Essays on health, mortality, and intergenerational transfers in rural Malawi

Brian Chin, University of Pennsylvania


This dissertation is a collection of three essays exploring micro relations between components of economic development, health, and social protection in rural Malawi, a developing country in sub-Saharan Africa with high poverty and a mature HIV/AIDS epidemic. The unique individual level longitudinal panel data used in the analyses come from the Malawi Longitudinal Study of Families and Health, formerly the Malawi Diffusion and Ideational Change Project. ^ The first chapter isolates the causal effect of income on health and well-being using an instrumental variable fixed effects model on three waves of the panel data from 2004 to 2008. The results show that when unobserved heterogeneity is taken into account, the direct effect of income on health and well-being is positive, with a slightly larger effect on well-being. ^ The second chapter examines the effect of HIV on demographic and socioeconomic correlates of adult mortality from 1998 to 2010. The results demonstrate that HIV testing drastically reduces estimated associations of mortality compared to controlling for HIV positivity. Schooling is associated with lower mortality for men, but not for women due to the high opportunity cost of marriage and HIV risk exposure in singlehood. There is higher mortality in the Southern region compared to the Central and Northern regions. Divorced women and widowed men have higher mortality. There is a particularly high mortality disadvantage due to HIV for Muslims. HIV positivity is highly associated with excess mortality, accounting for almost a quarter of the mortality burden during this period. ^ The third and last chapter explores three motives for intergenerational transfers between parents and children: altruism, exchange, and biology. The results suggest that the type of transfer, financial or non-financial, makes a difference in transfer motive. There is a dominance of the altruistic transfer motive for adult children's financial transfers, specifically by daughters who are more likely to transfer to parents in poor health and with age. Adult children's non-financial transfers to parents are mostly exchange-based. Mothers make exchange financial transfers and altruistic non-financial transfers, while fathers lack any specific significant transfer motive although there are tendencies of altruism for daughters and exchange for sons. ^

Subject Area

Economics, General|Health Sciences, Public Health|Sub Saharan Africa Studies|Sociology, Demography

Recommended Citation

Chin, Brian, "Essays on health, mortality, and intergenerational transfers in rural Malawi" (2011). Dissertations available from ProQuest. AAI3500222.