Demand for Vaccination in Sub-Saharan Africa: The Vertical Legacy of the Slave Trade

Athias, Laure and Macina, Moudo (2021): Demand for Vaccination in Sub-Saharan Africa: The Vertical Legacy of the Slave Trade.

Abstract

We combine historical data on the slave trade by ethnic group with individual-level data geolocated at the cluster level from the 2010-2014 Demographic and Health Surveys to examine the relationship between ancestors' exposure to the slave trade and children vaccination status against measles. Exploiting within-location variation, and hence isolating the vertical cultural transmission channel of the slave trade, we find that children from mothers whose ancestors were exposed to the slave trade are less likely to be vaccinated than children living in the same location but with mothers from a slave-free ethnic group. The effect is larger than that of standard determinants of health demand, such as education or revenue, and is not confined to parents health decisions for their children. We find evidence of increased adverse effect of slave trade exposure on contemporaneous demand for vaccination among the descendants whose family has a higher preference for traditional practices and higher incentives to transmit their inherited cultural traits. While we know that there is not a uniform health policy code deemed appropriate for all geographical areas, our results suggest that there is space to integrate ethnic groups' historical-specificity in health policy design and communication.

• Item Type: MPRA Paper
• Language: English
• Keywords: Vaccine, Health demand, Trust, Slave trade, Vertical Cultural transmission
• Subjects: D - Microeconomics > D1 - Household Behavior and Family Economics > D12 - Consumer Economics: Empirical Analysis; I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior; I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health; N - Economic History > N5 - Agriculture, Natural Resources, Environment, and Extractive Industries > N57 - Africa ; Oceania; Z - Other Special Topics > Z1 - Cultural Economics ; Economic Sociology ; Economic Anthropology > Z13 - Economic Sociology ; Economic Anthropology ; Social and Economic Stratification

References

Alsan, M., and M. Wanamaker. 2017. "Tuskegee and the health of black men." The Quarterly Journal of Economics, 133(1): 407-455.

Attwell, Katie, David T. Smith, and Paul R. Ward (2018)"`The Unhealthy Other': How vaccine rejecting parents construct the vaccinating mainstream," Vaccine, 36 (12), 1621-1626.

Austen, R. A. 1979. "The Trans-Saharan Slave Trade: A Tentative Census In The Uncommon Market", Essays in the Economic History of the Atlantic Slave Trade.

Austen, R. A. 1988. "The 19th century Islamic slave trade from East Africa (Swahili and Red Sea Coasts : a tentative census." 21-44.

Austen, R. A. 1992. "The Mediterranean Islamic slave trade out of Africa: A tentative census." Slavery and Abolition, 13(1): 214-248.

Bertocchi, Graziella and Arcangelo Dimico (2019). "The long-term determinants of female HIV infection in Africa: The slave trade, polygyny, and sexual behavior," Journal of Development Economics, 140 (C), 90-105.

Bisin, A., and T. Verdier. 2001. "The economics of cultural transmission and the dynamics of preferences." Journal of Economic theory, 97(2): 298-319.

Boyd, Robert and Peter J. Richerson (1985) Culture and the evolutionary process. London: University of Chicago Press.

Boyd, Robert and Peter J. Richerson (2005) The Origin and Evolution of Cultures. London: Oxford University Press.

Brownlie, Julie and Alexandra Howson (2005). "`Leaps of Faith' and MMR: An Empirical Study of Trust," Sociology, 39 (2), 221-239.

Casari, M., A. Ichino, M. Michaeli, M. De Paola, G. Marandola, and V.Scoppa. 2018. "Civicness Drain." IZA Discussion Papers 11955.

Dalton, John and Tin Cheuk Leung (2014). "Why Is Polygyny More Prevalent in Western Africa? An African Slave Trade Perspective," Economic Development and Cultural Change, 62 (4), 599-632.

Douglas, Mary. 1969. "Is Matriliny Doomed in Africa?" Man in Africa, , ed. Mary Douglas and Phyllis M. Kaberry, 123-137, London:Tavistock Publications.

Dupas, P. 2011b. "Health Behavior in Developing Countries." Annual Review of Economics, 3(1): 425-449.

Eltis, D., D. B. Stephen, R. David, and S. K. Herbert. 1999. The Trans-Atlantic Slave Trade: a Database on CD-ROM. New York:Cambridge University Press.

