Grant Miller will discuss the results of his SAPARC-funded research in rural China, supplementing a large NIH-funded project about pay-for-performance to improve health. The research was designed to test the effect of offering school principals small incentives for anemia reduction on the health and academic performance of primary school students – potentially leading to substantially more cost-effective health policies.

Grant Miller, PHD, MPP, is an Associate Professor of Medicine at the Stanford School of Medicine, a Core Faculty Member at the Center for Health Policy/Primary Care and Outcomes Research, and a Research Associate at the National Bureau of Economic Research (NBER). He is also a Faculty Fellow of the Stanford Center for International Development and a Faculty Affiliate of the Stanford Center for Latin American Studies. His primary areas of interest are health and development economics and economic demography.

Miller's current research focuses broadly on behavioral obstacles to health improvement in developing countries. One line of studies investigates household decision-making underlying puzzlingly low adoption rates of highly efficacious health technologies (like point-of-use drinking water disinfectants and improved cookstoves) in many poor countries. Another vein of research investigates misaligned macro- and micro-level incentives governing the supply of health technologies and services. He has conducted these and other research projects at institutions including the National Bureau of Economic Research, the Urban Institute, and the University of California-San Francisco's Institute for Health Policy Studies. He received a BA in psychology from Yale College, a master's degree in public policy from the Kennedy School of Government at Harvard University, and a PhD in health policy/economics also from Harvard.

Providing people with safe drinking water is one of the most important health-related infrastructure programs in the world. The first part of our research investigates the effect of a major water quality improvement program in rural China on the health of adults and children. Using panel data covering about 4500 households from 1989 to 2006, we estimate the impact of introducing village-level access to water from water plants on various measures of health. The regression results imply that the illness incidence of adults decreased by 11 percent and their weight-for-height increased by 0.835 kg/m, and that children's weight-for-height and height itself both rose by 0.446 kg/m and 0.962 cm respectively, as a result of the program. And these estimates are quite stable across different robustness checks.

While the previous research has shown health benefit of safe drinking water program, we know little about the longer-term benefits such as education. The second part of our research examines the youth education benefits of this major drinking water infrastructure program. By employing a longitudinal dataset with around 12,000 individual observations aged between 16 and 25, we find that this health program has benefited their education substantially: increasing the grades of education completed by 0.9 years and their probabilities of graduating from a lower and upper middle schools by around 18 and 89 percent, respectively. These estimation results are robust to a host of robustness checks, such as controlling for educational policy and local resources (by including county-year fixed effects), village distance to schools, local labor market conditions, educational demand, instrumenting the water treatment dummy with topographic variables, among others. Our estimates suggest that this program is highly cost-effective.

Jing Zhang, an assistant professor, received her PhD from the University of Maryland in 2011, and joined Renmin University of China in the same year. Prior to that, she worked at the World Bank from 2010 to 2011. The focus of her research lies in health economics and public finance. Her publications include: “The Impact of Water Quality on Health: Evidence from the Drinking Water Infrastructure Program in Rural China,” Journal of Health Economics (2012) and “Soft Budget Constraints in China: Evidence from the Guangdong Hospital Industry,” International Journal of Healthcare Finance and Economics (2009).