History and Human Capital in Developing Economies

Abstract

This dissertation studies the historical causes and economic consequences of poor health -- an important component of human capital -- in developing countries, as well as the policies that can remedy its negative impacts. The link between these chapters is infectious disease: the first examines it as an outcome of historical processes, the second investigates links between childhood morbidity and the likelihood of contracting a deadly illness as a young adult, and the third studies novel domains in which disease control can have short- and long-run impacts on a developing economy.

Chapter 1 shows how common colonial labor regimes in Africa shaped HIV prevalence in Mozambique today through their long-run impacts on marriage and dating practices. To compare two of these extractive institutions -- one pushing men into circular migration and one restricting their mobility -- I exploit the arbitrary border within Mozambique that separated the regions under them for a half-century (1893-1942). Consistent with historians’ accounts, spousal age gaps in the colonial era were smaller in the migrant-sending area, even after the border was erased and circular migration rates converged. Today, HIV prevalence is substantially lower in this region, likely due to the narrower age gaps between partners that reduce exposure to the virus, but development outcomes are similar. These results demonstrate how different forms of colonial extraction affect health and wealth in Africa, and that marriage markets are a channel through which historical events shape the present.

Chapter 2 shows that treating schistosomiasis in secondary school-age girls in Zimbabwe reduced their likelihood of contracting HIV as young women by changing their marriage and dating behaviors. I examine Zimbabwe’s nationwide school-based deworming program (2012-17) that substantially reduced rates of the urogenital form of the disease. Using a difference-in-differences design, I find that 3 years after deworming began, HIV prevalence among young women had fallen more in formerly high-schistosomiasis districts than in low-morbidity ones. Human capital’s effects on marriage markets appear to explain the results: these young women were more likely to still be in school, age gaps with their partners shrank, and HIV risk factors associated with age gaps in relationships decreased more as well. These results imply that a cheap treatment for a common childhood disease can also be a highly cost-effective method of combating one of the modern world’s deadliest pandemics.

Chapter 3 shows that Brazil’s efforts to eliminate Chagas Disease transmission had short- and long-run effects in domains that are important for economic development but have not yet been included in cost-benefit analyses of disease control. Using a difference-in-differences strategy, we make comparisons before and after the campaign (1984-89) across states and municipalities with varying levels of pre-treatment vector prevalence. We find that adults’ employment rates rose shortly after spraying began and cohorts treated as children had higher incomes as adults, and the latter effect was much larger for non-white Brazilians. Using a triple-differences strategy, we also show that Brazil’s government-run health care system -- which consumes 4 percent of GDP -- spent substantially less on hospitalizations due to circulatory diseases than other causes. These results imply that the benefits of disease control can be larger than previously assumed, and that combating neglected tropical diseases can help to speed convergence in societies with large racial disparities.