Conference Agenda

Reducing infant mortality is a central development challenge. This paper studies how the growth of an informal economic activity shapes this challenge by examining the net health impacts of artisanal and small-scale gold mining (ASgM), now the predominant non-farm rural livelihood in many African countries. While ASgM raises incomes, it also generates substantial environmental externalities dangerous for infant health, both in its immediate vicinity, and through water pollution transmitted along river networks. We combine geocoded Demographic and Health Surveys covering more than 790,000 births in 33 African countries with geological gold suitability, international gold price fluctuations and hydrological basin data. Exploiting the exogeneity of shifts to mining incentives due to the international commodity market and the directionality of river systems, we distinguish the impacts of local mining exposure–where income and pollution effects coexist–from down-stream exposure, where environmental externalities are more likely to dominate. We find that exposure to upstream ASgM significantly increases infant mortality. In contrast, effects are muted in communities where mining can take place. We also show that the impacts of upstream ASgM are driven by areas that rely heavily on local river systems and subsistence agriculture, namely, rural areas and non-coastal areas. These findings reveal a spatially uneven health–wealth tradeoff where ASgM

externalities maybe invisible in practicing communities, but diffuse, water-mediated pollution from informal mining undermines progress toward child survival goals for far many more people downstream from them.