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Ethnic Diversity and Health Outcomes

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Abstract

This study hypothesizes a relationship between ethnic diversity and health outcomes. We explore the effects of ethnic and linguistic heterogeneity (measured by indices of ethnic and linguistic fractionalization) on various health outcomes in a cross-section of 91 countries. We explore outcomes relating to four major categories of health: (1) immunization rates, (2) prevalence of diseases, (3) life expectancy and mortality rates, and (4) health related infrastructure and staff. Across all dimensions examined, evidence suggests that higher heterogeneity is bad for health outcomes. We explore several potential mechanisms which could explain the observed negative effects of ethnic and linguistic diversity on health.

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Notes

  1. Detailed discussion on instrument and its composition can be found in Ahlerup and Olsson (2012). We further supplement the conventional 2SLS regressions with the Lewbel 2SLS which uses internally generated instruments, and propensity score matching (PSM). Given space constraints, we present details of the Lewbel (2SLS) and PSM methodologies in the online appendix.

  2. Results for robustness exercises are also reported in the online appendix.

  3. The inclusion of trust, social network and discrimination in our cross-section regression significantly reduces the number of observation thus making it difficult to make meaningful inferences. We therefore use the mixed effect panel regressions to test the effects of these variables on health outcomes. Also, the social networks variable is dropped from this regression due to a high correlation with trust. For brevity, we report results for regressions with ethnic fractionalization only. Note that the effects of potential channels remain the same in both specification given that only the index of fractionalization changes in each regression.

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Correspondence to Sefa Awaworyi Churchill.

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This manuscript is a substantial revised version of the working paper “Ethnic diversity makes me sick! An examination of ethnic diversity’s effect on health outcomes”. We are very grateful for comments from anonymous referees, and colleagues at Monash University and RMIT University. Any errors are ours.

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Appendix

Appendix

See Tables 14 and 15.

Table 14 Description and summary of variables
Table 15 Countries involved in analysis

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Awaworyi Churchill, S., Ocloo, J.E. & Siawor-Robertson, D. Ethnic Diversity and Health Outcomes. Soc Indic Res 134, 1077–1112 (2017). https://doi.org/10.1007/s11205-016-1454-7

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