Parental Health Outcomes of Children’s Migration: Experimental Evidence from Ethiopia
| Published date | 01 December 2020 |
| Author | Teferi Mergo |
| Date | 01 December 2020 |
| DOI | http://doi.org/10.1111/imig.12703 |
Parental Health Outcomes of Children’s
Migration: Experimental Evidence from
Ethiopia
Teferi Mergo*
ABSTRACT
This study uses experimental data from the United States Diversity‐Visa (DV) lottery to
explore the impact of migration of children on the sending parents’health, helping to over-
come the selection bias issue that plagues similar studies. Based on the inverted U‐shaped rela-
tionship between BMI and longevity, the study finds that the health prospects of senders with
BMIs under 25 increase weakly with migration, decreasing for those in the overweight cate-
gory. In families with more educated fathers, migration improves the health status of the sen-
ders in all weight groups. Overall, it affects the emotional health of the senders adversely, but
not in families which gain access to improved sanitation facilities due to migration. The most
plausible explanations for this finding are that migration inflicts emotional costs on the senders
due to separation from a family member, and that it potentially changes the senders’percep-
tion of what constitutes good health.
INTRODUCTION
International migration can raise the physical and emotional health of migrant senders, by increas-
ing the inputs that determine health outcomes. Indeed, numerous studies indicate that migrant
remittances have contributed to boosting the health outcomes of the senders (see, for example,
Hilderbrandt and McKenzie, 2005; Bohme et al., 2015). Nevertheless, the adverse consequences of
migration may overshadow its potential benefits for many reasons. For instance, remittances may
fail to make up for a loss in family income from migration, so migration could result in a net loss
to the wellbeing of the stayers. On the other hand, migrant‐sending families –even if they enjoy
improvements in their socioeconomic status (SES) and some measures of health due to financial
and social remittances –might have lower mental health outcomes due to being separated from
loved ones. Therefore, whether migration has net positive effects on the health of sending families
is an empirical research question, with the relative magnitudes of the positive and adverse effects
determining the direction and size of the treatment effect.
This study explores the impact of adult children’s migration on the health of the staying parents
in Ethiopia, using the Diversity Visa (DV) lottery to the United States as an exogenous source of
variation in migration status. The DV lottery has been in effect since 1995 and attracts tens of mil-
lions of applicants from around the world. About 50,000 individuals migrate to the US every year
*UniversityofWaterloo, CanadaWaterloo,Ontario
The peer review history for this article is available at https://publons.com/publon/10.1111/imig.12703
doi: 10.1111/imig.12703
©2020 The Author
International Migration ©2020 IOM
International Migration Vol. 58 (6) 2020
ISSN 0020-7985Published by John Wiley & Sons Ltd.
through this channel. Because of the low threshold requirements for entry into the lottery (one only
needs a high school education or two years of work experience), most of the applicants and win-
ners are low‐income families who stand to benefit materially from migration.
1
The key contribution of this study is that it is the first one, and the only one thus far, that uses
the DV generated experimental data to study the impacts of migration on certain indicators of phys-
ical and emotional health of the staying parents, making some inroads in overcoming the selection
bias issue that plagues similar studies. It uses a specially designed survey of previous DV lottery
participants from the Ethiopian capital, Addis Ababa, to estimate the health effects of emigration
on the sending parents. To the extent that there is a nexus between international migration and
development in general, and the income gradient of health varies by levels of economic develop-
ment and education in particular, Ethiopia is an important context to study (it is a low‐income, sec-
ond most populous African country with a steadily rising diaspora population). Thus, the findings
of the study are, arguably, more generalizable to similar contexts than those conducted on migrant‐
sending countries with higher levels of economic development.
Based on the well‐established empirical regularity in the health literature that longevity increases
monotonically in BMI up to 25, with BMI between 23 and 25 considered optimal for health (Fon-
taine et al, 2003; Whitlock et al., 2009; Kim et al, 2015; Ju et al, 2015), the study concludes that
migration enhances, weakly, the health prospects of migrant senders with BMI less than 25, by
increasing their average BMI by 0.6 from a baseline of about 22. Moreover, migration contributes
to a recession in the health of senders who are in the overweight category, by raising their BMI by
about 1.2. That Ethiopian migrants might be transferring dietary habits that prove to be detrimental
to the stayer’s health may be a feasible explanation for this finding. As predicted, education is
found to be a key mediating factor for these outcomes: in families with more educated fathers,
migration improves the health outlook of the sending parents regardless of their baseline weight.
The study also finds that migration of children has contributed to poor emotional health of the sen-
ders, although parents who gain access to improved sanitation facilities due to migration claim to
be in better health than their counterparts in the control group. That migration could inflict an emo-
tional cost on the senders, and that social remittances can change the senders’perception of what
constitutes good health, are the most plausible explanation for this finding. Additionally, consistent
with other similar studies (see, for instance, Stillman et al., 2015), non‐experimental estimates of
the health effects of the DV lottery are different from the experimental estimates in the expected
direction. Naïve regressions of the impacts of the lottery on both the BMI and the self‐appraisal of
the senders’health produce biased estimates, suggesting that DV applicants and migrants are posi-
tively selected from the overall population.
The article proceeds as follows. Section 2 presents a brief theory linking migration with the sen-
der’s health. Section 3 reviews the empirical literature on the nexus between migration and health,
and section 4 discusses migration trends associated with Ethiopia. Section 5 describes the identifi-
cation strategy, the data and the estimation methods. The study’s key results and the potential
mediating factors will be discussed in sections 6 and 7.
THEORY
If migrant remittances augment the sending families’SES, potentially allowing them to enjoy better
nutrition, housing, sanitation facilities, health care, and other conveniences, migration could have
beneficial effects on the health of the sending parents (Bohme et al., 2015). Nutrition plays an
important role in enhancing health outcomes in societies in the early stages of economic develop-
ment, while improvements in health infrastructure lead to positive association between SES and
health outcomes in more developed settings (Cutler et al., 2006). However, the widely documented
154 Mergo
©2020 The Author. International Migration ©2020 IOM
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