@utexas.edu.|Department of Sociology & Population Research Center, University of Texas, Austin, TX, USA. coffey@utexas.edu.|Indian Statistical Institute, Delhi, India. coffey@utexas.edu.
authors.forename: Diane
authors.initials: D
authors.lastname: Coffey
authors.affiliation: r.i.c.e., a research institute for compassionate economics, New Delhi, India.|Indian Statistical Institute, Delhi, India.|Department of Economics, University of Texas, Austin, TX, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: Spears
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D001827:Body Height; D002648:Child; D000067576:Child Health / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data*; D040362:Geographic Information Systems; D014943:Global Health; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008423:Maternal Age; D011156:Population Density; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012499:Sanitation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014038:Toilet Facilities / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Child height; Infant mortality; Population density; Sanitation; South Asia