Comments on:The permanent effects of recessions on child health: evidence from Peru

By : Adriana Camacho.

•Interesting and important for public health policy

•Contributes to evidence in developing countries, as the impact is the reverse of developed countries▫A very good country to study given strong

recessions•Deals with selection of mothers into

phases of the economic cycle.

Positive aspects

Channels: Recession can affect Health• Reduce (private and public) resources

1. Nutrition2. Medical care (prenatal, postnatal)

1.Breastfeeding▫ Result on nutrition not counterintuitive in this case.▫ Expect to see neonatal mortality flatter ▫ Exploit age heterogeneity with this channel

2a. Prenatal care visits ▫ If impact of recession starts during pregnancy, lag

GDP to check results with mortality.2b. Stress

▫ Birth Weight, term of delivery 2c Postnatal access to medical care

▫ Control for type of health insurance or public health programs in the area. (regional effects in the cross sections)

Include in the paper to Clarify of Motivate•literature on:

▫early child human capital development. •Health Production function

▫clarify income-substitution effect▫Genetics (mother fe)

•Brief explanation of health care system for pregnant woman and children.

•Shade recession years in the mortality figure

Other possible outcomes

•Probability of breastfeeding •Birth weight•Term delivery•Probability of complete vaccination by age•Intestinal and Respiratory Health

problems•Other Z scores for WfA, WfH (easier to

change)

Other things to do•Evidence of pro-poor anti-poor (unequal)

growth •Twins !! control for them

▫ Could be used to do a robustness check of the results.

•Heterogeneous effect by age▫child cohort

•Educational attainment of recession cohorts to validate the claim “permanent mark on children´s human capital”. ▫Positive selection into survival.

Check

•Compare IMR constructed from DHS with vital stats. Yours are really high!

•Explain better the way IMR was constructed when there is an overlap of years.

•Show data of counter-cyclical public expenditure

•Strongest impact in the last two recessions (mildest ones), evidence problems of retrospective info?

Minor changes• Include urban area control• Descriptive stats of GDP and growth• Fig 2. Mortality not Infant Mortality• Explain “continuous” 2004 DHS • Growth rates in fig do not coincide with

number in paper• Drop Aguero and Robles citation (credit

constraints not tested). • Conclusions have long discussion on

education?? (Drop fig 5, 6 and 7ª). (only significant for non educated)

Colombia:

7.20%

7.30%

7.40%

7.50%

7.60%

7.70%

7.80%

7.90%

8.00%

1998 1999 2000 2001 2002 2003

lbw

-5.0%

-4.0%

-3.0%

-2.0%

-1.0%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

gd

p g

row

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