天气冲击、婴儿死亡率与适应：来自乌干达的实验证据
Weather shocks, infant mortality, and adaptation: Experimental evidence from Uganda
Journal of Development Economics · 2025 · Martina Björkman Nyqvist、Tillmann von Carnap、Andrea Guariso、Jakob Svensson
中文摘要
气候变化正在加剧极端天气事件的强度。健康是气候变化影响福利的主要渠道之一。然而，关于强化卫生系统的缓解效应，目前仍基本缺乏相关估计。我们将一项通过随机试验引致的医疗服务可及性差异，与生长季降水的自然变异相结合，研究低收入国家背景下社区医疗服务的适应作用。生长季降雨量偏低后，婴儿死亡风险会上升，但获得社区医疗服务可使这一风险降低46%。将我们的估计结果与气候学模型的预测相结合，意味着潜在的适应效应可能更大。• 社区卫生工作者（CHW）能否增强卫生系统的气候韧性？• 低降雨季节后婴儿死亡率上升，但在随机分配社区卫生工作者的村庄中并未上升。• 气候变化可能导致干旱更加频繁和严重，从而提高社区卫生工作者带来的效益。• 初级医疗卫生投资能够缓解不利天气冲击对婴儿死亡率的影响。
Abstract
Climate change is increasing the intensity of extreme weather events. Health is a primary channel through which climate change affects welfare. Yet, estimates of the mitigating effects of health system strengthening are largely missing. We combine data from a randomized trial inducing variation in healthcare access with naturally-occurring variation in growing-season precipitation to study the adaptive impact of community healthcare in a low-income country setting. The risk of infant death increases following low growing-season rainfall, but access to community healthcare reduces this risk by 46 %. Using our estimates coupled with projections from climatological models implies even larger potential adaptive effects. • Can community health workers (CHW) strengthen the climate resilience of health systems? • Infant mortality increases after low-rainfall seasons, but not in villages randomly assigned to CHW. • Climate change may lead to more frequent and severe droughts, increasing CHW benefits. • Primary healthcare investments can mitigate adverse weather shocks' impacts on infant mortality.