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Sex and the Mission: The Conflicting Effects of Early Christian Missions on HIV in Sub-Saharan Africa

Author

Listed:
  • Julia Cagé

    (ECON - Département d'économie (Sciences Po) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique)

  • Valeria Rueda

    (University of Oxford)

Abstract

This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in, that we combine with individual-level Demographic and Health Survey data. With these data, we can address separately these two channels, within regions close to historical missionary settlements. First, we show that proximity to historical missionary health facilities decreases the likelihood of HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result. Second, we show that regions close to historical missionary settlements exhibit higher likelihood of HIV. This effect is driven by the Christian population in our sample. This suggests conversion to Christianity as a possible explanatory channel. Our findings are robust to alternative specifications addressing selection.

Suggested Citation

  • Julia Cagé & Valeria Rueda, 2020. "Sex and the Mission: The Conflicting Effects of Early Christian Missions on HIV in Sub-Saharan Africa," Post-Print hal-03877466, HAL.
    • Handle: RePEc:hal:journl:hal-03877466
    DOI: 10.1017/dem.2019.16
    Note: View the original document on HAL open archive server: https://sciencespo.hal.science/hal-03877466
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    as
    1. Jha, Saumitra, 2013. "Trade, Institutions, and Ethnic Tolerance: Evidence from South Asia," American Political Science Review, Cambridge University Press, vol. 107(4), pages 806-832, November.
    2. Bertocchi, Graziella & Dimico, Arcangelo, 2019. "The long-term determinants of female HIV infection in Africa: The slave trade, polygyny, and sexual behavior," Journal of Development Economics, Elsevier, vol. 140(C), pages 90-105.
    3. Nathan Nunn, 2008. "The Long-term Effects of Africa's Slave Trades," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(1), pages 139-176.
    4. Abel Brodeur & Warn N Lekfuangfu & Yanos Zylberberg, 2018. "War, Migration and the Origins of the Thai Sex Industry," Journal of the European Economic Association, European Economic Association, vol. 16(5), pages 1540-1576.
    5. Emily Oster, 2005. "Sexually Transmitted Infections, Sexual Behavior, and the HIV/AIDS Epidemic," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(2), pages 467-515.
    6. Ewout H.P. Frankema, 2012. "The origins of formal education in sub-Saharan Africa: was British rule more benign?," European Review of Economic History, European Historical Economics Society, vol. 16(4), pages 335-355, November.
    7. Elise Huillery, 2009. "History Matters: The Long-Term Impact of Colonial Public Investments in French West Africa," American Economic Journal: Applied Economics, American Economic Association, vol. 1(2), pages 176-215, April.
    8. Nico Voigtländer & Hans-Joachim Voth, 2012. "Persecution Perpetuated: The Medieval Origins of Anti-Semitic Violence in Nazi Germany," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1339-1392.
    9. Good, Charles M., 1991. "Pioneer medical missions in colonial Africa," Social Science & Medicine, Elsevier, vol. 32(1), pages 1-10, January.
    10. Edward Miguel & Sebastián M. Saiegh & Shanker Satyanath, 2008. "National Cultures and Soccer Violence," NBER Working Papers 13968, National Bureau of Economic Research, Inc.
    11. Pauline Grosjean, 2014. "A History Of Violence: The Culture Of Honor And Homicide In The Us South," Journal of the European Economic Association, European Economic Association, vol. 12(5), pages 1285-1316, October.
    12. Grosfeld, Irena & Zhuravskaya, Ekaterina, 2015. "Cultural vs. economic legacies of empires: Evidence from the partition of Poland," Journal of Comparative Economics, Elsevier, vol. 43(1), pages 55-75.
    13. Anonymous, 1956. "World Health Organization," International Organization, Cambridge University Press, vol. 10(2), pages 321-322, May.
    14. Felipe Valencia Caicedo, 2019. "The Mission: Human Capital Transmission, Economic Persistence, and Culture in South America," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 507-556.
    15. repec:hal:pseose:halshs-01157572 is not listed on IDEAS
