Anne Case

Large Cash Transfers to the Elderly in South Africa

We examine the social pension in South Africa, where large cash sumsþabout twice the median per capita income of African householdsþare paid to people qualified by age but irrespective of previous contributions. We present the history of the scheme and use a 1993 nationally representative survey to investigate the redistributive consequences of the transfers, documenting who receives the pensions, their levels of living, and those of their families. We also look at behavioral effects, particularly the effects of the cash receipts on the allocation of income to food, schooling, transfers, and savings. Two methodological issues run through our analysis. The first is the danger of interpreting simple correlations and regressions without adequate consideration of likely biases. The second is the problem of measuring the effects of a program that is determined by individual or household characteristics. We examine both in the context of the South African pension. Our results are consistent with the view that pension income is spent in much the same way as other income, and that a rand is a rand, regardless of its source.

Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century

Significance Midlife increases in suicides and drug poisonings have been previously noted. However, that these upward trends were persistent and large enough to drive up all-cause midlife mortality has, to our knowledge, been overlooked. If the white mortality rate for ages 45−54 had held at their 1998 value, 96,000 deaths would have been avoided from 1999–2013, 7,000 in 2013 alone. If it had continued to decline at its previous (1979‒1998) rate, half a million deaths would have been avoided in the period 1999‒2013, comparable to lives lost in the US AIDS epidemic through mid-2015. Concurrent declines in self-reported health, mental health, and ability to work, increased reports of pain, and deteriorating measures of liver function all point to increasing midlife distress. This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.

School Inputs and Educational Outcomes in South Africa

We examine the relationship between educational inputs—primarily pupilteacher ratios—and school outcomes in South Africa immediately before the end of apartheid government. Black households were severely limited in their residential choice under apartheid and attended schools for which funding decisions were made centrally, by White-controlled entities over which they had no control. The allocations resulted in marked disparities in average class sizes. Controlling for household background variables, we find strong and significant effects of pupilteacher ratios on enrollment, on educational achievement, and on test scores for numeracy.

Spatial Patterns in Household Demand

This paper discusses economic processes that may give rise to spatial patterns in data and explores the relative merits of alternative modeling approaches when data are spatially correlated. An estimation scheme is presented that allows for spatial random effects and attention is focused on cases in which such a framework may be preferred to the more general fixed effects framework that nests it. The models presented are used together with information on the location of households in an Indonesian socioeconomic survey to test spatial relationships in Indonesian demand for rice. Copyright 1991 by The Econometric Society.

Orphans in Africa: Parental Death, Poverty, and School Enrollment

We examine the impact of orphanhood on children’s school enrollment in 10 sub-Saharan African countries. Although poorer children in Africa are less likely to attend school, the lower enrollment of orphans is not accounted for solely by their poverty. We find that orphans are less likely to be enrolled than are nonorphans with whom they live. Consistent with Hamilton’s rule, the theory that the closeness of biological ties governs altruistic behavior, outcomes for orphans depend on the relatedness of orphans to their household heads. The lower enrollment of orphans is largely explained by the greater tendency of orphans to live with distant relatives or unrelated caregivers.

The Effect of Sibling Sex Composition on Women's Education and Earnings

This paper documents the impact of siblings on the education of men and women born in the United States between 1920 and 1965. We examine the effect of the number and sex composition of a boy or girls siblings on that childs educational attainment. We find that throughout the century womens educational choices have been systematically affected by the sex composition of her siblings, and that mens choices have not. Women raised only with brothers have received on average significantly more education than women raised with any sisters, controlling for household size. Since sibling sex composition affects womens educational attainment and plausibly may be unrelated to other determinants of earnings, it may provide a useful instrument for education in earnings functions for women. Our results suggest that standard estimates significantly underestimate the return to schooling for women.

Sex Differences in Morbidity and Mortality

Women have worse self-rated health and more hospitalization episodes than men from early adolescence to late middle age, but are less likely to die at each age. We use 14 years ofdata from the u.s. National Health Interview Survey to examine this paradox. Our results indicate that the difference in self-assessed health between women and men can be entirely explained by differences in the distribution ofthe chronic conditions they face. This is not true, however, for hospital episodes and mortality. Men with several smoking-related conditions-including cardiovascular disease and certain lung disorders-are more likely to experience hospital episodes and to die than women who suffer from the same chronic conditions, implying that men may experience more-severe forms of these conditions. While some of the difference in mortality can be explained by differences in the distribution of chronic conditions, an equally large share can be attributed to the larger adverse effects of these conditions on male mortality. The greater effects ofsmoking-related conditions on men’s health may be due to their higher rates ofsmoking throughout their lives.

The impact of parental death on school outcomes: Longitudinal evidence from South Africa

We analyze longitudinal data from a demographic surveillance area (DSA) in KwaZulu-Natal to examine the impact of parental death on children’s outcomes. The results show significant differences in the impact of mothers’ and fathers’ deaths. The loss of a child’s mother is a strong predictor of poor schooling outcomes. Maternal orphans are significantly less likely to be enrolled in school and have completed significantly fewer years of schooling, conditional on age, than children whose mothers are alive. Less money is spent on maternal orphans’ educations, on average, conditional on enrollment. Moreover, children whose mothers have died appear to be at an educational disadvantage when compared with non-orphaned children with whom they live. We use the timing of mothers’ deaths relative to children’s educational shortfalls to argue that mothers’ deaths have a causal effect on children’s educations. The loss of a child’s father is a significant correlate of poor household socioeconomic status. However, the death of a father between waves of the survey has no significant effect on subsequent asset ownership. Evidence from the South African 2001 Census suggests that the estimated effects of maternal deaths on children’s outcomes in the Africa Centre DSA reflect the reality for orphans throughout South Africa.

Election Goals and Income Redistribution: Recent Evidence From Albania

This paper examines the impact of political competition on block grants from federal to sub-federal levels of government. We model the extent and direction of income redistribution as determined proximately by the political agendas of central decisionmakers and, at a deeper level, by the institutions within which they find themselves operating. We contrast two institutional frameworks that give way to differing political objective functions and, in turn, to strikingly different empirical predictions of the ways in which politics should affect fiscal policy. Lessons learned here may prove important in understanding limits on the types of redistribution possible via block grants, given the institutional framework, in both developing and developed countries.

The Reach and Impact of Child Support Grants: Evidence from KwaZulu-Natal

This paper examines the reach and impact of the South African Child Support Grant, using longitudinal data collected through the Africa Centre for Health and Population Studies. The grant is being taken up for a third of all age-eligible resident children, and appears to be reaching those children living in the poorer households of the demographic surveillance area (DSA). Children who received the grant are significantly more likely to be enrolled in school in the years following grant receipt than are equally poor children of the same age. However, older brothers and sisters of grant recipients, when they were observed at younger ages, were less likely than other children to be enrolled in school – perhaps reflecting the greater poverty in grant-receiving households. Thus the grant appears to help overcome the impact of poverty on school enrolment.