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Mortality from Nestlé’s Marketing of Infant Formula in Low and Middle-Income Countries

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  • Jesse K. Anttila-Hughes
  • Lia C.H. Fernald
  • Paul J. Gertler
  • Patrick Krause
  • Eleanor Tsai
  • Bruce Wydick

Abstract

Infant formula use has been implicated in tens of millions of infant deaths in low and middle-income countries over the past several decades, but causal evidence of its link with mortality remains elusive. We combine birth record data from over 2.6 million infants across 38 countries in the Demographic and Health Surveys (DHS) with reconstructed historical data from annual investor reports on the timing of Nestlé entrance into infant formula country markets. Consistent with the hypothesis that formula mixed with unclean water could act as a disease vector, we find that infant mortality increased in households with unclean water sources by 19.4 per thousand births following Nestlé market entrance, but had no effect among other households. This rate is equivalent to a 27% increase in mortality in the population using unclean water and amounts to about 212,000 excess deaths per year at the peak of the Nestlé controversy in 1981.

Suggested Citation

  • Jesse K. Anttila-Hughes & Lia C.H. Fernald & Paul J. Gertler & Patrick Krause & Eleanor Tsai & Bruce Wydick, 2018. "Mortality from Nestlé’s Marketing of Infant Formula in Low and Middle-Income Countries," NBER Working Papers 24452, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:24452
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    References listed on IDEAS

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    1. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    2. Peña, R. & Wall, S. & Persson, L.-A., 2000. "The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993," American Journal of Public Health, American Public Health Association, vol. 90(1), pages 64-69.
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    Cited by:

    1. Little, Emily E. & Polanco, Maria Alejandra & Baldizon, Salvador R. & Wagner, Pascale & Shakya, Holly, 2019. "Breastfeeding knowledge and health behavior among Mayan women in rural Guatemala," Social Science & Medicine, Elsevier, vol. 242(C).
    2. Evan Plous Kresch, 2020. "The Buck Stops Where? Federalism, Uncertainty, and Investment in the Brazilian Water and Sanitation Sector," American Economic Journal: Economic Policy, American Economic Association, vol. 12(3), pages 374-401, August.
    3. Solène Delecourt & Anne Fitzpatrick, 2021. "Childcare Matters: Female Business Owners and the Baby-Profit Gap," Management Science, INFORMS, vol. 67(7), pages 4455-4474, July.
    4. Noelia Bernal & Joan Costa-i-Font & Patricia Ritter, 2022. "The Effect of Health Insurance on Child Nutritional Outcomes. Evidence from a Regression Discontinuity Design in Peru," CESifo Working Paper Series 9887, CESifo.
    5. Sarah W. Adelman & Katherine N. Schmeiser, 2019. "Infant Formula Trade and Food Safety," Applied Economics and Finance, Redfame publishing, vol. 6(1), pages 1-10, January.
    6. Issidor Noumba & Quentin Lebrun Nzouessah Feunke, 2020. "Parental Education, Household Health, and Household Standard of Living: Evidence from Rural Cameroon," International Business Research, Canadian Center of Science and Education, vol. 13(7), pages 113-113, July.

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    More about this item

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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