Pollution Externalities and Health: A Study of Indian Rivers

Water pollution levels in many developing countries remain significantly higher than in the developed world. While such pollution is often a byproduct of economic activity, it also imparts a health burden on the population. We study this health burden in the context of domestic water pollution in India's rivers, focusing on infant mortality as a measure of health outcomes. In particular, we quantify two impacts: The mortality burden of river pollution in the district of its measurement; and the persistence of that burden in neighboring, downstream districts. To avoid endogeneity problems, we construct an instrument for water quality in a given Indian district using water quality upstream of that district. Two-stage least squares (2SLS) regression reveals a positive district-level association between one-month infant mortality and the concentration of fecal coliforms in river water. This association strongly holds for both national demographic surveys that we use to compile infant mortality data. We interpret the association to be causal: The average effect of a one-percent increase in fecal coliforms is an additional 3-5 deaths per 100,000 births in a given month. In comparison, the corresponding downstream infant mortality impact is approximately 1-2 deaths per 100,000 births.