Flood Disasters and Health among the Urban Poor

(joint work with David Johnston, Rachel Knott and Rohan Sweeney). In this paper we estimate the effects of flood disasters on the mental and physical health of poor adults and children in urban Indonesia. Our data come from the Indonesia Family Life Survey and new surveys of informal settlement residents from the Revitalising Informal Settlements and their Environment program. We find that urban poor populations experience increases in acute morbidities and depressive symptoms following floods, that the negative mental health effects last longer, and that the urban wealthy show no health effects from flood exposure. Further analysis suggests that worse economic outcomes may be partly responsible. Overall, the results provide a more nuanced understanding of the morbidities experienced by populations most vulnerable to increased disaster occurrence.  

Recommended citation:  Escobar Carias, M. S., Johnston, D. W., Knott, R., Sweeney, R. (2022). Flood disasters and health among the urban poor. Health Economics, Vol 31(9), 2072-2089.  

A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia

In this paper, drawing on baseline findings from the Revitalising Informal Settlements and their Environments (RISE) transdisciplinary research program, we bring together ‘transformative WASH’ and planetary health in order to generate an empirically grounded conceptual model of health and environment in urban informal settlements.  We undertook a 12-month health and environmental assessment in 12 flood-prone informal settlements in Makassar, Indonesia. We obtained caregiver-reported health data, anthropometric measurements, stool and blood samples from children < 5 years, and health and wellbeing data for children 5–14 years and adult respondents. We collected environmental data including temperature, mosquito and rat species abundance, and water and sediment samples. Our planetary health model proposes a composite framework of markers to assess water and sanitation challenges and flood risks in urban informal settlements for optimal design and monitoring of interventions. 

Recommended citation: French, M., Barker, S. F., Taruc, R., et al. (2021) A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia. Environment International, Vol 155, 

Book Chapters

"Chapter XVII Free Trade Agreement between Mexico - Honduras: Transparency", published in book 'FTA Honduras - Mexico 10 years: Achievements and Prospects', 2011

Under Review

Temperature and decision making (Job Market Paper)

(joint work with David Johnston, Rachel Knott and Rohan Sweeney). This paper studies whether temperature is one of the potential factors that influences people's rationally and economic preferences. Using data from the Indonesia Family Life Survey (IFLS) and NASA’s MERRA-2 we exploit exogenous variations in outdoor temperatures caused by the quasi-random allocation of survey dates, to estimate the effects of temperature on elicited measures of risk aversion, rational choice violations, and impatience within climate zones (sub-province units binned by rurality, altitude and distance to the coast) over time. Our findings show that higher temperatures lead to significantly increased rational choice violations and impatience. We show that these effects are mainly driven by night-time temperatures on the day prior to the survey and less so by temperatures on the day of the survey. The evidence suggests that high nighttime temperatures significantly increase sleep disturbances, which in turn deplete cognitive functions the following day, math skills in particular. These math skills are then critical for people to engage in rational and utility maximizing decision making. We also find evidence that people's ability to cool their homes potentially plays an important role in moderating these effects. 

Economic Journal [revise & resubmit]

Long-term effects of the 2010 Haiti Earthquake on Child Nutrition

(joint work with Marina Dodlova and Michael Grimm).  This paper assesses the effects of natural disasters on human capital accumulation. In particular, we examine the impact of the 2010 Haiti earthquake on child nutrition and education. Using the geo-coded data from the USGS ShakeMaps and four waves of Demographic Health Surveys, we find strong negative impacts of the earthquake on child stunting and wasting as well as on school attendance and attainment. The results are robust to alternative specifications, sample changes and different methodologies applied for calculating shaking intensity. Importantly, the deterioration of child nutrition and education is significant after controlling for the aid allocated by the World Bank to overcome the earthquake’s aftermath. The results also hold after controlling for selective mortality and migration patterns. Our contribution accentuates the necessity to protect children’s nutrition, prevent food insecurity and protect education after natural disasters in resource-poor settings.

Journal of Human Resources [previously under review]

Work in Progress

Temperature, Health and Liveability: Evidence from Informal Settlements

(joint work with Grant Duffy, David Johnston, Rachel Knott, Emma Ramsay and Rohan Sweeney). This paper examines the relationship between outdoor temperature and health in the context of informal settlements (slums). We use self-reported mental and physical health data from adults and children in 24 informal settlements in Indonesia and Fiji, combined with weekly weather reanalysis data from NASA. We then employ a longitudinal analysis to study the temperature-health nexus. Our findings show that hotter weeks significantly increase the likelihood of having restless sleep, of feeling that it requires more effort to perform normal daily activities, of feeling that one's home is uncomfortably hot, and of being in poor health for Indonesian adults. Fijian adults experience increases of a similar magnitude in trouble concentrating and discomfort. Likewise, the children of these respondents experience comparable deteriorations in their sleep quality and physical health. These estimated effects become larger when both temperature and humidity are high. Next, we use unique settlement level temperature data to study the consistency of this relationship when using more accurate temperature sensing instruments. We find that although the marginal effects are similar across instruments, the estimated probabilities of experiencing the above outcomes are higher with settlement-level temperature data, because settlements tend to be 2-4 degrees Celsius hotter than what NASA data reports for the rest of the city. Finally, we use unique high-frequency indoor temperature data to study the indoor-outdoor temperature gap and the economic determinants of indoor temperature. To do so, we pair neighbours within settlements, interacted with date fixed effects to compare the indoor temperatures of similar households in the same day over a period of 2-3 years. The results suggest that few assets make a dent in the burden of heat experienced indoors, with the only exception of air-conditioning in Indonesia and having plants for shade in Fiji. This explains why throughout most of the observation period, temperatures were almost always higher indoors than outdoors in any given day. 

Child Morbidity and Time Use in Informal Settlements (joint work with Nicole Black, David Johnston and Rohan Sweeney).

In a substantial reversal of the gender gap in educational attainment, boys now have lower school progression rates and test scores than girls across a wide cross-section of countries. We document one potential contributor to this trend: gendered differences in children’s time allocation and their elasticity to family disadvantage. We use novel time use data of children living in informal settlements in Indonesia and Fiji to estimate the gender gap in time use, employing within-neighbourhood and within-sibling comparisons. We find that boys spend significantly less time than girls on schooling and homework. This does not result from a substitution between education and labor, but rather from leisure being a large component of boys’ time. These gender gaps are highly responsive to family disadvantage. Boys whose parents have lower schooling and more financial constraints, spend even less time in educational activities than girls from similar backgrounds. 

The impact of Headspace centres on the mental health of Australian adolescents and young adults (joint work with Nicole Black, Anthony Harris, and David Johnston).