Etkin, N.L. and M.L. Tan (1994) Medicines: Meanings and Contexts, Quezon City: Health Action Information Network.

Gilson, Lucy (2003). "Trust and the development of health care as a social institution," Social Science and Medicine, 56 (7), 1453-1468.

Hall, R., and D. Jolley. 2011. "International measles incidence and immunization coverage." The Journal of infectious diseases, 204(suppl 1): 158-163.

Helps, Catherine, Julie Leask, Lesley Barclay, and Stacy Carter (2019). "Understanding non-vaccinating parents' views to inform and improve clinical encounters: a qualitative study in an Australian community," BMJ Open, 9 (5).

Jamison, Amelia M., Sandra Crouse Quinn, and Vicki S. Freimuth (2019). "`You don't trust a government vaccine': Narratives of institutional trust and influenza vaccination among African American and white adults," Social Science and Medicine, 221, 87-94.

Kiszewski, Anthony, Andrew Mellinger, Andrew Spielman, Pia Malaney, Sonia Ehrlich Sachs, and Jeffrey Sachs (2004). "A global index representing the stability of malaria transmission," The American journal of tropical medicine and hygiene, 70 (5), 486-498.

Larson, Heidi J. (2016). "Vaccine trust and the limits of information," Science, 353 (6305), 1207-1208.

Larson, Heidi J., Richard M. Clarke, Caitlin Jarrett, Elisabeth Eckersberger, Zachary Levine, Will S. Schulz, and Pauline Paterson (2018). "Measuring trust in vaccination: A systematic review," Human Vaccines & Immunotherapeutics, 14 (7), 1599-1609.

Lowes, Sara (2020). "Matrilineal Kinship and Spousal Cooperation: Evidence from the Matrilineal Belt," Working Paper.

Lowes, Sara and Eduardo Montero (2021). "The Legacy of Colonial Medicine in Central Africa," American Economic Review, 111 (4), 1284-1314.

MacDonald, Noni E. (2015). "Vaccine hesitancy: Definition, scope and determinants," Vaccine, 33 (34), 4161-4164.

Michalopoulos, S., and E. Papaioannou. 2016. "The long-run effects of the scramble for Africa." The American Economic Review, 106(7): 1802-1848.

Morel, Chantal M, Jeremy A Lauer, and David B Evans (2005) "Cost effectiveness analysis of strategies to combat malaria in developing countries," BMJ, 331 (7528), 1299.

Murdock, George P. (1959) Africa: Its peoples and their cultural history, New York: McGraw-Hill Book Company.

Murdock, G. P. 1967. Ethnographic Atlas. Pittsburgh: University of Pittsburgh Press.

Nunn, N. 2008. "The long-term effects of Africa's slave trades." The Quarterly Journal of Economics, 123(1): 139-176.

Nunn, N., and L. Wantchekon. 2011. "The Slave Trade and the Origins of Mistrust in Africa." American Economic Review, 101(7): 3221-52.

Radcliffe-Brown, A.R. 1950. "Introduction." African Systems of Kinship and Marriage, , ed. A.R. Radcliffe-Brown and Daryll Forde. Oxford University Press.

Rogers, Alan R. (1988). "Does Biology Constrain Culture?" American Anthropologist, 90 (4), 819-831.

Streefland, Pieter, A.M.R Chowdhury, and Pilar Ramos-Jimenez (1999). "Patterns of vaccination acceptance," Social Science & Medicine, 49 (12), 1705-1716.

Teso, Edoardo (2018). "The Long-Term Effect of Demographic Shocks on the Evolution of Gender Roles: Evidence from the transatlantic Slave Trade," Journal of the European Economic Association, 17 (2), 497-534.

Thiede, Michael (2005). "Information and access to health care: is there a role for trust?" Social Science and Medicine, 61 (7).

Wiley, Kerrie E., Julie Leask, Katie Attwell, Catherine Helps, Chris Degeling, Paul Ward, and Stacy M. Carter (2020) "Parenting and the vaccine refusal process: A new explanation of the relationship between lifestyle and vaccination trajectories," Social Science & Medicine, 263, 113259.

World Health Organization. 2018. "Measles." Retrieved from https://www.who.int/immunization/diseases/measles/en/.

Yaqub, Ohid, Sophie Castle-Clarke, Nick Sevdalis, and Joanna Chataway (2014). "Attitudes to vaccination: A critical review," Social Science & Medicine, 112, 1-11.