Urban Water Disinfection and Mortality Decline in Developing Countries

58 Pages Posted: 26 Mar 2017

See all articles by Sonia R. Bhalotra

Sonia R. Bhalotra

IZA Institute of Labor Economics

Alberto Diaz-Cayeros

Stanford University

Grant Miller

Stanford University - School of Medicine; National Bureau of Economic Research (NBER)

Alfonso Miranda

Keele University - School of Economic and Management Studies; Institute for the Study of Labor (IZA)

Atheendar Venkataramani

University of Pennsylvania - Perelman School of Medicine

Abstract

Historically, improvements in the quality of municipal drinking water made important contributions to mortality decline in wealthy countries. However, water disinfection often does not produce equivalent benefits in developing countries today. We investigate this puzzle by analyzing an abrupt, large-scale municipal water disinfection program in Mexico in 1991 that increased the share of Mexico's population receiving chlorinated water from 55% to 85% within six months. We find that on average, the program was associated with a 37 to 48% decline in diarrheal disease deaths among children (over 23,000 averted deaths per year) and was highly cost-effective (about $1,310 per life year saved). However, we also find evidence that age (degradation) of water pipes and lack of complementary sanitation infrastructure play important roles in attenuating these benefits. Countervailing behavioral responses, although present, appear to be less important.

Keywords: clean water, chlorination, child mortality, infectious disease, diarrhea, Mexico, cost-effectiveness, sanitation, behavioral responses

JEL Classification: I18, H41, J11

Suggested Citation

Bhalotra, Sonia R. and Diaz-Cayeros, Alberto and Miller, Grant and Miranda, Alfonso and Venkataramani, Atheendar, Urban Water Disinfection and Mortality Decline in Developing Countries. IZA Discussion Paper No. 10618. Available at SSRN: https://ssrn.com/abstract=2940608

Sonia R. Bhalotra (Contact Author)

IZA Institute of Labor Economics ( email )

P.O. Box 7240
Bonn, D-53072
Germany

Alberto Diaz-Cayeros

Stanford University ( email )

Stanford, CA 94305
United States

Grant Miller

Stanford University - School of Medicine ( email )

291 Campus Drive
Li Ka Shing Building
Stanford, CA 94305-5101
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Alfonso Miranda

Keele University - School of Economic and Management Studies ( email )

United Kingdom

Institute for the Study of Labor (IZA) ( email )

P.O. Box 7240
Bonn, D-53072
Germany

HOME PAGE: http://www.iza.org/en/webcontent/personnel/photos?key=2804

Atheendar Venkataramani

University of Pennsylvania - Perelman School of Medicine ( email )

423 Guardian Drive
Philadelphia, PA 19104
United States

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