Department of Economics, University of Oklahoma, Norman, OK 73072.
Department of Economics, University of California, Berkeley, CA 94720.
Proc Natl Acad Sci U S A. 2021 Apr 6;118(14). doi: 10.1073/pnas.2023185118.
Estimating the impact of child health investments on adult living standards entails multiple methodological challenges, including the lack of experimental variation in health status, an inability to track individuals over time, and accurately measuring living standards and productivity in low-income settings. This study exploits a randomized school health intervention that provided deworming treatment to Kenyan children, and uses longitudinal data to estimate impacts on economic outcomes up to 20 y later. The effective respondent tracking rate was 84%. Individuals who received two to three additional years of childhood deworming experienced a 14% gain in consumption expenditures and 13% increase in hourly earnings. There are also shifts in sectors of residence and employment: treatment group individuals are 9% more likely to live in urban areas, and experience a 9% increase in nonagricultural work hours. Most effects are concentrated among males and older individuals. The observed consumption and earnings benefits, together with deworming's low cost when distributed at scale, imply that a conservative estimate of its annualized social internal rate of return is 37%, a high return by any standard.
估算儿童健康投资对成人生活水平的影响需要克服多个方法学挑战，包括健康状况缺乏实验性变化、无法随时间跟踪个体，以及在低收入环境中准确衡量生活水平和生产力。本研究利用一项随机的学校卫生干预措施，为肯尼亚儿童提供驱虫治疗，并利用纵向数据估算 20 年后对经济结果的影响。有效回应者的追踪率为 84%。接受两到三年额外儿童驱虫治疗的个体，消费支出增加了 14%，每小时收入增加了 13%。居住和就业部门也发生了转变：治疗组的个体更有可能居住在城市地区，非农业工作时间增加了 9%。大多数影响集中在男性和年龄较大的个体中。观察到的消费和收入效益，加上驱虫治疗在大规模分发时的低成本，意味着其年化社会内部收益率的保守估计为 37%，按照任何标准衡量都是高回报。
