Sharing the Burden of Disease: Gender, the Household Division of Labor and the Health Effects of Indoor Air Pollution

Joint with: Mark R. Rosenzweig and Md. Nazmul Hassan

In many rural areas of low-income countries, biomass fuel is the principal source of household energy so that indoor air pollution (IAP) is a serious health problem. If exposure to IAP is greatest in areas where combustion occurs, primarily the kitchen, IAP will mostly affect the women who cook and children whom they supervise. Using a 2000-2003 survey of 1,638 rural households in Bangladesh, where biomass fuel provides more than 90 percent of household energy, and a 1999 national survey of 7,734 rural households in India we investigate (i) the extent to which the division of household responsibilities, household structure, nutritional intake, dimensions of location of kitchen facilities, and fuel and stove types causally affect the health of women and children, taking into account heterogeneity among household members and optimizing behavior within households, and (b) whether households act as if they are optimally sharing the burden of the disease. The results suggest that proximity to stoves adversely affects the respiratory health of women and the young children they supervise and that households appear to be aware of and attempt to mitigate the health effects of cooking with biomass fuels in their time allocation decisions, including effects on young children, such that women with lower endowed health have greater exposure to smoke and women with very young children have less exposure to pollutants. We also find, however, that due to measurement error, conventional estimates of the impact of smoke inhalations are underestimated substantially but that neglect of nutritional intake in prior studies is not a major source of bias. Finally, our results suggest that improving ventilation by increasing the permeability of roofs or walls has no significant effect on health, consistent with prior studies examining point-source pollutants and health data. However, chimneys can evidently significantly reduce the health impacts of stove proximity when biomass fuels are used.

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