Protecting Infants from Natural Disasters: The Case of Vitamin A Supplementation and a Tornado in Bangladesh

Snaebjorn Gunnsteinsson; Achyuta Adhvaryu; Parul Christian; Alain Labrique; Jonathan Sugimoto; Abu Ahmed Shamim; Keith P. West Jr

doi:10.3386/w25969

Protecting Infants from Natural Disasters: The Case of Vitamin A Supplementation and a Tornado in Bangladesh

Snaebjorn Gunnsteinsson, Achyuta Adhvaryu, Parul Christian, Alain Labrique, Jonathan Sugimoto, Abu Ahmed Shamim & Keith P. West Jr

Working Paper 25969

DOI 10.3386/w25969

Issue Date June 2019

Severe environmental shocks have grown in frequency and intensity due to climate change. Can policy protect against the often devastating human impacts of these shocks, particularly for vulnerable populations? We study this question by leveraging data from a situation in which a tornado tore through an area involved in a double-blind cluster-randomized controlled trial of at-birth vitamin A supplementation in Bangladesh. Tornado exposure in utero and in infancy decreased birth size and physical growth, and increased the incidence of severe fevers. But infants who received vitamin A supplementation, which boosts immune system functioning, were protected from these effects. Tornado impacts and protective effects were both substantially larger for boys. Our results suggest that wide-scale supplementation policies would generate potential health benefits in disaster-prone areas of low-income countries.

Thanks to Marcella Alsan, Nava Ashraf, Prashant Bharadwaj, Hoyt Bleakley, Andy Foster, Paul Gertler, Jess Goldberg, Pam Jakiela, Anant Nyshadham, Rafael Perez-Escamilla and Atheen Venkataramani, as well as seminar participants at the NBER (CH & DEV), Michigan, Yale, USC, Maryland, Barcelona GSE, NEUDC, PopPov, and the CDC for helpful discussions. Adhvaryu gratefully acknowledges funding from the NIH/NICHD (5K01HD071949). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

Parul Christian
Field work for this study was supported by Micronutrients for Health Cooperative Agreement No. HRN-A-00-97-00015-00 between the Office of Health, Infectious Diseases and Nutrition, US Agency for International Development (USAID), Washington DC, and Johns Hopkins University, Baltimore, MD and Global Control of Micronutrient Deficiency Grant GH614 from the Bill & Melinda Gates Foundation, Seattle, WA with additional support from the USAID Mission, Dhaka, Bangladesh; the Nutrilite Health Institute, Access Business Group, LLC, Buena Park CA, and the Sight and Life Global Nutrition Research Institute, Baltimore, MD.

Keith P. West Jr
Field work for this study was supported by Micronutrients for Health Cooperative Agreement No. HRN-A-00-97-00015-00 between the Office of Health, Infectious Diseases and Nutrition, US Agency for International Development (USAID), Washington DC, and Johns Hopkins University, Baltimore, MD and Global Control of Micronutrient Deficiency Grant GH614 from the Bill & Melinda Gates Foundation, Seattle, WA with additional support from the USAID Mission, Dhaka, Bangladesh; the Nutrilite Health Institute, Access Business Group, LLC, Buena Park CA, and the Sight and Life Global Nutrition Research Institute, Baltimore, MD.
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Snaebjorn Gunnsteinsson, Achyuta Adhvaryu, Parul Christian, Alain Labrique, Jonathan Sugimoto, Abu Ahmed Shamim, and Keith P. West Jr, "Protecting Infants from Natural Disasters: The Case of Vitamin A Supplementation and a Tornado in Bangladesh," NBER Working Paper 25969 (2019), https://doi.org/10.3386/w25969.

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Protecting Infants from Natural Disasters: The Case of Vitamin A Supplementation and a Tornado in Bangladesh

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