Tag Archives health

Why is it important to start a cycling culture with small children?

By Posted on 2275 views
Photo Credit: Amanda Padilla, 2022

A cycling culture should start with kids, allowing them to improve their health, social interaction and learning process. However, Latin American cities have some barriers linked to insecure cycling infrastructure, road safety and weak cycling habits. In this blog article, Amanda Padilla discusses how a cycling activity focused on small infants integrally addresses their well-being and harvests long-term positive impacts on society, the environment and mobility.

Significant issues have been affecting children from early childhood, such as passive habits, reduced social interaction and poor health conditions with obesity being a serious global health problem. In 2022, obesity affected one in eight people worldwide, impacting 3 million children under five years old in South America. In Ecuador, a study shows that 36% of children between five to eleven years old are obese or overweight. Likewise, this problem escalates in young people and adults, leading to inactive and solitary lifestyles that impede social, mental and physical development.

In the context of child health, cycling not only addresses obesity, enhances social interaction and strengthens physical skills, but also positively impacts urban environments by decreasing air pollution and bridging socio-economic gaps. However, developing countries lack a robust urban cycling culture and school cycling programmes for children.

In 2022, only 0,6% of the population of Quito uses cycling as a mode of transportation. Inadequate and insecure cycling lanes, a weak cycling culture and a car-oriented lifestyle hinder the shift towards sustainable transportation. Despite local and national laws prioritizing active mobility and the efforts of activists and cycling organizations, a new cycling vision with strong and integrated cycle programmes will lead to a deep-routed cycling culture and policies.

Despite these challenges, promising practices are addressing these issues and contributing to urban solutions. In 2019, I learned about child-friendly cycling activities in Copenhagen and Quito, coordinating the project of the Cycling Games at the INEPE school from 2019 to 2024, an activity based on the Danish ‘Learning by playing’ methodology. This experience has underscored the importance of starting with young children to cultivate a cycling culture. The benefits observed from this activity include:

1. Long-term impact

In Quito, children and caregivers rarely cycle, reflecting a modest cycling habit. Introducing cycling to young children can help establish it as a lifelong habit. An activity that begins in early childhood will persist throughout the kid’s life and early childhood cycling experiences prepare children for urban cycling dynamics, promoting safety and confidence. Learning cycling skills can help them navigate and better cope with insecure cycle infrastructure in Quito.

2. Spreading the Cycling Practice

When children enjoy an activity, their parents often follow suit. In fact, ’cycling creates connections at many different levels and the value that young children and caregivers derive from these connections‘. When children start cycling, their fascination often motivates caregivers to participate and encourages them to spend time with their children. Thus, this culture is increasing and a deep-routed cycling culture can be achieved.

Photo Credit: Amanda Padilla, 2023

3. Development of social and physical skills through Cycling Games. 

Cycling activities emphasize the development of various capacities and balance through play. This approach implemented both in Copenhagen and Quito, encourages active routines that foster the development of social and physical skills, tackling obesity and passive habits. The results are evident as children apply these skills in other areas of their lives. In Quito, for example, children are required to complete certain assignments before they can go out and play. This practice helps them establish a routine that cultivates a sense of responsibility and goal-oriented behavior. In Copenhagen, the frequent use of public spaces allows children to navigate through obstacles and urban furniture, which not only enhances their understanding of street dynamics but also strengthens their physical abilities. Public spaces are key elements on the child growth. Sporadically, in Quito, the activity is developed in streets, creating new relationships between the city and children, yet Quito doesn’t guarantee road safety and secure cycling infrastructure to expand it frequently.

4. Teachers develop new ways to educate

Training children in diverse contexts and cultures presents unique challenges, yet the educational benefits gleaned from activities like the Cycling Games are universally significant. Educators have adapted and enhanced their teaching methods based on these activities, demonstrating remarkable flexibility and creativity to meet the varying needs of their students. Each group of students presents different dynamics and requirements, necessitating a tailored approach to teaching. For instance, teachers at Hylet Kindergarten in Copenhagen have devised new games that require children to memorize elements with different colours, shapes and routes to prove skills simultaneously. In Quito, trainers have developed cycling games that minimize physical contact or develop soft games, specifically to accommodate and protect children with physical or mental disabilities.

5. Interaction contributes to socialization

The Cycling Games significantly contribute to the development of socialization skills. By promoting group play, mutual support and peer learning, the games create an environment where children can interact and build relationships with their classmates. This interaction fosters respect and teamwork, qualities that extend beyond the cycling activities into other areas of their lives, including interactions with family and schoolmates.

Photo Credit Amanda Padilla, 2023

Broad Impact of the Cycling Games in Quito: ‘Please, bus driver, stop at the yellow light’

The Cycling Games in Quito have significantly influenced the community, particularly through their educational impact on road safety. Children of the Cycling Games project at the INEPE school, for example, teach adults important safety measures like stopping at yellow lights, demonstrating the programme’s success in instilling these habits. Over several years, the Cycling Games have fostered a strong cycling culture, with students, caregivers, teachers and school authorities all recognizing the programme’s benefits such as improving health and promoting sustainable mobility.

 The Cycling Games is a key initiative in promoting mobility in Quito, fostering children’s development, health outcomes* and contributing to long-term changes in mobility. Data from 2021 shows a strong desire among children to cycle outside of school, indicating a positive shift towards incorporating cycling into daily routines. This enthusiasm suggests a broader impact on community behaviors and future city policies, promoting a more active and environmentally conscious urban lifestyle.

Photo Credit Amanda Padilla, 2023

New infant-care public policies are being developed in Quito, presenting a great opportunity to introduce children’s cycling projects to address significant issues such as obesity or passive habits, contribute to increasing sustainable mobility and enhance urban cycling lifestyles. Those powerful contributions will create a new city scenario with a secured cycle infrastructure, a robust cycling culture and a healthy community.

Bibliography:

Padilla, A. (01 de July de 2020). A seed in the Mobility of Quito. Quito, Ecuador.

World Health Organization. (01 de March de 2024). One in eight people are now living with obesity. https://www.who.int/news/item/01-03-2024-one-in-eight-people-are-now-living-with-obesit

United Nations Children’s Fund. (2023). 2023 Report. Childhood overweight on the rise. Is it too late to turn the tide in Latin America and the Caribbean? Panama City: UNICEF Latin America and the Caribbean Regional Office (LACRO).

The Bernard van Leer Foundation & BYCS. (2020). Cycling Cities for Infants, Toddlers, and Caregivers. Amsterdam.

