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1.
Proc Natl Acad Sci U S A ; 120(23): e2218210120, 2023 06 06.
Article in English | MEDLINE | ID: mdl-37253010

ABSTRACT

Global outdoor biomass burning is a major contributor to air pollution, especially in low- and middle-income countries. Recent years have witnessed substantial changes in the extent of biomass burning, including large declines in Africa. However, direct evidence of the contribution of biomass burning to global health outcomes remains limited. Here, we use georeferenced data on more than 2 million births matched to satellite-derived burned area exposure to estimate the burden of biomass fires on infant mortality. We find that each additional square kilometer of burning is associated with nearly 2% higher infant mortality in nearby downwind locations. The share of infant deaths attributable to biomass fires has increased over time due to the rapid decline in other important causes of infant death. Applying our model estimates across harmonized district-level data covering 98% of global infant deaths, we find that exposure to outdoor biomass burning was associated with nearly 130,000 additional infant deaths per year globally over our 2004 to 2018 study period. Despite the observed decline in biomass burning in Africa, nearly 75% of global infant deaths due to burning still occur in Africa. While fully eliminating biomass burning is unlikely, we estimate that even achievable reductions-equivalent to the lowest observed annual burning in each location during our study period-could have avoided more than 70,000 infant deaths per year globally since 2004.


Subject(s)
Air Pollutants , Air Pollution , Fires , Infant , Humans , Biomass , Infant Mortality , Infant Death , Mortality , Air Pollutants/analysis
2.
Demography ; 58(1): 273-294, 2021 02 01.
Article in English | MEDLINE | ID: mdl-33834245

ABSTRACT

Can women's contraceptive method choice be better understood through risk compensation theory? This theory implies that people act with greater care when the perceived risk of an activity is higher and with less care when it is lower. We examine how increased over-the-counter access to emergency contraceptive pills (ECPs) accompanied by marketing campaigns in India affected women's contraceptive method choices and incidence of sexually transmitted infections (STIs). Although ECPs substantially reduce the risk of pregnancy, they are less effective than other contraceptive methods and do not reduce the risk of STIs. We test whether an exogenous policy change that increased access to ECPs leads people to substitute away from other methods of contraception, such as condoms, thereby increasing the risk of both unintended pregnancy and STIs. We find evidence for risk compensation in terms of reduced use of condoms but not for increases in rates of STIs.


Subject(s)
Contraceptive Agents , Levonorgestrel , Condoms , Contraception , Female , Humans , India , Pregnancy
4.
Nat Commun ; 14(1): 6780, 2023 Oct 25.
Article in English | MEDLINE | ID: mdl-37880232

ABSTRACT

Rural electrification policies in the developing world primarily focus on household power, often at the cost of electricity supply to other productive sectors of the economy. We examine the consequences of this imbalance in rural electrification policy priority on agricultural development in India. Electric pumping of groundwater for irrigation is a major driver of India's agricultural growth. However, the government of India shifted its rural electrification focus towards universal household electrification starting early 2000s. Using a newly constructed panel-dataset spanning three decades, we find that districts electrifying after the policy change experience much lower gains in electrified groundwater irrigation. On average, electrifying 100 additional rural households is associated with an increase of two additional electrified wells among newly electrified districts - eight times lower compared to 16 electrified wells per 100 electrified households among districts electrified pre-policy change. Our estimates imply that newly electrified districts would have witnessed nearly 20% more irrigated cropland in the dry season if rural electrification policy priorities had not shifted away from agriculture. These results highlight the need to complement household electrification with powering income-generating sectors of the rural economy.

5.
Sci Rep ; 13(1): 13591, 2023 08 21.
Article in English | MEDLINE | ID: mdl-37604890

ABSTRACT

Trace soil minerals are a critical determinant of both crop productivity and the mineral concentration of crops, therefore potentially impacting the nutritional status of human populations relying on those crops. We link health data from nearly 0.3 million children and one million adult women across India with over 27 million soil tests drawn from a nationwide soil health program. We find that soil zinc availability is positively associated with children's linear height growth, and soil iron availability is positively associated with hemoglobin levels. The link between soil zinc and childhood stunting is particularly robust-a one standard deviation increase in satisfactory soil zinc tests is associated with approximately 11 fewer children stunted per 1000. We also find that this zinc-stunting relationship is strongest in wealthier households. Our results suggest that soil mineral availability impacts human nutritional status and health in at least some areas of India, and that agronomic fortification may be a beneficial intervention.


Subject(s)
Micronutrients , Soil , Adult , Child , Humans , Female , India/epidemiology , Zinc , Growth Disorders/epidemiology
6.
JMIR Res Protoc ; 11(8): e35249, 2022 Aug 10.
Article in English | MEDLINE | ID: mdl-35947440

ABSTRACT

BACKGROUND: Determining the longer-term health effects of air pollution has been difficult owing to the multitude of potential confounding variables in the relationship between air pollution and health. Air pollution in many areas of South Asia is seasonal, with large spikes in particulate matter (PM) concentration occurring in the winter months. This study exploits this seasonal variation in PM concentration through a natural experiment. OBJECTIVE: This project aims to determine the causal effect of PM exposure during pregnancy on pregnancy and child health outcomes. METHODS: We will use an instrumental variable (IV) design whereby the estimated month of conception is our instrument for exposure to PM with a diameter less than 2.5 µm (PM2.5) during pregnancy. We will assess the plausibility of our assumption that timing of conception is exogenous with regard to our outcomes of interest and will adjust for date of monsoon onset to control for confounding variables related to harvest timing. Our outcomes are 1) birth weight, 2) pregnancy termination resulting in miscarriage, abortion, or still birth, 3) neonatal death, 4) infant death, and 5) child death. We will use data from the Demographic and Health Surveys (DHS) conducted in relevant regions of Bangladesh, India, Nepal, and Pakistan, along with monthly gridded data on PM2.5 concentration (0.1°×0.1° spatial resolution), precipitation data (0.5°×0.5° resolution), temperature data (0.5°×0.5°), and agricultural land use data (0.1°×0.1° resolution). RESULTS: Data access to relevant DHSs was granted on June 6, 2021 for India, Nepal, Bangladesh, August 24, 2021 for Pakistan, and June 19 2022 for the latest DHS from India. CONCLUSIONS: If the assumptions for a causal interpretation of our instrumental variable analysis are met, this analysis will provide important causal evidence on the maternal and child health effects of PM2.5 exposure during pregnancy. This evidence is important to inform personal behavior and interventions, such as the adoption of indoor air filtration during pregnancy as well as environmental and health policy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35249.

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