Essays in health and development economics

This dissertation examines the relationship between financial resources and health outcomes. My first chapter estimates the impact of a conditional cash transfer program on the usage of health facilities during childbirth in Nepal. My second chapter explores the relationship between mother's landownership and child health in Nepal. My third chapter analyzes the impact of housing wealth shocks on physical and mental wellbeing in the United States.

In the first chapter, I examine the effects of the Safe Delivery Incentive Program in Nepal, a cash transfer program that reduced the costs of childbirth in a healthcare facility. Using a difference-in-differences design, I find that low-parity women in high Human Development Index (HDI) districts increased facility delivery by 8.6 percentage points. Despite larger cost reductions, low-parity women in low HDI districts did not increase facility delivery but increased delivery with skilled personnel by 5 percentage points. The impact in low HDI districts was driven by the program's supply-side incentive, which paid health workers to deliver in facilities or homes. This program had no impact on high-parity women, who become eligible two years later. Pre-existing barriers such as poor infrastructure of roads and facilities, customs, liquidity constraints, and lack of program awareness limited the effectiveness of the program.

In the second chapter, I provide empirical evidence on the relationship between mother's land ownership and child health outcomes using data from Nepal Demographic and Health Survey 2001, 2011, and 2016. I employ a technique that uses selection on observable characteristics as a guide for selection on unobservable characteristics to estimate bounded treatment effects of land ownership. My results indicate that mother's land ownership decreases the incidence of child underweight and stunted with estimates that are robust to selection on unobservables. I show that the improvements in child health driven by land ownership are concentrated in rural households and for women employed in agriculture. I also provide evidence that increases in women's decision-making power upon access to land are significant drivers of the relationship between land ownership and child health.

In the third chapter, we explore the causal relationship between wealth and health by using contemporaneous changes in housing prices. Employing data from Panel Study of Income Dynamics, we find that increases in housing prices have positive effects on the self-reported health of homeowners. We show that a $100,000 increase in housing price over four years increases the probability of being healthy by 1.3 percentage points and decreases the probability of being unhealthy by 0.3 percentage points. Housing wealth shocks also affect the incidence of more objective health measures, causing decreases in metabolic disorders and work-limiting disabilities. We show that market-level housing prices fluctuations drive these effects and that renters are unaffected by these changes. Heterogeneous analysis suggests that the estimated impacts of housing wealth shocks are larger for older adults in terms of work-limiting disabilities and self-reported poor health.