(Tello, Ocaña, García-Zambrano, Enríque-Moreira, & Dueñas-Espín, 2023)

The Municipality of the Metropolitan District of Quito. (March de 2024). Plan Maestro de Movilidad para el Distrito Metropolitano de Quito 2009-2025. Quito, Ecuador.

C40 Cities. January 2021. Ciclovías en la capital. https://www.c40.org/case-studies/ciclovias-en-la-capital/

Pucher, J., & Buehler, R. (2012). City Cycling. Massachusetts: The MIT Press.

Charlotte Basiliadis (Pedagog and educator at Kindergarten Hylet) in discussion with the author, May 16, 2024.

Guisella Pintag (Pedagog and educator at the INEPE school) in discussion with the author, April 30, 2024.

Opinions expressed in Bliss posts reflect solely the views of the author of the post in question.

About the author

Amanda Padilla

Amanda Padilla is an architect who graduated from the Polytechnic University of Milan. She is into developing child-care projects, develops public policies and manages public space projects and urban plans at public departments. Amanda has collaborated with Urban Cycle Planning of Denmark, coordinating the Cycling Games project in Quito, supporting data collection of this activity in La Havana, and assisting the Bikeable City Masterclass in Copenhagen. She represents Quito in the Bicycle Major Network Programme of BYCS.

Are you looking for more content about Global Development and Social Justice? Subscribe to Bliss, the official blog of the International Institute of Social Studies, and stay updated about interesting topics our researchers are working on.

From sacred to clinical: how the lack of proper burials during the Covid-19 pandemic affected communities in Uganda

By Posted on 2516 views

When Covid-19 started spreading across the globe, the World Health Organization issued strict burial guidelines in a bid to curb the spread of the virus. In Uganda, the national health department took over the burial of Covid-19 victims, interring them quickly and without adhering to proper cultural and religious procedures. In a country where death rituals form a central part of the grieving process, the undignified burials that took place during the pandemic have had severe psychological consequences for bereaved families and communities.

In the Global South and in Africa particularly, most development studies research concentrates on survival issues; economic needs and death/loss are generally discussed in relation to poverty or AIDS, while the few available bereavement studies focus on the grieving experiences of individuals or groups.[1] However, injustices are also apparent in processes of grieving; unpacking the way in which grief is collectively and individually experienced is a necessary first step in addressing these injustices. Here, I show how the strict burial guidelines imposed during the Covid-19 pandemic were received in Uganda and why we should take note.

 

The many facets of death rituals

Death rituals, defined as “forms of expressions and connections performed by individuals, groups of people or communities in communication with the living-dead and the Supreme Being”[2], connect the dead and living in Africa. These rituals serve to mediate between the physical and spiritual worlds as the spirit of the deceased crosses between worlds. Many African families for example have a graveyard within the compound they live in because they believe that the dead remains part of the living family.[3]

During death rituals, the bereaved family plays a direct role in preparing the body, washing the body and shaving the deceased’s head; domestic animals are also slaughtered for ritual purposes. Slaughtering a sheep, for example, is meant to please the ancestors so that they do not demand another death.[4] And a death is communicated to the entire community as part of the ritual. A study of death rituals in Bugumba in Uganda shows how community members participate in death rituals once a large bonfire has been lit in the compound of the deceased to communicate bereavement to everyone in the community.[5]

Other death-related rites and beliefs include a belief among the Ethur of northeastern Uganda in life after death, with the spirit of the dead person travelling to the realm of ‘Obanga’, as well as the common belief that the dead are spirits that can send curses if disturbed.[6] Not performing death rituals would be considered one way of disturbing the dead. Similarly, in northern Uganda, a harmonious relationship between the living and dead is maintained to avoid ‘cen’, or vengeful spirits, by performing rituals.[7]

Death rituals are considered so important that in cases where a bereaved family lacks adequate resources to perform crucial rituals, community members may contribute the required resources – something that is reciprocal. In studying bereavement, the concept of Ubuntu[8] helps us to understand how cohesion and solidarity are maintained during and after burial through communal rituals and mourning. People travel from far away to participate in death rituals or attend funerals because death comes with misfortune for those who don’t participate in rituals. Paying close attention to the rituals while maintaining solidarity is a key healing factor from loss due to death.[9]

 

The inability to say goodbye properly

Limitations on death rituals during the Covid-19 pandemic and the interment of Covid-19 victims by health authorities thus caused great distress in Uganda and beyond. During the pandemic, following protocols issued by the World Health Organization (WHO) to curb the spread of the virus, strict guidelines for burials were issued by the government of Uganda under its Ministry of Health. They included limiting the handling of the deceased body to health/burial teams only, wrapping the body in waterproof plastic bags before handing it over for burial, and preventing the public from seeing the body. Family members and other mourners had to stay two meters away from the body.

Many district governments came up with further burial guidelines that included the time at which the burial was to take place, the prohibition of death announcements over radios to prevent the burials from attracting crowds, and ensuring a burial would take no more than two hours. The burial team, dressed in white wellington boots, full plastic protective suits, goggles, face shields, and gloves besides preparing the body secured the burial sites, dug the graves, and conducted the burials. They were nicknamed ‘Angels’ because they appeared mystical to the community members.

 

Indignation and defiance

Besides leading to personal suffering, these clinical burials also led to political dissatisfaction. The burial teams were heckled and some attacked for not following burial traditions. This is because in Uganda, a dead person is very special to the community and must be treated with full respect during the entire burial process. Burials were considered undignified because of the rough handling of the dead and the mourning of those close to the deceased in isolation, when this would usually take place as part of the burial process.[10] The departure from the traditional rituals led to psychosocial suffering (distress for bereaved families) that affecting healing, since no space was provided to express grief.

The community felt that the creation of distance between the deceased person and mourners, the wrapping of the body in artificial materials, and the handling of the body by seemingly alien entities did not ensure sufficient respect. The mystery and criticism was inspired by a deep distrust of the government during the pandemic, leading to allegations such as government’s burying of empty coffins and speculation that Covid-19 deaths concealed the trafficking of individuals.

“How could the spirit of the dead be reached and engaged when it is so trapped? Can the spirit be able to escape its ‘plastic prison’ and join the ancestors, or remain locked in captivity?” asks Brian Mukalazi in the Daily Monitor newspaper, describing how the burial of Covid-19 victims in a ‘scientific’ way angered the communities and led them to defying the burial guidelines by secretly exhuming the bodies to conduct decent burials. Communities such as the Budaka in eastern Uganda, the Buikwe, and the Palissa who resorted to this claimed they needed to ensure decent burials for their departed kin since their spirits had started disturbing their living relatives and some community members.

