Terrorism and early childhood health outcomes: Evidence from Pakistan
Terrorism and early childhood health outcomes: Evidence from Pakistan
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DOI：
10.1016/j.socscimed.2019.112453
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发表时间：
2019-09-01
影响因子：
5.4
通讯作者：
Ray, Arijit
中科院分区：
文献类型：
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作者：
Grossman, Daniel;Khalil, Umair;Ray, Arijit
目的：研究最近恐怖活动的增加如何影响遭受暴力的儿童的健康。方法：利用巴基斯坦恐怖袭击的空间和时间变化，结合各个层面的固定效应策略，我们确定了恐怖活动对儿童身高、体重和健康行为的因果影响。结果：如果袭击发生在怀孕期间和 12 岁至 12 岁之间，袭击强度增加一个标准差（定义为每次袭击的死亡人数），会导致每 1000 名儿童中约 5 名儿童发育迟缓。如果出生后发生攻击，每 1000 名儿童中就有 19 名儿童发育迟缓。对于低体重（衡量短期营养不良的指标）而言，我们发现，如果袭击发生在出生后，恐怖袭击强度每增加一个标准差，就会导致每 1000 名儿童中体重过低的儿童增加 8 至 12 人。对于严重发育迟缓和体重极轻的情况，我们发现仅对妊娠期间的发作有统计上显着的影响。我们还记录了，为了应对出生前的恐怖主义，每 1000 名儿童的疫苗接种率减少了 2 至 8 名。结论：总体而言，我们的结论是，子宫内或幼儿期经历的暴力事件可能对健康和人力资本发展产生长期持久影响。减少与医疗保健基础设施的互动是一种可能的机制。
Objective: To study how the recent rise in terrorist activity affects health of children exposed to violence.Method: Using spatial and temporal variation in terrorist attacks in Pakistan, combined with a fixed effect strategy at various levels, we identify the causal effect of terrorist activity on height, weight, and health behaviors of children.Results: A one-standard deviation increased intensity of attack, defined as number of fatalities per attack, leads to approximately 5 more children per 1000 being stunted if attacks occur during gestation and between 12 and 19 more children per 1000 being stunted if attacks occur post birth. For low weight, a measure of short-term malnutrition, we find a one-standard deviation increased intensity of terrorist attack leads to between 8 and 12 more children per 1000 being low weight if attacks occur post birth. For both severely stunted and very low weight, we find statistically significant effects only for attacks during gestation. We also document a reduction of between 2 and 8 per 1000 children in vaccination take-up, in response to terrorism immediately before birth.Conclusions: Overall, we conclude that violent events experienced in utero or in early childhood can have long lasting impacts on health and human capital development. Reduced interaction with healthcare infrastructure is a possible mechanism at work.