Run if you can: impacts of investments in sanitation on health, using completion time of works as exogenous variation

Authors

DOI:

https://doi.org/10.1590/1980-53575241asrr

Keywords:

Sanitation, Evaluation of public policy, Infant health

Abstract

This paper analyzes the effects of sanitation investment projects on hospitalization rates in municipalities the Ministry of Cities selected for credit “decontingency”. As these authorizations to borrow were issued in different periods, since the National Secretary of Environmental Sanitation carried out its project selection in rounds, we used this fact to estimate a difference-in-differences model, with a correction for the possible endogeneity in the projects’ execution time. Our results point to important effects of those investments to reduce hospitalization rates. Results are particularly important for infants, but also for children up to 5 years old and the elderly (above 60 years old). As one analyzes the effects by different diseases, the reduction in hospitalization rates is more important for infectious, respiratory diseases and diseases related to inadequate environmental sanitation.

Downloads

Download data is not yet available.

Author Biographies

  • Pt Pt, Pt

    Economista

  • Pt Pt, Pt

    Professor Adjunto

References

Alsan, M. e C. Goldin. 2019. “Watersheds in child mortality: the role of effective water and sewerage infrastructure, 1880 1920”. Journal of Political Economy 127 (2): 586-638.

Bardhan, P. 2016. “State and development: The need for a reappraisal of the current literature”. Journal of Economic Literature 54 (3): 862-92.

Borraz, F., N. Gonzalez Pampillon e M. Olarreaga. 2013. “Water nationalization and service quality”. The World Bank Economic Review 27 (3): 389-412.

Cairncross, S. e R. Feachem (1993). Environmental Health Engineering in the Tropics: An Introductory Text. 2ª ed.. Chichester: John Wiley & Sons.

Callaway, B. e P. H. Sant’Anna. 2021. “Difference-in-differences with multiple time periods”. Journal of Econometrics 225 (2): 200-230.

Cutler, D. e G. Miller. 2005a. “The role of public health improvements in health advances: the twentieth-century United States”. Demography 42 (1): 1-22.

Cutler, D e G. Miller. 2005b. “Water, water, everywhere: municipal finance and water supply in American cities”. NBER Working Paper 11096, National Bureau of Economic Research, Cambridge.

Da Mata, D., L. Emanuel, V. Pereira e B. Sampaio. 2021. “Climate adaptation policies and infant health: evidence from a water policy in Brazil”. IZA Discussion Paper 14295, Institute of Labor Economics, Bonn.

Ferreira, D., I. Graziele, R. Marques e J. Gonçalves. 2021. “Investment in drinking water and sanitation infrastructure and its impact on waterborne diseases dissemination: The Brazilian case”. Science of The Total Environment 779 (20): 146279.

Freitas, F. G. e A. L. Magnabosco. 2017) Benefícios Econômicos e Sociais da Expansão do Saneamento Brasileiro. São Paulo: Instituto Trata Brasil.

Fujiwara, T. 2005. “A privatização beneficia os pobres? Os efeitos da desestatização do saneamento básico na mortalidade infantil”. Anais do 33º Encontro Nacional de Economia.

Galiani, S., P. Gertler e E. Schargrodsky. 2005. “Water for life: The impact of the privatization of water services on child mortality”. Journal of Political Economy 113 (1): 83-120.

Hennessy, T. W., T. Ritter, R. Holman, D. Bruden, K. Yorita, L. Bulkow, J. Cheek, R. Singleton, J. Smith. 2008. “The relationship between in-home water service and the risk of respiratory tract, skin, and gastrointestinal tract infections among rural Alaska natives”. American Journal of Public Health 98 (11): 2072-2078.

Kresch, E. P. 2020. “The Buck Stops Where? Federalism, Uncertainty, and Investment in the Brazilian Water and Sanitation Sector”. American Economic Journal: Economic Policy 12 (3): 374-401.

Laffont, J.-J. 1988. Fundamentals of Public Economics. Cambridge: MIT Press.

Lambert, B. 2019. “The Effect of Water and Sanitation Privatization on Child Mortality Rates in Guayaquil, Ecuador”. Undergraduate honors thesis, University of Colorado.

Matsuura, K. e C. J. Willmott. 2018a. “Terrestrial Air Temperature: 1900-2017 Gridded Monthly Time Series (Version 5.01)]”. Technical Report, Department of Geography, University of Delaware, Newark.