 

Conclusion

It is clear from the above that the suffering stemming from the loss of a loved one can be compounded by the lack of proper treatment of the deceased, in this case by the absence of proper burial rituals. However, these emotional impacts of injustices linked to bereavement processes on those close to the deceased and their communities are not yet sufficiently understood. It is crucial to address the psychosocial needs of those that lost loved ones to the pandemic. To prevent recurrence, and to help the bereaved find closure, academic research should focus more deliberately on cultural and psychological needs that arise during bereavement processes.

 

[1] McCarthy, J. R., Evans, R., Bowlby, S., & Wouango, J. (2020). Making sense of family deaths in urban Senegal: Diversities, contexts, and comparisons. OMEGA-Journal of Death and Dying, 82(2), 230-260.

[2] Baloyi, L., & Makobe-Rabothata, M. (2014). The African conception of death: A cultural implication.

[3] Umoh, D. S. (2012). Death is not natural: The African story.

[4] Haram, L. (2021). Bodily grief work meets Christian interiority: The Meru case. Death studies, 45(1), 51-60.

[5] Vokes, R. (2018). Before the call: Mobile phones, exchange relations, and social change in south-western Uganda. Ethnos, 83(2), 274-290.

[6] Wayland, E. J. (1931). Preliminary studies of the tribes of Karamoja. The Journal of the Royal Anthropological Institute of Great Britain and Ireland, 61, 187-230.

[7] Kembel, A. S. (2015). When the Dead Are Not Silent: The Investigation of Cultural Perspectives Concerning Improper Burials in Northern Uganda.

[8] As a theoretical perspective, Ubuntu is expressed in many languages in African communities but with the same meaning (Mugumbate and Chereni, 2020). Ubuntu caring solidarity translates to Uganda’s context through a saying which literally means “today it’s me, tomorrow someone else”.

[9] Lee, R., & Vaughan, M. (2008). Death and dying in the history of Africa since 1800. The Journal of African History, 49(3), 341-359.

[10] Lubega, M., Nakamya, C. S., Namugumya, E., & Najjemba, J. (2022). The effect of COVID-19 public health guidelines on the funeral traditions and burial rituals among the Baganda, a tribe in Central Uganda. PAMJ-One Health, 7(7).

 

Opinions expressed in Bliss posts reflect solely the views of the author of the post in question.

About the author:

Henry Okidi Okoth holds a MA Development Studies degree from the International Institute of Social Studies of Erasmus University Rotterdam. Currently, he is a researcher and consultant with Collaborative Social Change. His research interests are death and bereavement studies from a decolonial perspective, marginalization and poverty, gender, conflict, and human rights.

Are you looking for more content about Global Development and Social Justice? Subscribe to Bliss, the official blog of the International Institute of Social Studies, and stay updated about interesting topics our researchers are working on.

Transformative Methodologies | Changing minds and policy through collaborative research?

By Posted on 5145 views

Can collaborative research with marginalised communities be transformative, turning around unjust social relations, and supporting solidarity and rights in a practical sense? In this blog post, we (Jack Apostol, Helen Hintjens, Joy Melani and Karin Astrid Siegmann) reflect on this question based on our experience with the PEER approach, a participatory research methodology, that we used in a study on undocumented people’s access to healthcare in the Netherlands. The answer? We posit that the claim that social science methodologies can directly transform social realities, may be raising expectations too high, at least for the PEER approach. Yet, dissolving barriers between academic and non-academic knowers might be useful in itself, leading to greater respect for, and the amplification of the voices of marginalised people.

https://www.istockphoto.com/nl/foto/vluchtelingen-mensen-met-bagage-lopen-in-een-rij-gm921353784-253049275

What is PEER?

PEER stands for Participatory Ethnographic Evaluation and Research. The participatory aspect stems from the involvement of members of marginalised and stigmatised communities as co-researchers. It is used in contexts where it is essential to build trust, where new insights are needed, and where the underbelly of sensitive topics can be exposed through mostly non-directive (open-ended) interviews with hard-to-research and marginalised groups in society. Examples of such topics include research on sexual health, sex work, the illicit or informal economy, and refugees on the move.

 

PEER research on undocumented people’s access to healthcare

We used the PEER methodology to understand the puzzle of why undocumented people in the Netherlands rarely access healthcare, despite their health rights being formally guaranteed in Dutch and EU regulations. Our research team consisted of people based at universities, like Helen, Karin, and our colleague Richard Staring, and non-academic experts from a group of undocumented peer researchers, including Joy and Jack. Interview questions were developed within the team, with peer researchers knowing best how to address sensitive issues with other undocumented people. Once interviews were concluded, debriefing meetings with the peer researchers formed the starting point of our data analysis.

The benefits of the PEER methodology for accessing and learning from people, who have good reasons to remain under the radar, came out clearly in our study. Joy highlights trust as the main advantage of reaching out to fellow undocumented persons for an interview: “Undocumented people cannot trust anyone. But if we interview them, they know that we are undocumented, and they can open up easily. They can tell the real story, their own emotions, and experiences. Because they know, having the same situation, you can understand them, how they feel, their thoughts.”

Time constrains were tough for peer researchers for whom research came on top of their normal working day. Working as a domestic worker full time, Jack recalls: “I worked as a full domestic worker that time. I started my work from the morning until 6 in the afternoon. Attending workshops and meetings during the whole period of PEER research project were a challenge to me. Usually, I rushed to the evening meetings at ISS [International Institute of Social Studies] after my whole day work. This made me physically and mentally a bit tired to participate in the discussion and share my ideas. Sometimes, I came late due to extra work. But I ought to do it as part of my commitment to the project.”

Two PEER researchers simulating an interview during training, August 2014, The Hague

So can the PEER Methodology change minds, influence policy?

Contributing to social change clearly motivated Jack:

“First, I believed that the project was for the well-being of the undocumented migrants in the Hague. This was about a health issue which was vital for the interest of the undocumented migrants whose access to medical care had been hindered by lack of information, discrimination, and ignorance of some medical professionals about the existing health policy of the government.” But what is the actual potential of such collaborative research to transform the injustices that undocumented people experience? Jack soberly concludes that any broader impact depends on the political context: “Absolutely, a rightist government is against migrants. Any outcome of the research based on a PEER approach would not actually convince the rightist government to take initiatives to change their policy in favour of migrants.”

