Sanitation and health: empirical evidence for Brazilian municipalities

The relationship between sanitation policies (access and quality) and health in Brazilian municipalities was estimated from 2003 to 2010 using a panel data model with corrections for missing data. The results suggest a limited effect of sanitation policy on health. Compared with results from the literature, we found that the worsening quality of water appears to be associated with increased rates of mortality and hospitalization for children up to one month of age. Improvements in sewage sanitation have reduced the mortality and morbidity rates in children aged one to four. Improved access to piped water is associated with decreased hospitalization related to dysentery and acute respiratory infections (ARI) and does not have an effect on child mortality. Finally, epidemiological transition is only supported by weak evidence, including a more intense effect of reduced access to sanitation in municipalities with the worst mortality and morbidity indicators. In most models, this theory has been rejected