Long-lasting consequences of war on disability

Abstract

This article investigates the impact of exposure to United States air force bombing during 1965–75 on the disability status of individuals in Vietnam in 2009. Using a combination of national census and US military data and an instrumental variable strategy which exploits the distance to the former North–South border as a quasi-experiment, the article finds a positive and significant impact of bombing exposure on district level disability rates 40 years after the war. The overall effect of bombing on the long-term disability rate among the Vietnamese population is highest among heavily bombed districts. Districts in the top bombing quintile experience a 25% relative increase in the rate of disability attributable to bombing compared with districts in the lowest bombing quintile. Effects are highest on the prevalence of severe disability and among cohorts before the war’s end. A smaller, yet significant, effect is found among cohorts born after the war. The article finds further evidence of indirect channels through which bombing may have impacted on long-term disability including adverse effects on nutritional environment and human capital attainment. These findings add to the evidence from Vietnam and indicate that wars inflict costs on the health of human populations that last longer than those relating to economic growth and welfare.