This suggests the practical limits of what one can realistically achieve with academic research under an illiberal dispensation. On its own, without a shift in attitudes, social research cannot shift policy parameters. As the saying goes, one can take a horse to water, one cannot make it drink! Yet PEER research does break down barriers. The status-quo that segregates undocumented people from the rest of society is challenged, as PEER researchers open doors to long-concealed stories of undocumented life in the midst of plenty. Those without status are respected experts in self-organisation, and can be supported to negotiate access to rights and services. In conclusion, one can highlight the vital transformative role played by migrant self-help organisations like Filmis and others, whose solidarity work has stepped up since the start of the COVID pandemic.

Opinions expressed in Bliss posts reflect solely the views of the author of the post in question.

About the authors:

Jacob Apostol is the co-founder and the current president of the Filipino Migrant in Solidarity (FILMIS) Association. He is a human rights advocate.

 

 

Helen Hintjens has been interested in pro-asylum advocacy for about 40 years now. She is inspired by the self-advocacy of those confronting current deterrence-based policies on migration and asylum.

 

Melanie (Joy) Escano is the Vice-President of Migrant Domestic Workers Union. She is also the co-founder and the current public relation officer of the Filipino Migrant in Solidarity (FILMIS) Association.

 

Karin Astrid Siegmann is Associate Professor in Labour and Gender Economics at the International Institute of Social Studies (ISS).

 

Are you looking for more content about Global Development and Social Justice? Subscribe to Bliss, the official blog of the International Institute of Social Studies, and stay updated about interesting topics our researchers are working on.

 

How do grassroots networks in Kenya tackle violence against children?

By Posted on 2591 views

In the absence of state infrastructure, grassroots networks play a crucial role in addressing the prevalence of violence against children in Kenya. How do these networks work and how can they be supported to overcome their challenges?

In much of Africa, where the state plays a limited role in preventing child vulnerability and in-service provision, grassroots informal community-based networks play an important role in addressing violence against children (VAC). I draw on research carried out in 2019-20 with Civsource Africa that focused on the role of different types of networks on the prevention of violence against children in Kenya, showing that while different actors at different levels are networked in the prevention of VAC, grassroots networks are on the front line of preventing and responding to this violence.

However, our research notes that there are challenges in the functionality of these networks, including in the way they interact with other more formal networks working to prevent VAC. These issues need to be addressed, taking care that grassroots networks do not lose their unique identity.

How do grassroots networks work?

Networks are conceptualised as interconnected webs of actors, pooling together for mutual reciprocity in addressing VAC. In our research, there were formal and structured networks that comprised non-state actors like NGOs and other state institutions such as Kenya’s Department of Children Services, the Ministry of Health and actors in the court system.

At the community level, the unstructured grassroots networks included individual community volunteers, child protection volunteers, community-based organisations and community health workers. They also include community-based paralegals, who support children and caregivers in legal redress, as well as opinion leaders who are consulted in issues of violence against children.

These grassroots individuals and groups either worked separately within their communities or were networked with other actors, to whom they reported to or referred issues of child protection. For example, they were working with local community leaders in charge of sub-counties (known as chiefs), the Department of Children’s Services, the Ministry of health, the police and with different NGOs.

Some of these grassroots actors worked as appendages to the state system of child protection. For example, child protection volunteers are selected by the community but vetted by the Children Office and are expected to monitor issues of violence in the community and report to the Children Officers. The community health workers are appointed and vetted by the community during meetings known as Barazas. While some worked independently, they were part of the Ministry of Health strategy for delivering services to the grassroots and therefore expected to take up issues of child abuse and violence and referral to appropriate services. Being selected by the community reinforces the codes of trust that make them accountable to the local population. These actors were therefore expected to give periodic reports on VAC through public meetings.

The financing and capacity arrangements of these structures are diverse. For example, the community-based networks pool together their resources and energy to carry out dialogue in the community and follow up after cases of VAC. Some of them receive funding from the organisations they are affiliated with. Some volunteers working with the NGOs were receiving training, small funding for targeted activities and transport to follow up after cases of VAC. Some of the volunteers and CBOs were also working with several organisations at the same time.

 

The benefits of community networks

Working independently or through other structures, these grassroots networks of community volunteers build the resilience of children by training them on their rights, offering psychosocial support and identifying cases of violence. They also build bonds that make it easier to address violence, by encouraging the development of positive norms and an ethos of child protection through dialogue on responsibility towards children. They also enhance the community’s collective efficacy in caring for their children through training on income generating activities. The grassroots actors also build bridges by connecting children with the police and other leaders who enforce laws, and probation and children officers who ensure state child protection.

Vertical collaborations with larger networks addressing violence against children enables these networks to draw synergies since some NGOs provide services addressing structural causes of VAC. For example, a CBO in an informal settlement in Nairobi noted that one of the NGOs supported the development of a community VAC alert system. Such collaboration ensures that effort in violence prevention is not just a local exercise but is connected at different nodes, thus ensuring that broader interventions are based on children’s everyday experiences of violence. For example, the child protection volunteers are part of the local Children Area Advisory Council, which is part of the National Council for Children Services, the highest oversight body on children’s issues.

These networks are homegrown and rely on community trust relations and, therefore, enhance faster dissemination of information on VAC at the grassroots level. They also act as first responders or what is seen as the first mile on issues of violence against children in their communities.

Similarly, our research finds that grassroots actors are acknowledged by other actors such as the police, children’s officers and local administrations, who listen to them. This validation is important in accountability to children’s rights since it might help the grassroots actors to check for excesses by such leaders when handling issues of violence, without fear of reprisals.

Overall, these simultaneously local and place-based, vertically integrated and culturally competent responses to violence emerged as important in addressing violence against children. They also, however, face challenges.

Challenges the networks face in addressing violence against children

Due to a lack of adequate resources, including for transport and in some cases support to children facing violence, our research found that some volunteers stopped following up after cases of violence. While some were receiving support from other organisations, most of them used their own resources; some of the larger networks they work with often rely on donor funding and so, when funding ceases, the NGOs moved on, breaking the VAC referral pathways. The NGOs that participated in the research explained that community volunteers are not remunerated since they were seen as serving their communities.

In cases where community-based networks were linked to other structured networks, the playing field was uneven. The volunteers felt that they only participated nominally in these networks and were being ‘used’ as cogs by providing their services and information for writing grants, and then ‘dumped’ after the NGOs received them. This should also be seen through the lens of the philanthropy-wide shifts in Africa where funders require NGOs to demonstrate that they are working with community structures, which supports van Stapele’s research in Kenya where community based organisations characterised the relationship with NGOs as colonialist and saw themselves as ‘donkeys’, engaged in drudgery for the NGOs’ benefit.

In our research, the grassroot actors reported that, to get even, they would hoard information or register their own organisations to access the largesse of donor funds. Such tensions weaken the synergies that would accrue from networking, ultimately affecting efforts to address violence against children.

