Healthy, nudged, and wise: Experimental evidence on the role of information salience in reducing tobacco intake.

We evaluate the performance of two behavioral interventions aimed at reducing tobacco consumption in an ultra-poor rural region of Bangladesh, where conventional methods like taxes and warning labels are infeasible. The first intervention asked participants to daily log their tobacco consumption expenditure. The second intervention placed two graphic posters with warnings about the harmful effects of tobacco consumption on tobacco users and their children in the sleeping quarters of the participating households. While both interventions reduced household tobacco consumption expenditure, male participants who logged their expenditure substituted cigarettes with cheaper smokeless tobacco. The reduction in tobacco intake is larger among males with a non-tobacco consuming spouse. Exploratory analysis reveals that risk-averse males who spent relatively more on tobacco responded more to the logbook intervention. More educated, patient males with children below age five responded better to the poster intervention. The findings suggest that in countries with multi-tiered tobacco excise tax structures, which incentivize downward substitution, extending complementary demand-side policies that worked elsewhere to the rural poor might be unwise. Instead, policies may leverage something as universal as parental concern for their children's health to promote better health decision-making.

Pandemic catch-22: The role of mobility restrictions and institutional inequalities in halting the spread of COVID-19.

Countries across the world responded to the COVID-19 pandemic with what might well be the set of biggest state-led mobility and activity restrictions in the history of humankind. But how effective were these measures across countries? Compared to multiple recent studies that document an association between such restrictions and the control of the contagion, we use an instrumental variable approach to estimate the causal effect of these restrictions on mobility, and the growth rate of confirmed cases and deaths during the first wave of the pandemic. Using the level of stringency in the rest of the world to predict the level of stringency of the restriction measures in a country, we show while stricter contemporaneous measures affected mobility, stringency in seven to fourteen days mattered most for containing the contagion. Heterogeneity analysis, by various institutional inequalities, reveals that even though the restrictions reduced mobility more in relatively less-developed countries, the causal effect of a reduction in mobility was higher in more developed countries. We propose several explanations. Our results highlight the need to complement mobility and activity restrictions with other health and information measures, especially in less-developed countries, to combat the COVID-19 pandemic effectively.

Bangladesh Chars Tobacco Assessment Project (CTAP) 2018: a data note.

OBJECTIVES: The Chars Tobacco Assessment Project 2018 is a holistic survey conducted in the chars (riverine islands) of Gaibandha in Northern Bangladesh, covering 985 households over 24 clusters. The survey was conducted with two objectives: (1) to assess levels of tobacco consumption and evaluate prevailing socio-economic, behavioral and health status of the chars population, and (2) to look at the effectiveness of advocacy campaigns to reduce tobacco consumption through behavioral nudges via randomized controlled trials (RCTs) in rural Bangladesh. The study site was purposively chosen due to its high tobacco consumption rate, and the geographical segregation of the chars aided in reducing spillovers for RCT design. DATA DESCRIPTION: In addition to detailed information on tobacco (smoking and smokeless) consumption and perception, data was collected on: household composition, housing and plot ownership, consumption, risks and shocks coping, dowry, farm production, loans, savings and lending, labor income, asset holdings, migration and remittance, anthropometry, respiratory diseases, co-morbidities, reproductive history, risk and time preference. Unique to the dataset are carbon monoxide readings for accurate short term smoking measurement and FEV1 and PEF values for identification of long term lung damage. The data is representative only for the chars of Gaibandha.

Revisiting the child health-wealth nexus.

OBJECTIVE: The causal link between a household's economic standing and child health is known to suffer from endogeneity. While past studies have exemplified the causal link to be small, albeit statistically significant, this paper aims to estimate the causal effect to investigate whether the effect of income after controlling for the endogeneity remains small in the long run. By correcting for the bias, and knowing the bias direction, one can also infer about the underlying backward effect. DESIGN AND SETTING: This paper uses an instrument variables two-stage-least-squares estimation on the Young Lives 2009 cross-sectional dataset from Andhra Pradesh, India, to understand the aforementioned relationship. RESULTS: The selected measure of household economic standing differentially affects the estimation. There is significant positive effect of both short-run household expenditure and long-run household wealth on child stunting, with the latter having a larger impact. The backward link running from child health to household income is likely an inverse association in our sample with lower child health inducing higher earnings. While higher average community education improved child health, increased community entertainment expenditure is found to have a negative effect. CONCLUSION: While policies catered towards improving household wealth will decrease child stunting in the long run, maternal education and the community play an equally reinforcing role in improving child health and are perhaps faster routes to achieving the goal of better child health in the short run.

Determinants of malnutrition among urban slum children in Bangladesh.

BACKGROUND: This paper analyzes the role of child, maternal and household variables on weight-for-age nutritional status of children in the largest urban slum of Bangladesh. METHODS: We use anthropometric weight-for-age nutrition status of children for an ordered logistic analysis. Our dataset gives us the advantage of segregating health knowledge into three indices: health-seeking practices index, child health precautions index and medical cost knowledge index, which are used as covariates to understand the role of health knowledge towards child health. Gender specific regressions are also run to understand male and female children nutritional function differences. RESULTS: Per capita income significantly improves child health but household assets do not, casting doubt on the robustness of permanent income. After controlling for health knowledge and health-seeking behavior, the remaining impact of maternal education on child health is no longer significant. Health knowledge indices significantly improve child health albeit differentially. While male children are more sensitive to "child health precautions" and "medical cost knowledge", female children are more sensitive to "health-seeking practices". CONCLUSION: Role of health knowledge on child health carries a significant portion of the education effect. Policy makers looking to improve the nutritional status of female children vis-a-vis male children in study area, should promote programs focusing on health-seeking practices.