PUBLICATIONS & WORKING PAPERS

The Effects of an Epidemic on Prenatal Investments, Childhood Mortality and Health of Surviving Children. With Ricardo Sanchez. Journal of Population Economics, 2023.

The potential death toll from an epidemic is larger than the number of deaths directly associated with the infection. In this study, we find that prenatal exposure to a cholera epidemic in Peru increased childhood mortality and that surviving children were more likely to be underweight and to suffer from diarrhea. We further find that a significant part of this mortality happened during the first day of life, and that prenatal exposure to cholera decreased prenatal care and institutional deliveries, suggesting that the mortality and possibly other longer-term effects were partially driven by a reduction in prenatal investments.

Soda Expansion in The Tropics: The Effect on Obesity Rates Among Women Without Piped Water At Home. Economics and Human Biology, 2023. 

Obesity rates and soda consumption are increasing at a worrisome pace in developing countries. In particular, soda companies seem to be targeting areas with poor access to clean water. This paper exploits a natural experiment in Peru and finds evidence that changes in the price of soda generate important effects in terms of obesity among individuals without piped water at home. These significant effects are driven by a combination of a large effect in the consumption of soda and an effect close to zero in the consumption of potential substitutes high in calories. This paper also provides some evidence that a reduction in price of soda reduces diarrhea prevalence, suggesting that some individuals substitute away contaminated water. This evidence suggests that soda taxes might be particularly beneficial among this population in terms of the prevention of obesity and possibly related diseases such as diabetes and cardiovascular diseases. The potential trade-off between obesity and diarrhea needs to be investigated in greater depth.

First Place Poster Winner, Thursday Nov. 12, 2015, APPAM Annual Research Conference

Finalist, Paper Competition Award, Illinois Economic Association (with an early version)

The Unintended Effect of Piped Water at Home on Childhood Overweight Rate. Experimental Evidence from Urban Morocco. Review of Economics of the Household, 2023.

Obesity is a global epidemic costing billions of dollars and millions of deaths. Roughly 79% of overweight children under five live in middle-income countries, where only about half of the households have access to piped water at home. This study exploits a social experiment that encourages connection to piped water in the city of Tangiers and finds an unintended effect: a large reduction in children’s overweight rate. It also finds evidence of several potential channels: a reduction in the cost of water, an increase in available time, in particular to perform household chores, and a reduction in stress levels.

Twice Unlucky. From Early Life Cholera Exposure to Adult Covid-19 Mortality. With R. Sanchez 

Many individuals in developing countries experience multiple shocks over their lifetimes, yet the interplay between these shocks is not well understood. This study estimates the impact of prenatal exposure to the cholera epidemic in Peru in the early 1990s on COVID-19 mortality several decades later. We find that a one-standard deviation increase in cholera exposure during the first trimester in utero—measured by regional infection rates—results in a 5% increase in COVID-19 mortality among working-age women. Significant long-term effects on cardiovascular health and economic vulnerability were identified as potential mediators. Given that cholera is the second most common type of epidemic worldwide, this study suggests that policies aimed at reducing the spread of such epidemics could yield substantial long-term benefits. Additionally, countries with a history of cholera may experience disproportionate benefits from COVID-19 vaccination efforts.

Does Early-Life Medicaid Protect Against Pandemic Mortality? Evidence from COVID-19. With Michael DiNardi

This paper tests whether the long-run health gains from early-life Medicaid exposure translate into protection against acute, large-scale mortality shocks, using the COVID-19 pandemic as a natural experiment. Exploiting variation from the rollout of Medicaid in the 1960s, we find that childhood Medicaid eligibility reduced adult mortality during the pandemic, with effects comparable in magnitude to those observed in the decade prior to COVID-19. We also find similar reductions in COVID-19 and non-COVID mortality, suggesting that Medicaid’s long-run benefits extend beyond chronic disease to increase resilience to acute infectious shocks. Although estimated treatment effects are not statistically different across racial groups, higher exposure and baseline mortality among non-white individuals imply that childhood Medicaid contributed to narrowing racial disparities in pandemic mortality. These findings highlight the role of early-life health investments as a tool for reducing population vulnerability during future pandemics.

The Effect of Internet and Telephones on Employment and Agricultural Production in Rural Villages in Peru. With Maria E. Guerrero.  [Link]

 “Más te Quiero, Más te Pego?” The Effect of the Cash Transfer Program Juntos on Women Empowerment. Lima: Instituto Nacional de Estadistica e Informatica, 2014. Spanish version  [Link]