Even more, while proximity to the community is a resource, it also has a downside; some volunteers reported that they are victimised by the perpetrators of violence.

How to support grassroots networks

Grassroots networks in Kenya play an important role in preventing violence against children, and their work can be a basis for testing innovative models in child protection, and take to scale the prevention of VAC, and therefore they need to be supported. Care should, however, be taken so that systems in these networks that rely on trust are enabled to respond to violence without being undermined.

Efforts should also be made to ensure that collaborations are not only geared towards meeting the needs of external catalysts, such as NGOs, without tangible benefits for children. Further, these networks should not be co-opted into donor funding cycles which may not allow space for innovation because of their short-term and competing motivations.

To address the skewed power dynamics between actors, there is a need for strengthening the accountability of these grassroots organisations, as this will enhance accountability to the community and ultimately to children. There is an imperative for revisiting the very terms on which these organisations are crowded in by other actors.

 This post is an output from LSE’s Centre for Public Authority and International Development at the LSE’s Firoz Lalji Centre for Africa and first appeared here

About the author:

Elizabeth Ngutuku has a PhD in Development Studies from the International Institute of Social Studies of Erasmus University Rotterdam. Her work investigates young people’s experience of poverty, vulnerability, citizenship claims and sexual and reproductive health.

 

Are you looking for more content about Global Development and Social Justice? Subscribe to Bliss, the official blog of the International Institute of Social Studies, and stay updated about interesting topics our researchers are working on.

Children as experts: rethinking how we produce knowledge by Kristen Cheney

By Posted on 2648 views
Children in the rain

Most research on adolescent sexual and reproductive health and rights is adult-led and adult-centred, not only ignoring young voices but denying diversity amongst young people. But a new project co-led by Kristen Cheney of the ISS departs from the premise that young people are the experts of their own lives, giving children and adolescents the chance co-create knowledge. In this article, Cheney details the importance of youth-led participatory research and how this is done through the new project.

It is often assumed that social research is the domain of experts—and that those experts are necessarily adults. Most research on adolescent sexual and reproductive health and rights (ASRHR) is adult-led and adult-centred, not only ignoring young voices but denying diversity amongst young people. Information about young people’s sexuality therefore often remains insulated within their peer groups, preventing innovation in ASRHR programming. This too often leads to a deficit or pathological perspective on adolescence in ASRHR research and intervention.

ISS departs from this premise in our latest youth participatory research project, Adolescents’ Perceptions of Healthy Relationships. The APHR project is funded by the Oak Foundation, with the objective to inform their child abuse prevention programming through greater attention to the broader societal, structural factors that provide an enabling environment for the sexual abuse and exploitation of children. The project is led by ISS’ Kristen Cheney and involves Auma Okwany as East Africa lead researcher.

Instead of embracing prevalent adult-imposed models of adolescence, the APHR project departs from the premise that young people are the experts on their own lives. Indeed, we believe that young people are essential co-creators of knowledge, best suited to conduct research on their own thoughts and experiences. They have the best access to their peer groups where vital information is often kept locked away from adults’ gazes. So whenever possible, we conduct youth-led, participatory research. This way, young people become not mere objects of research but co-producers of knowledge about young people’s lives through greater disclosure of more authentic viewpoints.

Conducting research in Oak’s two main project areas, East Africa and Eastern Europe, ISS leads an international team consisting of partners from International Child Development Initiatives (Netherlands), Animus Association (Bulgaria), and Nascent Research and Development Organization (Tanzania). Together, they support young people in Bulgaria and Tanzania to participate in every step of the research, from designing quantitative and qualitative tools to data collection to analysis, dissemination and advocacy. This Circles of Support youth-centered approach provides training for adolescents as young as twelve years old to act as young peer researchers (YPRs), with support for research activities throughout the project—while always ensuring that young people’s considerations take precedence over adults’ opinions (Figure 1). Despite some adults’ concerns that young people might not be up to the task, we consistently find that young people are not only competent researchers, but also capable self-advocates.

Untitled.png
Figure 1. YPRs in Dar Es Salaam discuss important aspects to consider in research on adolescents’ perceptions of healthy relationships (2017). Their input is incorporated into the research design from the start.

Preliminary Findings

Having completed an extensive survey of nearly 2,000 adolescents aged 10-18 across Bulgaria and Tanzania, our approach has proven fruitful for getting at adolescents’ views on what constitutes healthy relationships. We are still collecting qualitative data that will both validate and deepen our understanding of the survey findings, but our preliminary observations from the survey revealed which characteristics and relationships adolescents value most in each setting.

In Bulgaria, responses indicated that adolescents generally value trust and respect most in their relationships. While they reported mostly positive relationships with family—particularly with their mothers—adolescents’ responses indicated that the more problematic relationships were those with peers and others in their school settings.

We are following up the survey to further unpack these results, in order to understand how adolescents define trust and respect, as well as to understand family and school dynamics.

Untitled1
Figure 2. A YPR in Sofia, Bulgaria, shares her group’s qualitative questions with the group.

In Tanzania, adolescents also reported supportive relationships with their mothers. In addition, they found that religious leaders were important in guiding young people’s behaviour. They indicated that a large part of their understanding of being loved, in various relationships, is someone providing for their needs, both emotional and material. But preliminary survey findings also pointed to widespread abuses toward adolescents—from various people at home, school, or in the community. To some extent, their answers even pointed toward a normalisation of that violence; for example, some pointed out that there were high levels of bullying in school, yet they did not necessarily consider this a bad thing, depending on the circumstances. Some saw excessive discipline from teachers as concern for their learning, while others reported that fighting to defend a friend shows that you are loyal and is therefore ‘healthy.’ The TZ team is currently completing qualitative data collection (Figure 3), which we hope will help us further unpack these responses during analysis.

Untitled2.png
Figure 3. A YPR in Tanzania interviews a classmate (2018).

Scholar Activism

Our research team has been providing excellent support to our phenomenal young peer researchers (YPRs). Through our Circles of Support approach, the team in each country has been able to tailor training to the YPRs’ needs and abilities. To ensure that young people’s concerns predominate, we have consulted YPRs at every stage, while constantly checking our own tendencies to want to redirect research toward ‘adult’ concerns. As a result, we are seeing exceptional personal growth as well as group cohesion amongst our YPRs.

Untitled3
Boy and girl YPRs in Magu, Tanzania, come up with research questions together (2017).