Matsuura, K e C. J. Willmott. 2018b. “Terrestrial Precipitation: 1900-2017 Gridded Monthly Time Series (Version 5.01)]”. Technical Report, Department of Geography, University of Delaware, Newark.

Mattos, E., C. Pinto, L. Teixeira e L. Meloni. 2019. “Sanitation and Health: Empirical evidence for Brazilian Municipalities”. Brazilian Review of Econometrics 39 (2): 269-302.

Mendonça, M. J. C. d. e R. S. d. Motta. 2007. “Saúde e saneamento no Brasil”. Pesquisa e Planejamento Econômico 30: 15-30.

Ortiz-Correa, J. S., M. Resende Filho e A. Dinar. 2016. “Impact of access to water and sanitation services on educational attainment”. Water Resources and Economics 14: 31-43.

Pimentel, L. e L. Capanema. 2018. “Água e Esgoto”. In Visão 2035: Brasil, país desenvolvido: agendas setoriais

para alcance da meta, editado por F. P. Puga e L. B. D. Castro. Rio de Janeiro: Ed. BNDES.

Pimentel, L. e M. Miterhof. 2021. “O Financiamento dos Serviços de Água e Esgoto: Análise do Passado Recente (2016-2019) e Desafios da Diversificação de Fontes para Chegar à Universalização”. BNDES Setorial 27 (53): 7-81.

Rocha, R. e R. R. Soares. 2010. “Evaluating the impact of community based health interventions: evidence from Brazil’s Family Health Program”. Health Economics 19 (S1): 126-158.

Rocha, R. e R. R. Soares (2015). “Water scarcity and birth outcomes in the Brazilian semiarid”. Journal of Development Economics 112: 72-91.

Saiani, C. e P. F. d. Azevedo. 2018. “Is privatization of sanitation services good for health?” Utilities Policy 52: 27-36.

Sant’Anna, A. A., R. A. Martini e L. B. Pimentel. 2019. “Esgotamento sanitário e saúde infantil nos municípios brasileiros: Análise a partir da expansão no acesso a financiamento de longo prazo”. 47º Encontro Nacional de Economia, ANPEC.

Sant’Anna, A. A., R. Rocha, L. B. Pimentel e M. Miterhof. 2021. “Fatos estilizados sobre o financiamento ao setor de água e esgoto no Brasil”. R. BNDES 28 (55): 161-188.

Scriptore, J. S., C. R. Azzoni e N. A. Menezes Filho. 2018. “Os impactos do saneamento básico sobre a educação: Usando a privatização como variável instrumental”. 46º Encontro Nacional de Economia, ANPEC.

Seroa da Motta, R. e A. Moreira. 2006. “Efficiency and regulation in the sanitation sector in Brazil”. Utilities Policy 14 (3): 185-195.

Souza Junior, P., C. Szwarcwald, G. Damacena, S. Stopa, M. Vieira, W. Almeida, M. Oliveira, L. Sardinha e E. Macário. 2021. “Cobertura de plano de saúde no Brasil: análise dos dados da Pesquisa Nacional de Saúde 2013 e 2019”. Ciência & Saúde Coletiva 26: 2529-2541.

Spears, D. e S. Lamba. 2016. “Effects of early-life exposure to sanitation on childhood cognitive skills: evidence from India’s total sanitation campaign”. Journal of Human Resources 51 (2): 298-327.

Swarthout, Jenna, P. K. Ram, C. D. Arnold, H. N. Dentz, B. F. Arnold, S. Kalungu, A. Lin, S. M. Njenga, C. P.

Stewart, J. M. Colford Jr. et al. 2020. “Effects of Individual and Combined Water, Sanitation, Handwashing, and Nutritional Interventions on Child Respiratory Infections in Rural Kenya: A Cluster-Randomized Controlled Trial”. American Journal of Tropical Medicine and Hygiene 102 (6): 1286-1295.

Watson, T. 2006. “Public health investments and the infant mortality gap: Evidence from federal sanitation interventions on US Indian reservations”. Journal of Public Economics 90 (8-9): 1537-1560.

Published

23-12-2022

Issue

Section

Articles

How to Cite

Pt, P., & Pt, P. (2022). Run if you can: impacts of investments in sanitation on health, using completion time of works as exogenous variation. Estudos Econômicos (São Paulo), 52(4), 657-693. https://doi.org/10.1590/1980-53575241asrr