Determinants of Diarrheal Disease in Jakarta

Abstract

Is there defensive behavior to prevent diseases such as diarrhea in Jakarta? Yes. And evidence suggests that individual defensive behavior is influenced by exposure to contamination and income and education - as expected. So, given the opportunity and knowledge, individuals try to modify the effect of contamination on the incidence of diarrhea. But that incidence is also affected by the water company and its problems, factors that lie outside the realm of the household. Alberini, Eskeland, Krupnick, and McGranahan develop and estimate a model of household defensive behavior and illness. Using cross-section data from a household survey in Jakarta, they observe defensive behavior (washing hands after using the toilet) consistent with expectations: Defensive effort intensifies with exposure to contamination, and with income and education. Variables associated with the cost of defensive behavior - such as interruptions in the water supply - reduce defensive behavior. The data suggest that wealthier households are no less vulnerable to illness. The water sources that supply the wealthy (the water company and private wells) are disrupted more often, interfering with their defensive behavior. There is also evidence, although weak, to support findings by van der Slice and Briscoe (1993): that pathogens originating within a household are less harmful to household members than are pathogens originating from other households. Given the opportunity and knowledge, individuals try to modify the effect of contamination on the incidence of diarrhea. But diarrhea`s incidence is also affected by decisions and problems outside the realm of the household, including the performance of the water company. This paper - a product of the Public Economics Division, Policy Research Department - is part of a larger effort in the department to analyze pollution control in developing countries. The study was funded by the Bank's Research Support Budget under the research project Pollution and the Choice of Policy Instruments in Developing Countries (RPO 676-48).