For this reason, we consider our participatory approach ‘always already advocacy’. ‘Protection’ is sometimes invoked to deny young people’s participation, but participation can be inherently protective, especially in ASRHR, where knowledge is power. Our training covers basic concepts that help empower kids to know their rights and develop their ASRHR competencies—which they then disseminate to others. Participatory research also fosters more interpersonal communication by modeling healthy relationships within the research process itself (Figure 4).

Headshot 02 17About the author: 

Kristen Cheney is Associate Professor of Children and Youth Studies at ISS. She is author of Crying for Our Elders: African Orphanhood in the Age of HIV and AIDS and co-editor of the forthcoming volume, Disadvantaged Childhoods and Humanitarian Intervention: Processes of Affective Commodification.

Deglobalisation Series | (de)globalisation and the fear of trade by Ana Cristina Canales Gomez

By Posted on 2588 views

While the consequences of globalisation over health and nutrition can be contradictory, trade openness can be a relevant policy for reducing food insecurity. This relatively inexpensive action, when compared to technology or research-based programmes, can increase the availability of nutritional foods, increase higher nutritional variety in diets, and can stabilise the food supply, reducing food shortages.

“One of the biggest ideas to hit the political world in recent years is that politics is increasingly defined by the division between open and closed, rather than left and right” (The Economist, March 24, 2018)

The recent trend of pushing against globalisation is based on different sources of information that varies from science-based evidence to ideas that trade and global agreements form part of a mastermind plan of invisible benefactors of the globalisation system. This phenomenon of deglobalisation has occurred before, but a major difference can be seen between the current and previous manifestations: in the 1930s, deglobalisation was pushed by governments, while the current expression of deglobalisation is pushed by the general public through social media.

When it comes to health and nutrition, the matter of globalisation and its impacts can be somewhat contradictory, and as with most economic matters, the perception of globalisation will depend on the viewer’s position: if you are in the LDCs where malnutrition is a leading cause of mortality, hinders development and entails national losses of around 6% of GDP[1], you might see globalisation as a beacon that could signal the introduction of greater nutritional diversity to local diets. If, on the other hand, you live in countries such as Chile or Mexico where undernourishment is no longer the main issue and the country now faces a transitional economic phase wherein obesity becomes a cause of concern, the increased inflow of foods from countries such as the United States might be viewed in a more negative light—as an influx of unhealthy types of food that contribute to obesity (Giuntella 2017).

Untitled.png
Graph 1 Changes in trade (% of GDP) and the prevalence of stunting in children under 5 years of age, world level. Source: author’s elaboration using STATA and the WDI (Last updated January 25, 2018).

From a descriptive perspective, during the last 30 years, and particularly after the Marrakech negotiations that led to the formation of the World Trade Organization (WTO) and its agreements, there has been an increase in trade openness and a reduction in the prevalence of stunting (PAHO 2017), even though hunger is still the leading cause of death and primary contributor to disease worldwide (Pongou et al. 2006).

We can assess the impact of trade openness using the Depth of the Food Deficit (DFD), an outcome indicator that measures inadequate access to food (Reddy et al. 2016, Santeramo 2015) by determining the amount of calories needed to lift the undernourished out of this position, ceteris paribus (Reddy et al. 2016, World Bank Group. 2017, Dithmer and Abdulai 2017).

Pic 2.png
Table 1: Effect of the import and export value indexes (2000=100) over the depth of the food Deficit (kcal per person per day), world level.

Table 1 shows the effect of Export and Import Value Indexes, included in logarithmic form, over the DFD. There is overall a strong and significant relation between both values and the indicator: an increase of one percentage point of the Import Value Indexes reduces the Depth of the Food Deficit in a range of 21 to 37 kilocalories, such change being consistent to the inclusion of all controls. Hence, a reduction of the DFD responding to an increase in both exported and imported values speaks of narrowing gaps between current nutritional status and the average dietary energy requirements of the population, and can contribute to SDG2—Zero Hunger.

Pic 3.png
Table 2: Effect of import and export Values (2000=100) over depth of the food deficit (kcal per person per day) in Latin American countries (excluding Haiti, Cuba and the Small Caribbean States).

The same regression can be run for the Latin American countries, including a variable constructed by the author measuring the number of food security programmes per country per year. The impact of trade openness over DFD is still strong and relevant in magnitude, and there is a linear albeit insignificant relation where programmes reduce the prevalence of undernutrition. When the quadratic variable is applied it hints—the coefficients are not significant—that such an effect only goes so far, and that, after a breaking point, these programmes show detrimental results.

Considering all of the above, the evidence shows that trade openness is in fact a relevant policy when it comes to reducing food insecurity, increasing social wellbeing and leading to socioeconomic progress. Furthermore, it would seem that trade openness is a more effective tool than the implementation of specific programmes that attempt to target food insecurity that many times end up doing more harm than good. This could be explained by the fact that there is a trend towards the indiscriminate adoption of programmes, both local and foreign. Additionally, more programmes usually signal the lack of effective stakeholder coordination, the lack of continuity in governmental strategies, and the inefficient expenditure of available resources.

Pic 4.png
Table 3: Effect of export and import Values (2000=100) over obesity prevalence for children under 5 years of age, world level.

When it comes to obesity, our research shows inconclusive results: there is a significant albeit small effect of trade openness—both export and import values—on the prevalence of obesity, but this effect fades when controls are included in the models. This can be due to the fact that obesity is a more recent phenomenon and besides integration of economies into global markets responds to many factors, such as economic growth, urbanisation trends, and the rise of the middle class (PAHO 2017).

Conclusion

While the consequences of globalisation over health and nutrition can be contradictory, it is an effective tool for the reduction of hunger, currently the leading cause of death in the world. This relatively inexpensive action, when compared to technology or research-based programmes, can increase the availability of nutritional foods, increase higher nutritional variety in diets, and can stabilise the food supply, reducing shortages in times of dearth. Overall, opening up to trade, at least from the health and nutrition perspective, seems to be a policy worth trying, but there is only so much that trade can do without a strong institutional background.

[1] Which is the case for Central America and the Dominican Republic according to the CEPAL (as cited by Jara Navarro (2008: 9)

[2] According to the WHO, stunting is defined as the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age ratio is more than two standard deviations below the WHO Child Growth Standards median.

