India’s Sample Registration System publishes annual birth and death rates for a sixth of the world’s people but releases no underlying records. This paper develops a test of whether published survey estimates vary as much as their sampling design implies, and finds that recent state birth-rate and infant-mortality series are implausibly smooth.
In part of India, richer mothers pay more for riskier care in private facilities. This paper develops an econometric model of selection and uses a spatial RDD at district borders to show public facilities cut newborn mortality by over 25 per thousand births, a gap that operates through interventions following separation of mothers and babies.
With Sangita Vyas.
Revision requested at the Journal of Development Economics. A large-scale sanitation program in India made open defecation more salient as a social issue. This paper documents how the relationship between children’s heights and open defecation weakened after the program, consistent with it worsening response bias. The estimate of the true prevalence of open defecation from our econometric model is much higher than survey estimates.
With Aashish Gupta, Dean Spears, and Diane Coffey.
Revision requested at Population Studies. Using NFHS-4 data, this paper estimates India’s 2012–16 maternal mortality at 228 deaths per 100,000 live births—far above official figures. If correct, the findings suggest India is not on track to meet SDG targets and that current systems may be undercounting maternal deaths.
Published in Social Science and Medicine, 2025. With Diane Coffey, Nikhil Srivastav, Aditi Priya, Asmita Verma, Alok Kumar, and Dean Spears.
43,000 excess neonatal deaths occur among private-facility births to rural mothers in India’s EAG states. Public facilities serve lower-SES patients but private-facility births have higher mortality. The mortality gap is worse after standardizing for SES. All birth subsamples we use show a public-private mortality gap, even low-risk ones. This is evidence of low-quality natal care in the private facilities studied.
Published in PLOS One, 2024. With Smita and Diane Coffey.
The study analyzes longitudinal births in Odisha (2007–2011) using a mother fixed‑effects model to identify the impact of cesarean delivery on breastfeeding initiation. It finds that babies born via C-section are about 11 percentage points more likely to experience delayed breastfeeding (beyond 24 hours) compared to their vaginally born siblings.
Published in Demography, 2022. With Samuel Arenberg, Kevin Kuruc, Sangita Vyas, Nicholas Lawson, Melissa LoPalo, Mark Budolfson, Michael Geruso, and Dean Spears.
Even when children closely mirror their parents’ fertility, population growth isn’t guaranteed. Using demographic models, the study shows that intergenerational transmission might not overcome low fertility’s long-run momentum toward decline.
Published in Economics Letters, 2020. With Dean Spears.
This paper shows that two ideas in population ethics—the intuition against adding miserable lives (the sadistic conclusion) and the appeal of adding happy ones (mere addition)—are logically equivalent. Under mild assumptions, you can’t accept one without accepting the other.
Published in Ideas for India, 2025.
Policy article: In rural Uttar Pradesh and Bihar, newborn mortality is 60% higher in private health facilities than in public ones, even though families with higher socioeconomic status use private care. Fee-for-service payment gives private facilities incentives to perform unnecessary, harmful interventions.
Published in Data Sharing for Demographic Research, 2022. With Diane Coffey, Samuel Arenberg, Minle Xu, and Sangita Vyas.
The Annual Health Survey, 2007–2012 is a longitudinal panel of over 4 million households in nine high-mortality Indian states, designed to track maternal and child health outcomes at the district level. I was part of a team that assembled, cleaned, and documented the raw government microdata, releasing user-friendly versions through ICPSR to support high-quality research.
Published in Ideas for India, 2021. With Diane Coffey and Dean Spears.
Policy paper: The Swachh Bharat Mission was introduced by Government of India in 2014 to eliminate open defecation. Based on data from the National Family and Health Survey (NFHS)-5 factsheets, this article shows that the sanitation situation has broadly remained the same between NFHS-4 in 2014 and NFHS-5 in 2019. Under fairly strong assumptions based on early data, half of the rural population in the states of Uttar Pradesh, Madhya Pradesh, Bihar, and Rajasthan, continue to defecate in the open.