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。这项研究旨在调查这样一个意想不到的后果：1999年左右孟加拉国发生的大规模行为转变对儿童健康的持续负面影响，当时数百万家庭从使用方便的浅管井作为家庭饮用水的来源，转向不太方便的深管井。这一转变是为了回应人们的担忧，即浅层管井中的砷污染会增加健康风险。然而，根据调查人员的初步发现，与更换后院水源相关的幼儿健康风险似乎被严重低估，这表明在更换水源的家庭中，儿童死亡人数大幅增加。这项研究的经验贡献是将行为转变的影响与其他影响健康的社会经济因素分开。研究人员指出，在非常地方的层面上，砷污染存在准随机变化--村子里的一些家庭受到了污染，而其他非常接近的家庭拥有未受污染的水井。因此，这一分析可以比较同一村庄内水中有或没有砷污染的家庭在1999年行为转变发生之前和之后的儿童死亡率，从而可以确定是否存在意想不到的后果。这项工作将有助于确定世界各地对砷污染的适当政策反应，并将开发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.