References
Dithmer, J. and A. Abdulai (2017) ‘Does Trade Openness Contribute to Food Security? A Dynamic Panel Analysis’, Food Policy 69: 218-230.
Giuntella, O., M. Rieger and L. Rotunno (2017) ‘Weight Gains from Trade in Foods: Evidence from Mexico’, University of Pittsburgh, Kenneth P. Dietrich School of Arts and Sciences. Working Paper Series 17/010 Weight gains from trade in foods: Evidence from Mexico. 17/010.
Jara Navarro, M.I. (2008) ‘Hambre, Desnutrición y Anemia: Una Grave Situación De Salud Pública’, Revista Gerencia y Políticas de Salud 7(15): 7-10.
PAHO (Last updated 2017) ‘Sobrepeso Afecta a Casi La Mitad De La Población De Todos Los Países De América Latina y El Caribe Salvo Por Haití’ (a webpage of PAHO/WHO). Accessed April 12 2017 <http://www.paho.org/chi/index.php?option=com_content&view=article&id=856:sobrepeso-afecta-a-casi-la-mitad-de-la-poblacion-de-todos-los-paises-de-america-latina-y-el-caribe-salvo-por-haiti&Itemid=1005&gt;.
Pongou, R., J.A. Salomon and M. Ezzati (2006) ‘Health Impacts of Macroeconomic Crises and Policies: Determinants of Variation in Childhood Malnutrition Trends in Cameroon’, International journal of epidemiology 35(3): 648-656.
Reddy, A.A., C.R. Rani, T. Cadman, S.N. Kumar and A.N. Reddy (2016) ‘Towards Sustainable Indicators of Food and Nutritional Outcomes in India’, World Journal of Science, Technology and Sustainable Development 13(2): 128-142.
Santeramo, F.G. (2015) ‘On the Composite Indicators for Food Security: Decisions Matter!’, Food Reviews International 31(1): 63.
The Economist (2018) ‘Bagehot: Rethinking Open v Closed’, The Economist March 24th-30th 2018 9084: 33.
WHO (Last updated 2017) ‘Noncommunicable Diseases’ (a webpage of WHO Media Centre). Accessed April 12 2018 <http://www.who.int/mediacentre/factsheets/fs355/en/&gt;.
Winters, L.A. (2004) ‘Trade Liberalisation and Economic Performance: An Overview’, The Economic Journal 114(493).
World Bank (Last updated 2018) ‘World Development Indicators’ (a webpage of The World Bank). Accessed March 1 2018 <http://databank.worldbank.org/data/reports.aspx?source=world-development-indicators#&gt;.

0894f1c-2.jpgAbout the author:

Ana Cristina Canales Gómez is a veterinarian at the Universidad de Chile who holds a Masters degree in Public Policy from the same institution and a Masters degree in Development Studies from the ISS. Currently, she works as a consultant for Food & Foodstuffs Trade and Nutrition Policies in the Food and Agriculture Organization (FAO).

 

Weight gains from trade in foods: evidence from Mexico by Osea Giuntella, Matthias Rieger and Lorenzo Rotunno

By Posted on 1668 views

Originally published on VoxEU.org on 02 February 2018

The majority of obese adults are now found in developing countries. This column presents new evidence on the effects of trade on obesity in Mexico. The results indicate that across Mexican states, a one standard deviation increase in the unhealthy share of food imports from the US increases the likelihood of individuals being obese by about 5 percentage points. As developing countries around the world open up their food markets to industrialised countries, they may be accelerating their ongoing nutrition transition and imposing high future costs on their health systems.

Obesity is not the first health challenge that comes to mind when thinking about the global south. Obesity is rather associated with the Global North, particularly the US (think soda drinks, fast food, and lack of exercise). But this conventional wisdom is passé. The majority of obese adults – those with a body mass index of 30 and more – are now found in developing countries (Ng et. al 2014). The Global South is in the midst of a health and nutrition transition (Popkin and Gordon-Larsen, 2004). While communicable diseases and undernutrition are on a (slow) decline, non-communicable diseases and overnutrition are taking hold of populations, and they are doing so rapidly.

Given the known health risks (such as diabetes and cardiovascular diseases) and economic costs of obesity, what can policymakers in the Global South do to prevent obesity in epidemic proportions? Important lessons may come from countries that have already undergone this transition and from examining potential drivers that are amenable to public policy. The much-discussed case of Mexico is ideal for such an exercise.

Obesity and trade: The case of Mexico

Mexico’s obesity rates increased from 10% to 35% over the period 1980-2012 (according to our analysis sample including adult females). And among the already obese OECD countries, Mexico ranked second in 2015, surpassed only by the US (OECD 2017).

Coinciding with these profound changes in population health, Mexico has opened itself to trade in foods mostly with the US. Currently over 80% of Mexican food imports are American. In Figure 1, we show the evolution of Mexican imports of foods and beverages from the US over time. While overall food imports have increased dramatically, food that is typically considered unhealthy has surged quite spectacularly. Notably, exports of ‘food preparations’ are 23 times larger in 2012 compared to 1989.

Figure 1 Mexican imports of food and beverages from the US over time

In Figure 2, we classify Mexican imports from the US as unhealthy or healthy food using the United States Department of Agriculture (USDA) Dietary Guidelines (for instance, ‘dark green vegetables’ are recommended for increased consumption, while ‘refined flour and mixes’ are advised for reduced consumption). US exports to Mexico of both food groups have increased since the late 1980s, but unhealthy food groups at a much faster rate.

Figure 2 Unhealthy and healthy Mexican food and beverage imports from the US

Such trends naturally raise the suspicion of a possible, causal link running from greater consumption of US foods to rising obesity prevalence (e.g. Jacobs and Richtel 2017, Rogoff 2017). However, to date no paper has attempted to estimate a direct causal relationship between obesity and trade.

Estimating weight gains from trade in foods

In a new working paper, we quantify the impact of US food exports on individuals’ likelihood of being obese across Mexican states over the period 1988 to 2012 (Giuntella et al. 2017). To this end, we match several rounds of anthropometric and household expenditure surveys with product-level food trade data. Our main results are based on female adults for which data are available over this long time span.

We calculate the unhealthy share of food imports from the US by differentiating food items using the USDA Dietary Guidelines for Americans. We then allocate these aggregate food imports (healthy, unhealthy) to Mexican states. More specifically, we exploit variation in Mexican states’ historical expenditure by food products prior to trade integration. Our identification strategy assumes that aggregate trade shocks heterogeneously impact sub-national units as a function of time-invariant or ‘baseline’ variables (e.g. Dix-Carneiro and Kovak 2017, Autor et al. 2013). Note that there is substantial heterogeneity across Mexican states in obesity rates and historical food expenditure patterns, which further motivates our modelling approach.

Our empirical models also control for a host of state (such as food prices, GDP, FDI, migration) and individual covariates, as well as state fixed effects and state-specific time trends. In a second empirical strategy, we relate long-run differences in obesity rates at the state level to changes in unhealthy food imports conditional on baseline covariates. We instrument US exports of unhealthy foods to Mexico with corresponding US exports to other countries. And alternatively, we use ‘gravity residuals’ singling out the comparative advantage of the US in unhealthy food production relative to Mexico (akin to Autor et al. 2013).

