Abstract: Despite government campaigns aimed at raising awareness of non-communicable disease prevention, improvements in awareness remain limited, in part because demand for disseminated preventive health information is low. I posit that one reason for this low demand is the lack of salience of health shocks in everyday life, which leads individuals to neglect or underestimate future health risks and consequences. To test this, I implement a randomised controlled trial that evaluates the effect of a story about living with diabetes on demand for preventive health information. This story is designed to make a health shock and its consequences salient and relatable. I find that the intervention increases the demand for a diabetes prevention article, which is low in the control group, by nearly a half. The treatment effect also extends to a second health article that is neither diabetes-related nor self-related, but instead spouse-related, indicating spillovers across diseases and within the household. Mechanism analysis suggests that the intervention increases perceived health risks and the salience of family-related health consequences. These findings suggest that stories about health shock experiences should be incorporated into health information dissemination campaigns to increase demand.
Abstract: The roll-out of antiretroviral therapy (ART), an HIV treatment, since 2000 has been found to dramatically improve HIV survival and increase adult life expectancy. We exploit the roll-out of ART in rural Malawi and provide national-level evidence on the effects of ART on an extensive array of health and economic outcomes. Combining a nationally representative survey data set with administrative data from Malawi’s Ministry of Health on health clinics, we construct a spatial and temporal variation in ART availability and estimate a difference-in-difference model. We find that access to the life-saving therapy significantly reduced illness-related prime-age mortality and morbidity. ART roll-out explains 60 per cent of the total decline in illness-related prime-age mortality observed in our data between 2004 and 2016. This improved health is accompanied by a significant increase in the work time of casual labour by 22 per cent but not in other activities, such as agriculture. This increase in work time did not change income, total expenditure and assets owned. Despite the null effects on economic well-being, we detect substantial effects on household expenditure on health and education. Our findings suggest that ART availability may have created surplus labour in a mainly rural economy like Malawi so that increased ability to work and human capital investments did not translate into improved economic well-being.