The causal effect of parental education on child mortality: evidence from the education reform in Vietnam (Lead author, with Dr. Minh Nguyen and Prof. Yoko Ibuka) (R&R, World Development) Presented at: the 3rd AWEHE, the 2021 JEA Autumn Meeting, the 2023 VEAM, Keio Applied Economics Workshop, Sophia Economics Seminar.

This paper examines the causal effects of paternal education on child mortality and potential underlying mechanisms. Using the 2009 Vietnam Population and Housing Census, we exploit the 1991 Universal Primary Education reform, which increased the duration of compulsory schooling from zero to 5 years, to implement a RD to address the endogeneity of paternal education to child mortality. The reform increased the average years of education for women and men by 0.55 and 0.53 years, respectively. Our IV results indicate that one additional year of maternal schooling induced by the education reform reduced child mortality by 29.4%. Increased paternal education also has a negative impact on child mortality, but the effect becomes insignificant when controlling for maternal education. Most of the improvement in child mortality were concentrated among women living in rural areas and in less developed regions. We also identify a number of pathways through which increased maternal education might affect child mortality, including increasing the likelihood of engaging in the labor force, having fewer children, delaying the onset of marriage, and having better prenatal care and health-seeking behaviors during and after pregnancy. 

The Effects of Spousal Caregiving on Caregivers’ Health and Well-being: 

Evidence from Vietnam (Lead author with Dr. Truc Dang and Prof. Long Giang) - R&R, Research on Aging

To date, little is known about the effects of informal caregiving in developing countries. To bridge that gap in research, we examine the effect of informal care on health and well-being of spousal caregivers in Vietnam, a developing country with a fast-aging process and early stage of LTC system development. Utilizing the national survey on aging in Vietnam with propensity score matching estimations to address potential endogenous problems of the decision to provide care between caregivers and non-caregivers, we found that providing care increased the probability of having poor psychological well-being, poor life-satisfaction and at least functional limitation by 7.3, 9.7, and 8.6 percentage points, respectively. These results are robust to many robustness checks. We also found that the caregiving effects are heterogenous by age groups, gender, educational levels, working status, and place of residence.

The Effects of Caring for Grandchildren on Health and Well-being of Grandparents: Evidence from Vietnam (Lead author with Prof. Long Giang) - Under review by Review of Economics of the Household

To date, the effects of grandparenting on grandparents’ health and well-being do not reach the same conclusion and most of them have been conducted in developed countries. We add to this literature by examining the causal relationship between grandparenting and grandparents’ health and well-being in Vietnam, where the social norm and reciprocal relationships between adult children and their older parents are strong. Using instrumental variable estimations, we find that grandparenting care had positive effects on psychological well-being, life satisfaction, and self-rated health of grandparents. These results are robust to many robustness checks. Further exploring mechanisms underlying the effects reveals that improvements in memory and stronger social network were potential channels through which grandparenting might improve the health and well-being of grandparents.

Re-examining the Impact of Maternal Education on Child Mortality: Evidence From an Increase Tuition Fee Policy in Vietnam (Lead author) - Under review by International Journal of Educational Development

In this study, we revisit the paper by Phung-Nguyen (2023) (International Journal of Educational Development 96: 102704) who find that maternal education reduced neonatal, infant, and under-five mortality in Vietnam. She uses exposure to the introduction of tuition fee policy in1989 as an exogenous variation and using it to instrument for maternal education. We aimed to replicate her findings since the effect sizes of maternal education found in her paper are enormous. Using the same data and policy, we found no effect of maternal education on child mortality. Our result holds even when we use an alternative data for robustness checks.

Explaining socioeconomic inequality in depression among older people: A comparison between Vietnam and Myanmar (Lead author with Dr. Truc Dang) - Under review by Innovation in Aging

This study applied two commonly used decomposition analyses in health inequality studies to examine factors contributing to socioeconomic-related inequalities in depression within and between Vietnam and Myanmar. Using two comparable surveys from the 2012 Myanmar Aging Survey (N=4,056) and the 2011 Vietnam National Aging Survey (N=2,688), we found that the inequality, measured by concentration index (CI), was disproportionally concentrated among the worse-off in both countries, with the degree of inequality being less in Myanmar than in Vietnam. The first decomposition (CI decomposition) results showed that subjective income and financial assistance from children were the major drivers to the observed inequality across countries examined. Finally, the second decomposition (the Oaxaca-Blinder decomposition) results revealed that the observed difference between Vietnam and Myanmar in the inequality was mostly owing to less uneven distributions of wealth across factors examined in Myanmar relative to Vietnam.

The Intergenerational Health Effects of Child Marriage Bans (Lead author with Prof. Terera Molina, Prof. Yoko Ibuka, and Prof. Rei Goto) Presented at NBER, University of Connecticut, University of Hawaii at Manoa, 2023 JEA, Hitotsubashi University, and Sophia University

Using a sample of over 200,000 women across 18 countries, we investigate the effects of child marriage bans on infant and under-5 mortality rates of the next generation. We exploit variation in mothers’ exposure to the ban across cohorts within each country, as well as subnational regional variation in “treatment intensity,” which we define based on the prevalence of and average age among child marriages prior to the ban. We find that child marriage bans reduced infant and under-5 mortality, with magnitudes of 14.3 and 19.9 percent corresponding to a one standard deviation change in treatment intensity, respectively. Reductions were driven by low-income countries and less wealthy households. Increases in age at first marriage and first birth, which may have led to better bargaining power and agency for these mothers during the prenatal and postnatal period, appear to be the main drivers of the mortality reductions documented.

The effects of public health insurance on healthcare expenditures among older beneficiaries in Vietnam: RD-DID approach (Lead author with Prof. Rei Goto and Prof. Yoko Ibuka)

This paper evaluates the effects of changes in health insurance co-payment rates stipulated in the 2009 Health Insurance Law on healthcare expenditures and utilization by older pensioners in Vietnam. We adopt the most current appropriate econometric techniques in health economics to model healthcare data and then we exploit the enactment of the 2009 Law as a natural experiment to conduct a quasi-experiment study using RD-DID estimations. Using data from the Vietnam Household Living Standard Survey 2004-2014, we found that the effects of the 2009 Law, based on the best-fitting models for healthcare expenditure and utilization outcomes, were a significant increase in healthcare spending for both outpatient and the total healthcare expenditures, while the number of outpatient and inpatient visits were found to be significantly increased across levels of healthcare facilities. The results of this study suggest the ex-ante moral hazard in the use of healthcare whereby individuals who are offered a lower rate of co-payment tend to use more care.