Quantifying weight gains from trade in foods

We find that a one standard deviation increase in the unhealthy share of imports (equivalent to a 14 percentage point increase) raises the likelihood of obesity by about 5 percentage points. The effect amounts to 18% of the sample average in obesity. Findings using long-run difference models and IV estimates, as well as gravity residuals, are qualitatively similar – pointing to a plausibly causal effect.

Our main finding passes a series of robustness and placebo checks:

  • Plausibly unrelated imports from the US (such as apparel products) do not impact obesity.
  • The effects associated with food imports from the rest of the world are insignificant and small, underlining the specific importance of US foods for obesity.
  • Likewise, unhealthy Mexican food exports to the US are not correlated with obesity.
  • Similar patterns emerge if we employ food imports from the US for final demand.
  • Overall (the sum of healthy and unhealthy) food imports do not correlate with obesity, highlighting the importance of differentiating ‘unhealthy’ and ‘healthy’ US foods.
  • Our main results are robust to dropping Mexican states one by one.
  • Similar patterns are obtained using body mass index (in quantile regressions) or overweight as outcome variables.

Health inequality and trade

Weight gains due to trade vary across socioeconomic groups. As illustrated in Figure 3, women with low levels of education face a greater risk of trade-induced obesity – their obesity risk is 5 percentage points higher than that of more educated women in a Mexican state with average exposure to unhealthy food imports. This differential goes up to 8 percentage points as the state’s trade exposure rises by 14 percentage points (one standard deviation). This interaction effect between education and trade is robust to the inclusion of state-time fixed effects (that is, purging the main local effect of trade exposure). The results are consistent with the well-known hypothesis that more educated individuals are more efficient producers of health investment than less educated ones. This educational gradient may be exacerbated in food environments where individuals are faced with more unhealthy food choices (Mani et al. 2013, Mullanaithan 2011, Dupas 2011).

Figure 3 Inequality between education groups in obesity risk and unhealthy food imports

Income, prices, and tastes

Having established a direct impact of US food exports on obesity prevalence in Mexico, we next turn to exploring possible mechanisms. Trade impacts incomes, prices, and tastes (due, for instance, to exposure to a foreign lifestyle and advertisement), all of which may drive the observed impacts on obesity. First, note that our main effect is robust to controlling for state GDP per capita, the total share of expenditures on unhealthy foods, as well as the relative prices of healthy versus unhealthy goods. Second, estimating demand equations over healthy and unhealthy food groups, we find that exposure to unhealthy foods from the US has redirected overall expenditure towards unhealthy foods. This observed shift is robust to controlling for real income and prices (for a similar empirical strategy, see Atkin 2013). In other words, trade with the US appears to influence tastes for relatively unhealthy foods. Increased variety of unhealthy foods boosts demand. These patterns are in line with a shift to ‘Western’ food consumption and increases in body weight among East Germans following the fall of the Berlin Wall (Dragone and Ziebarth 2017).

Policy implications

Nations have a lot to gain from trade. But weight gains and the associated health losses from trade in foods have been largely omitted from the equation. As developing countries around the world open up their food markets vis-à-vis industrialised countries – which tend to have a comparative advantage in more processed and less healthy foods – they may accelerate their ongoing nutrition transition. Obesity may put high costs on future health systems and the economies of the Global South.

Undoing the nutrition transition is likely harder than moderating it in the first place. Obesity and unhealthy food habits tend to be persistent. The Mexican experience is informative for countries in the Global South. Integrating nutrition and other health concerns into the formulation of food trade policies is paramount,[1] and such concerns should feature high up on the agenda in future trade negotiations.

Our findings suggest that differentiating between healthy and clearly unhealthy imports may help slow down secular trends in obesity around the world.

References

Atkin, D (2013), “Trade, tastes, and nutrition in India”, American Economic Review 103(5): 1629-1663.
Autor, D H, D Dorn and G H Hanson (2013), “The China Syndrome: Local Labor Market Effects of Import Competition in the United States”, American Economic Review 103(6): 2121-68.
Colantone, I, R Crino and L Ogliari (2017), “Import competition and mental distress: The hidden cost of globalization”, mimeo.
Dix-Carneiro, R and B K Kovak (2017), “Trade Liberalization and Regional Dynamics”, American Economic Review 107(10): 2908-46.
Dragone, D and N R Ziebarth (2017), “Economic Development, Novelty Consumption, and Body Weight: Evidence from the East German Transition to Capitalism”, Journal of Health Economics(51): 41-65.
Dupas, P (2011), “Health behavior in developing countries”, Annual Review of Economics 3(1): 425-449.
Giuntella, O, L Rotunno and M Rieger (2017), “Weight Gains from Trade in Foods: Evidence from Mexico”, University of Pittsburgh Working Paper No. 17/010.
Jacobs, A and M Richtel (2017), “A Nasty, Nafta-Related Surprise: Mexico’s Soaring Obesity”, New York Times, 11 December.
Mani, A, S Mullainathan, E Shafir and J Zhao (2013), “Poverty impedes cognitive function”, Science341(6149): 976-980.
McManus, T C and G Schaur (2016), “The effects of import competition on worker health”, Journal of International Economics 102: 160-172.
Mullainathan, S (2011), “The psychology of poverty”, Focus 28(1): 19-22.
Ng, M et al. (2014), “Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013”,The Lancet 384(9945): 766-781.
Pierce, J R and P K Schott (2016), “Trade Liberalization and Mortality: Evidence from U.S. Counties”, NBER Technical Report No. 22849.
Popkin, B M and P Gordon-Larsen (2004), “The nutrition transition: worldwide obesity dynamics and their determinants”, International Journal of Obesity 28: S2-S9.
Rogoff, K (2017), “The US is Exporting Obesity”, Project Syndicate, 1 December.

Endnotes

[1] Related studies provide evidence for adverse effects of manufacturing imports on the health of workers – see for instance, Colantone et al. (2017) and the associated VoxEU column, McManus and Schaur (2017), and Pierce and Schott (2016).   

Picture credit: Adam Clark

giuntella2Osea Giuntella is Assistant Professor of Economics at the University of Pittsburgh.
riegerMatthias Rieger is Assistant Professor of Development Economics at the  International Institute of Social Studies, Erasmus University Rotterdam.rotunno_4Lorenzo Rotunno is Assistant Professo of Economics at the Aix-Marseille University.