Consistent with the increasing focus on issues of equity in developing countries, I extend the literature analyzing the relationship between economic inequality and individual health to the developing world. Using survey data from Bangladesh and Kenya with economic status measured by a wealth index and with three different geographic definitions of community, I analyze six competing hypotheses for how economic inequality may be related to stunting among children younger than 5 years old. I find little support for the predominant hypothesis that economic inequality as measured by a Gini index is an important predictor of individual health. Instead, I find that the difference between a household's wealth and the mean household wealth in the community is the measure of economic inequality that is most closely related to stunting in these countries. In particular, a 1 standard deviation increase in household wealth relative to the community mean is associated with a 30–32 percent decrease in the odds of stunting in Bangladesh and a 16–21 percent decrease in the odds of stunting in Kenya.
Background
Scholars have long been sceptical about the effectiveness of human rights treaties in changing the behaviour of states parties and prior empirical research has often justified that scepticism. However, only a few prior studies have considered the effects of adoption of core human rights treaties on health outcomes and only one prior study has analysed the effects of adoption of the Convention on the Rights of the Child (CRC) on children’s health outcomes.
Methods
In this study, we estimated the effects of CRC adoption on child mortality rates and vaccination rates in less developed countries. In particular, we compared 43 less developed countries that adopted the CRC in 1990 with synthetic control groups drawn from 21 less developed countries that adopted it after 1992.
Results
We find that CRC adoption may be related to additional reductions in infant and under-5 mortality rates of about 1 to 2 deaths per 1000 live births, on average, during the first three years after adoption, although those relationships are not statistically significant. And we find that CRC adoption is related to additional increases in vaccination rates for the five vaccines that we considered of about 4 to 5%, on average, during the first three years after adoption and that those relationships remain significant for up to seven years after adoption.
Conclusion
From a policy perspective, our results further support the effectiveness of CRC adoption in promoting children’s right to health in less developed countries. And from a research perspective, our results show the advantages of using synthetic control methods in these types of studies, because our analyses using other methods that have most commonly been used in these studies did not find any consistent, significant relationships between CRC adoption and mortality or vaccination rates.
Medicaid and the Children's Health Insurance Program (CHIP) both combine federal mandates to cover certain services and groups with state options in providing that coverage and in covering other services and groups. Using state‐level panel data, we investigated the relationships of 83 state Medicaid and CHIP options with 2 child insurance outcomes from 2008 to 2018 using structural equation modeling, controlling for 10 possible demographic and economic variables, state fixed effects, and a quadratic year count variable. Our results suggest that eliminating asset tests for children's and parents’ coverage, eliminating or reducing waiting periods for children's coverage, providing express and continuous eligibility for children's coverage, and eliminating face‐to‐face interview requirements for children's coverage may have been especially important in reducing child uninsurance rates and increasing the percentage of children covered by means‐tested public insurance.
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