Journal of Population Economics

, Volume 26, Issue 3, pp 855–885 | Cite as

Childhood disease and the precautionary demand for children

  • Anna-Maria Aksan
  • Shankha ChakrabortyEmail author
Original Paper


The childhood disease burden depends on the prevalence of infectious diseases, their case fatalities, and long-term morbidity. We propose a quantity–quality model of fertility choice under uncertainty that emphasizes morbidity and mortality from infectious disease. The fertility response to a decline in child mortality depends on the morbidity effect of the disease, the prevalence rate, and whether the prevalence or case fatality rate declines. Fertility follows mortality and morbidity, but since mortality and morbidity do not always move in the same direction, the fertility response may be dampened or nonmonotonic. Disease-specific evidence from sub-Saharan Africa supports these theoretical predictions.


Infectious disease Child mortality Morbidity Fertility Precautionary demand Demographic transition 

JEL Classification

I12 J11 O12 



We would like to thank Alfredo Burlando, David Canning, Jason Lindo, Tom Murray, William Vasquez, and especially two anonymous referees and the editor of this journal for valuable suggestions. Feedback from seminar participants at various places this paper was presented is gratefully acknowledged as is Fiona Gore’s (WHO) help with the National Burden of Disease database. The usual caveat applies.

Supplementary material

148_2012_430_MOESM1_ESM.pdf (117 kb)
(PDF 120 KB)


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of EconomicsFairfield UniversityFairfieldUSA
  2. 2.Department of EconomicsUniversity of OregonEugeneUSA

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