公共卫生与长期人力资本——基于中国农村“改水改厕”事件的研究

The Long-term Effect of Public Health on Human Capital: Evidence from Rural China’s Renovating Water Supply and Toilets

一个地区的公共卫生建设,可以有效遏制各类地方病和传染病的发生,而良好的公共卫生设施对人民的身心健康、教育等方面都具有较大的正面影响。我国政府一直高度重视公共卫生建设,并取得了举世瞩目的成就。然而较少有研究关注农村地区公共卫生建设的长期影响,而这对我国公共政策的制定有着重要的意义。文章基于中国健康与养老追踪调查(CHARLS)数据,以农村地区1980年代开始的“改水改厕”事件为准自然实验,构造倍差法来考察农村公共卫生建设的长期影响。研究发现“改水改厕”事件显著提高了农村居民的受教育水平,经历过“改水改厕”事件的青少年将来接受高中和大学教育的概率更高。机制考察发现“改水改厕”事件改善了儿童的日常健康。成本收益分析显示“改水改厕”事件具有良好的经济效益和社会效益。在乡村振兴背景下,文章的研究为持续推动农村地区公共卫生建设提供了一定的参考依据。

Health is an important factor which affects national welfare and economic development.Eliminating the difference of residents’ health level among countries can greatly reduce the difference of labor per capita GDP(Well, 2007). To improve residents’ health, governments and social organizations have vigorously promoted public health campaigns, such as tap water popularization, the use of chlorine disinfection technology, the construction of sewers in cities, and various health campaigns against epidemics. Research shows that the above public health campaigns have mostly had a positive impact on reducing child mortality,promoting children’s health and improving children’s literacy rate(Cutler & Miller, 2005;Bleakley, 2007;Alsan & Goldin, 2019).However, the public health situation in rural areas of developing countries is still severe. The lack of tap water and sanitary toilets restricts people’s daily life. As the largest developing country in the world, China’s rural areas have made great achievements in the popularization of drinking water and sanitary toilets in the past three decades. This paper studies how the event affects children’s long-term human capital, and makes a costbenefit analysis. Based on the China Health and Retirement Longitudinal Study(CHARLS) data, according to the time difference of changing water and toilets among villages and individual birth cohort, the DID recognition strategy is constructed. The study finds that renovating water supply and toilets can significantly promote children’s long-term human capital accumulation. Those who experienced this campaign under 16 increased the year of education by 1.28 years, and the probability of receiving high school and university education increased by 23% and 10% respectively. This paper also finds that the earlier the adolescents experienced this campaign, the higher their level of human capital. What’s more, the areas with infectious diseases in history have more obvious improvement. The cost-benefit analysis shows that the annual return rate of water and toilet reform is more than 230%.This paper may have several contributions:(1) From the perspective of development economics, it examines the impact of promoting water and toilet reform in rural areas of developing countries, which enriches the relevant research on the long-term effect of public health movement.(2) The research design is based on the quasi-natural experiment to construct a DID model, and the conclusion is more reliable.(3) It suggests that the benefits of water and toilet reform are reflected in not only the improvement of current life convenience, but also the promotion of long-term human capital. The conclusions provide powerful support for renovating water supply and toilets in rural areas, and give a reference to the formulation of relevant subsidy standards.