ABSTRACT
INTRODUCTION: Fetal environments play significant roles in determining adult well-being, particularly as they relate to non-communicable diseases and skill formation. We studied gender-specific distributional consequences of fetal environment (in the form of in-utero exposure to Ramadan, the Islamic holy month of fasting), in Indonesia, on birth weights, performance on Raven's Colored Progressive Matrices (CPM), math scores, hours worked and earnings. METHODS: We used quantile regressions to conduct a quantitative comparison of distributional consequences, by gender, of full month exposures to Ramadan in-utero on outcomes of interest. Our data included Muslim children and adults measured during rounds 1 and 4 of the Indonesian Family Life Survey. Our main outcome measures were: birth weights-559 observations (females) and 624 (males); Raven's CPM scores-1693 (females) and 1821 (males) for 8-15 year olds; math test scores-1696 (females) and 1825 (males) for 8-15 year olds; hours worked-3181 (females) and 4599 (males) for 18-65 year olds; earnings-2419 (females) and 4019 (males) for 18-65 year olds. RESULTS: Full month of exposure to Ramadan in-utero led to significant reductions at the 5% significance level that were concentrated in the bottom halves of the outcome distributions: among 8-15 years, lower scores on Raven's CPM tests for females (mean: -9.2%, 10thQ: -19%, 25th Q: -19.4%) and males (mean: -5.6%, 10thQ: -12.5%); lower math scores for females (mean: -8.6%, 25thQ: -15.9%) and males (mean: -8.5%, 10thQ: -13.6%); among females 18-65 years, significant reduction in hours worked (mean: -7.5%, 10thQ: - 26.3%). CONCLUSION: Events during the fetal period have far-reaching consequences for females and males in the lowest (10th and 25th) quantiles of outcome distributions, affecting the 'relatively poor' the most. These results call for caution in interpreting studies on child development that rely on mean comparisons alone.
ABSTRACT
BACKGROUND: Road traffic deaths are a substantial barrier to population health improvement in low-income and middle-income countries (LMICs). In South Africa, the road-traffic injury mortality (RTM) rate of 27 per 100 000 population is twice the global average, over 60% of which are alcohol-related. Recent US studies suggest the Uber ride-sharing service may reduce alcohol-related RTM, however RTM burden in the USA is relatively low and transport behaviours differ from LMICs. METHODS: Using certification data from all deaths occurring in South Africa in the years 2010-2014 (n=2 498 216), we investigated the relative change in weekly road traffic-related death counts between provinces which received Uber services (beginning in 2013) against those that did not using a difference-in-differences approach. RESULTS: Weekly road traffic-related deaths in provinces with Uber were lower following Uber introduction than in comparison provinces without Uber. The effect size was larger in the province which had Uber the longest (Gauteng) and among young adult males (aged 17-39 years). However, the absolute effects were very small (<2 deaths per year) and may coincide with seasonal variation. CONCLUSIONS: Overall, findings did not support either an increase or large decrease in province-level road traffic-related deaths associated with Uber introduction to South Africa. More localised investigations in South Africa and other LMICs are needed.
