国家财富与人口健康：主权债务危机对儿童死亡率影响的准实验设计
The wealth of nations and the health of populations: A quasi-experimental design of the impact of sovereign debt crises on child mortality
摘要：
国家的财富与人口的健康密切相关，但经济繁荣（人均国内生产总值）在多大程度上改善了健康状况仍有争议。本文的目的是分析主权债务危机（SDC）对儿童死亡率的影响，使用1990年至2015年期间人口与健康调查调查的57个低收入和中等收入国家的样本。这些调查提供了229个家庭的数据，包含了大约300万个生育历史记录。这种对SDC而不是GDP的关注提供了一个准实验时刻，其中未观察到的混杂因素的影响小于分析GDP正常波动的时刻。这项研究测量了六个临界值的儿童死亡率：新生儿、一岁以下（婴儿）、两岁以下、三岁以下、四岁以下和五岁以下死亡率。使用机器学习（ML）模型进行因果推断，这项研究发现，虽然SDC对新生儿死亡率造成了不利但统计学上不显著的影响，但所有其他儿童死亡率组样本都受到了不利影响，概率为0.12至0.14（所有统计学上显著的阈值均为95%）。通过这种ML，本研究还发现，在整个调整集中，最重要的治疗异质性调节剂是孩子是否出生在低收入国家。
英文摘要：
The wealth of nations and the health of populations are intimately strongly associated, yet the extent to which economic prosperity (GDP per capita) causes improved health remains disputed. The purpose of this article is to analyze the impact of sovereign debt crises (SDC) on child mortality, using a sample of 57 low- and middle-income countries surveyed by the Demographic and Health Survey between the years 1990 and 2015. These surveys supply 229 household data and containing about 3 million childbirth history records. This focus on SDC instead of GDP provides a quasi-experimental moment in which the influence of unobserved confounding is less than a moment analyzing the normal fluctuations of GDP. This study measures child mortality at six thresholds: neonatal, under-one (infant), under-two, under-three, under-four, and under-five mortality. Using a machine-learning (ML) model for causal inference, this study finds that while an SDC causes an adverse yet statistically insignificant effect on neonatal mortality, all other child mortality group samples are adversely affected between a probability of 0.12 to 0.14 (all statistically significant at the 95-percent threshold). Through this ML, this study also finds that the most important treatment heterogeneity moderator, in the entire adjustment set, is whether a child is born in a low-income country.
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