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Cruz SE, 2003-22540 Determining the Impact of Urbanization on Child Health: An Analysis Using Propensity Score Matching (An Econ 300 Thesis Proposal) Regional variations in childhood health indicators can be observed in the Philippines. For example, infant mortality is lowest in Zamboanga Peninsula with 14 deaths per 1000 lives births and highest in ARMM with 56 deaths. Under-five mortality, on the other hand, is lowest in NCR with 24 deaths per 1000 live births and still highest in ARMM with 94 deaths. In terms of micronutrients intake, the percentage of children aged 6-59 months who were given iron supplements in the past seven days is lowest in MIMAROPA and ARMM with 11.9 % and 15.6%, respectively, and is highest in NCR with 62.3%. Prevalence of diarrhea also varies across regions from 5 percent in Bicol to 16 percent in SOCCSKSARGEN.
These results provide evidence of urban-rural health differentials in the
country and thus, merit in exploring the impact of urbanization on health outcomes, particularly on children. Urbanization can be simply defined as the rise in the proportion of the population living in urban areas. It is often characterized by growing industrialization and agglomeration which not only create employment opportunities but also increase the provision of various physical infrastructures and public services. These enable adult and children to efficiently access education and healthcare facilities resulting to improved health status in urban locales. However, urbanization in many developing countries nowadays has also been associated with unprecedented increase in population whether through natural growth or massive rural-urban migration. In the Philippines, urban population
2008 Philippines National Health and Demographic Survey
Urbanization and Sustainability. al.org/Documents/Books/Urbanization-Sustainability/chapter11. solid waste management and insufficient access to health facilities in areas (WHO. et. solves this dimensionality problem by computing for the probability that the observation unit will be treated based on the observed value of its characteristics. transport facilities. inadequate infrastructure. PSM is an offshoot of the general matching method used in many impact evaluation studies. This proposal thus seeks to find a causal relationship between urbanization and child health.2% of the national population (World Bank. The World Bank.has reached 56. Accessed through http://www. Accessed through http://www. Impact Evaluation in Practice. This issue is known as the dimensionality problem. urban population is expected to comprise close to 70% of total population in the country. under-five mortality rates by utilizing a quasi-experimental design known as Propensity Score Matching (PSM). road traffic injuries. These include overcrowding. Paul. air pollution.3 Finding a close match to the treatment observations however is often found to be relatively difficult if there is a long list of characteristics to be matched or if these characteristics are continuous or take on many values. This value is the propensity score ranging from 0 to 1 Mangahas.93 mio or 64. Matching essentially uses statistical techniques to construct an artificial comparison group by identifying for every possible observation under treatment a nontreatment observation (or set of non-treatment observations) that has the most similar characteristics possible. PSM however. 2011.org/ 2 . By 2030. rising levels of risk factors like tobacco use.2 The rapid pace of urbanization and growth of cities thus present a myriad of health hazards and challenges. physical inactivity and the harmful use of alcohol.pdf 3 Gertler.adb. particularly. 2010).worldbank. unhealthy diet. 2008). Joel.
the population propensity score for municipal i can be defined as: P(Xi) = Prob (Hi = 1 | Xi) where: Hi represents the “pre-project/pre-intervention” explanatory variables Xi represents the municipality i (0<P(Xi)<1) . Following Rosenbaum and Rubin (1983). our treatment group will be composed of municipalities with high levels of urbanization whereas our control group will be comprised of municipalities with low levels of urbanization. Matching shall be implemented by finding a municipality in control group that is similar in observed characteristics or covariates to a municipality in the treatment group. The sampling units that will be used in this study are municipalities. the mean impact is estimated to be the difference between the treatment municipalities and the matched comparison municipalities on under-five mortality rates. Regional Accounts while information on under-five mortality rates will be obtained from 2008 National Health and Demographic Survey. A municipality in the control group who has a close propensity score to a household in treatment group is considered a match comparison or control municipality. PSM involves comparing the propensity scores – the probability of under-five mortality rate in the municipality caused by urbanization. Data on urbanization will be sourced from NSO’s 2008 Census of Population. Thus. Once the matched control group is determined.that represents all of the observed characteristics of the units as they influence the likelihood of being in the treatment group.
4 To achieve the conditional independence assumption for causality under the PSM. 4 . a standard logit model is used for each observation in the treatment and the matched control sample units. The Central Role of the Propensity Score in Observational Studies for Causal Effects. Given the inherent infeasibility of one-toone matching. D. These are one-to-one matching. caliper or radius. Biometrica. P. 1983).e. urbanization) given Xi. These may include municipal-level income. and Rubin. Rosenbaum. pollution level. 70.The above equation shows that if Hi are independent over all i’s and outcomes are independent of being influenced by the intervention (i.. In estimating the average treatment effects given the propensity score. these covariates are those that influence the municipality’s probability of under-five mortality rate outcomes. Matched-pairs of municipalities are then outlined on the basis of how close the estimated scores are across the two sample units. etc. the variables needed to compute for the propensity score should influence simultaneously being in the treatment and the outcome of the intervention. various matching solutions are available. In order to estimate the propensity score. nearest neighbor. nearest neighbor is the best next alternative in the matching process. just as they would be if participation is randomly assigned (Rosenbaum and Rubin. 1983. Stated differently. employment rates. stratification and interval matching and kernel matching. presence of healthcare facilities and other complementary infrastructures. then outcomes are also independent of intervention “participation” given P(Xi).