Collaborative Research: Unintended Consequences of Behavior Change: An Examination of the Impacts on Child Health of Behavior Change in Response to Arsenic Mitigation in Bangladesh

政策建议往往会产生意想不到的后果。本研究旨在调查这样一个意外的后果：持续的负面儿童健康影响的行为发生在孟加拉国的大规模转变，在1999年左右，数百万家庭从使用方便的浅管威尔斯作为家庭饮用水的来源，不方便的深管威尔斯。这一转变是为了应对人们对浅管井中的砷污染会增加健康风险的担忧。然而，根据调查人员的初步调查结果，远离后院水源对幼儿的相关健康风险似乎被严重低估了。调查结果表明，在转换水源的家庭中，儿童死亡率大幅上升。本研究的实证贡献旨在从影响健康的其他社会经济因素中理清行为转变的影响。研究人员指出，在非常地方的水平上，砷污染存在准随机变化--村庄内的一些家庭受到污染，而其他非常接近的家庭则拥有未受污染的威尔斯。因此，这种分析可以比较1999年之前和之后同一村庄内饮水中有或没有砷污染的家庭的儿童死亡率，当时发生了行为转变，因此可以确定是否存在意外后果。 这项工作将有助于确定对世界各地砷污染的适当政策反应，并将制定可用于确定多项政策建议的意外后果的方法。

Policy recommendations often have unintended consequences. This study aims to investigate one such unintended consequence: persistent negative child health impacts of a massive shift in behavior that occurred in Bangladesh around 1999 as millions of households moved away from the use of convenient shallow tube- wells as a source of household drinking water to less convenient deep tube-wells. The shift was in response to concerns that arsenic contamination in shallow tube-wells would increase health risks. However, the associated health risks for young children of switching away from backyard water sources appear to have been sharply underestimated according to preliminary findings by the investigators, which point towards substantial increases in child deaths in households that switch water source.The empirical contribution of this study aims is to disentangle the impact of the behavioral shift from other socioeconomic factors that affect health. The researchers note that at the very local level there is quasi-random variation in arsenic contamination - with some households within the village contaminated and others, very close by, having uncontaminated wells. This analysis can therefore compare child mortality for households within the same village who do or do not have arsenic contamination in their water both before and after 1999, when the behavioral switch took place, and can thus identify the existence of unintended consequences. The work will contribute to determining the appropriate policy response to arsenic contamination across the world, and will develop methods that can be used to identify unintended consequences of multiple policy recommendations.