    16. Marcella Alsan, 2015. "The Effect of the TseTse Fly on African Development," American Economic Review, American Economic Association, vol. 105(1), pages 382-410, January.
    17. Anonymous, 1956. "World Health Organization," International Organization, Cambridge University Press, vol. 10(3), pages 489-491, August.
    18. Anonymous, 1956. "World Health Organization," International Organization, Cambridge University Press, vol. 10(4), pages 642-644, November.
    19. Remi Jedwab & Felix Meier zu Selhausen & Alexander Moradi, 2022. "The economics of missionary expansion: evidence from Africa and implications for development," Journal of Economic Growth, Springer, vol. 27(2), pages 149-192, June.
    20. Lange, Matthew K., 2004. "British Colonial Legacies and Political Development," World Development, Elsevier, vol. 32(6), pages 905-922, June.
    21. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    22. Pascaline Dupas & Élise Huillery & Juliette Seban, 2018. "Risk Information, Risk Salience, and Teenagers Sexual Behavior: Experimental Evidence from Cameroon," Post-Print hal-01645677, HAL.
    23. James Feyrer & Bruce Sacerdote, 2009. "Colonialism and Modern Income: Islands as Natural Experiments," The Review of Economics and Statistics, MIT Press, vol. 91(2), pages 245-262, May.
    24. Woodberry, Robert D., 2012. "The Missionary Roots of Liberal Democracy," American Political Science Review, Cambridge University Press, vol. 106(2), pages 244-274, May.
    25. Esther Duflo & Pascaline Dupas & Michael Kremer, 2015. "Education, HIV, and Early Fertility: Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 105(9), pages 2757-2797, September.
    26. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    27. Doyle, Shane & Meier zu Selhausen, Felix & Weisdorf, Jacob, 2019. "The Blessings of Medicine? Patient Characteristics and Health Outcomes in a Ugandan Mission Hospital, 1908-1970," African Economic History Working Paper 45/2019, African Economic History Network.
    28. repec:hal:wpspec:info:hdl:2441/10262 is not listed on IDEAS
    29. Calvi, Rossella & Mantovanelli, Federico G., 2018. "Long-term effects of access to health care: Medical missions in colonial India," Journal of Development Economics, Elsevier, vol. 135(C), pages 285-303.
    30. repec:hal:spmain:info:hdl:2441/10262 is not listed on IDEAS
    31. Emily Oster, 2005. "Sexually Transmitted Infections, Sexual Behavior and the HIV/AIDS Epidemic," CID Working Papers 4, Center for International Development at Harvard University.
    32. Dupas, Pascaline & Huillery, Elise & Seban, Juliette, 2018. "Risk information, risk salience, and adolescent sexual behavior: Experimental evidence from Cameroon," Journal of Economic Behavior & Organization, Elsevier, vol. 145(C), pages 151-175.
    33. Rossella Calvi & Federico G. Mantovanelli, 2015. "Long-Term Effects of Access to Health Care: Medical Missions in Colonial India," Boston College Working Papers in Economics 883, Boston College Department of Economics.
    34. Daron Acemoglu & Francisco A. Gallego & James A. Robinson, 2014. "Institutions, Human Capital, and Development ," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 875-912, August.
    35. Jacob Moscona & Nathan Nunn & James A. Robinson, 2017. "Keeping It in the Family: Lineage Organization and the Scope of Trust in Sub-Saharan Africa," American Economic Review, American Economic Association, vol. 107(5), pages 565-571, May.
    36. La Ferrara, Eliana & DellaVigna, Stefano, 2015. "Economic and Social Impacts of the Media," CEPR Discussion Papers 10667, C.E.P.R. Discussion Papers.
    37. repec:hal:spmain:info:hdl:2441/453m2eks408pdoss8agfiaocu6 is not listed on IDEAS
    38. Leonard Wantchekon & Marko Klašnja & Natalija Novta, 2015. "Education and Human Capital Externalities: Evidence from Colonial Benin," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(2), pages 703-757.
    39. Waldinger, Maria, 2017. "The long-run effects of missionary orders in Mexico," LSE Research Online Documents on Economics 68841, London School of Economics and Political Science, LSE Library.
    40. Anonymous, 1956. "World Health Organization," International Organization, Cambridge University Press, vol. 10(1), pages 206-209, February.
    41. Elise Huillery, 2009. "History Matters: The Long Term Impact of Colonial Public Investments in French West Africa," SciencePo Working papers hal-01052798, HAL.
