Long-term health effects of a school construction program.
Muhammad Fikru RizalNicole BlackDavid W JohnstonRohan SweeneyPublished in: Health economics (2023)
Non-communicable diseases (NCDs) disproportionately affect people in low- and middle-income countries (LMICs), yet context-specific evidence on policies that impact NCD risk factors is lacking. We estimate the impact of a massive Indonesian primary school expansion program in the 1970s on NCD risk factors in later life using data from two surveys with very large sample sizes. We find that in non-Java regions of Indonesia, the program led to significant increases in the likelihood of overweight and high waist circumference among women, but not among men. The increase for women can be partly explained by increased consumption of high-calorie packaged and take-away meals. We find no meaningful impacts on high blood pressure for either sex. Despite the increase in body weight, the program had a negligible impact on diabetes and cardiovascular disease diagnosis. It led to an improvement in women's self-reported health outcomes in their early-40s, but these benefits largely disappeared once they reached their mid-40s.
Keyphrases
- body weight
- risk factors
- cardiovascular disease
- quality improvement
- polycystic ovary syndrome
- physical activity
- blood pressure
- type diabetes
- body mass index
- mental health
- pregnancy outcomes
- weight loss
- cervical cancer screening
- public health
- breast cancer risk
- cardiovascular events
- glycemic control
- hypertensive patients
- pregnant women
- artificial intelligence
- metabolic syndrome