    42. Francisco A. Gallego & Robert Woodberry, 2010. "Christian Missionaries and Education in Former African Colonies: How Competition Mattered," Journal of African Economies, Centre for the Study of African Economies, vol. 19(3), pages 294-329, June.
    43. Siwan Anderson, 2018. "Legal Origins and Female HIV," American Economic Review, American Economic Association, vol. 108(6), pages 1407-1439, June.
    44. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
    45. Marcella M. Alsan & David M. Cutler, 2010. "Why did HIV decline in Uganda?," NBER Working Papers 16171, National Bureau of Economic Research, Inc.
    46. Waldinger, Maria, 2017. "The long-run effects of missionary orders in Mexico," Journal of Development Economics, Elsevier, vol. 127(C), pages 355-378.
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    2. Fenske, James & Gupta, Bishnupriya & Neumann, Cora, 2022. "Missing Women In Colonial India," CEPR Discussion Papers 17189, C.E.P.R. Discussion Papers.
    3. Bertocchi, Graziella & Dimico, Arcangelo, 2020. "COVID-19, Race, and Redlining," GLO Discussion Paper Series 603, Global Labor Organization (GLO).
    4. repec:hal:spmain:info:hdl:2441/7ta31jvjhg900qkformecj6b01 is not listed on IDEAS
    5. Sascha O. Becker & Jared Rubin & Ludger Woessmann, 2024. "Religion and Growth," Journal of Economic Literature, American Economic Association, vol. 62(3), pages 1094-1142, September.
    6. Mihaylova, Iva, 2023. "Perpetuating the malign legacy of colonialism? Traditional chiefs’ power and deforestation in Sierra Leone," World Development, Elsevier, vol. 164(C).
    7. Dozie Okoye & Roland Pongou, 2024. "Missions, fertility transition, and the reversal of fortunes: evidence from border discontinuities in the emirates of Nigeria," Journal of Economic Growth, Springer, vol. 29(2), pages 251-325, June.
    8. Fenske, James & Wang, Shizhuo, 2023. "Tradition and mortality: Evidence from twin infanticide in Africa," Journal of Development Economics, Elsevier, vol. 163(C).
    9. Congdon Fors, Heather & Isaksson, Ann-Sofie & Lindskog, Annika, 2024. "Changing local customs: The long run impacts of Christian missions on female genital cutting in Africa," Journal of Development Economics, Elsevier, vol. 166(C).
    10. Becker, Sascha O. & Pfaff, Steven, 2022. "Church and State in historical political economy," The Warwick Economics Research Paper Series (TWERPS) 1409, University of Warwick, Department of Economics.
    11. Becker, Bastian & Schmitt, Carina, 2023. "License to educate: The role of national networks in colonial empires," World Development, Elsevier, vol. 169(C).
    12. Remi Jedwab & Felix Meier zu Selhausen & Alexander Moradi, 2022. "The economics of missionary expansion: evidence from Africa and implications for development," Journal of Economic Growth, Springer, vol. 27(2), pages 149-192, June.
    13. repec:spo:wpmain:info:hdl:2441/7ta31jvjhg900qkformecj6b01 is not listed on IDEAS
    14. Jedwab, Remi & Meier zu Selhausen, Felix & Moradi, Alexander, 2021. "Christianization without economic development: Evidence from missions in Ghana," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 573-596.
    15. Congdon Fors, Heather & Isaksson, Ann-Sofie & Annika, Lindskog, 2023. "Changing local customs: Long-run impacts of the earliest campaigns against female genital cutting," Working Papers in Economics 831, University of Gothenburg, Department of Economics.
    16. Dozie & Roland Pongou, 2021. "Missions and Heterogeneous Social Change: Evidence from Border Discontinuities in the Emirates of Nigeria," Working Papers 2112E Classification-I20,, University of Ottawa, Department of Economics.

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    More about this item

    Keywords

    Africa; Christianity; Historical persistence; Missions; Healthcare infrastructure; HIV/AIDS; Sexual behaviors;
    All these keywords.

    JEL classification:

    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • N37 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Africa; Oceania
    • N77 - Economic History - - Economic History: Transport, International and Domestic Trade, Energy, and Other Services - - - Africa; Oceania
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes
    • Z12 - Other Special Topics - - Cultural Economics - - - Religion
    • Z13 - Other Special Topics - - Cultural Economics - - - Economic Sociology; Economic Anthropology; Language; Social and Economic Stratification

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