Emily Oster is a Becker Fellow at the Becker Center on Chicago Price Theory and an Assistant Professor in the Department of Economics at the University of Chicago. She has written extensively on gender imbalances in developing countries, AIDS prevalence in Africa, and gender inequality in India. Her work has featured prominently in the Technology, Entertainment, Design (TED) series of lectures. 

Do you expect the gender imbalance in India and China  to right itself? 

The gender imbalance should be self-policing. As women are scarcer, they become more valuable—both in terms of the marriage market and the job market –so in theory, people should want to have more female children. We would expect the trend to self-correct, yet this imbalance has persisted, even gotten worse, in past years.

In what ways do you anticipate the gender imbalance will affect the marriage market? 

As the current generation of men approach marriage age, they will drastically outnumber women. At this point, the dangers of this imbalance should become harder and harder to ignore, as there simply aren’t enough women around for each man to have a wife. The women that are available will be much more valuable and, using the leverage in their scarcity, will most likely be choosier than usual in their husband selection. We can expect the women to choose wealthier-than- average suitors to ensure themselves economic stability. 

How will it affect the balance of the labor force? 

Traditionally, male participation in the labor force has far exceeded that of women. Herein lies one economic incentive that fuels the imbalance – male children are available to support their parents in old age, whereas girls would work instead to support the families of their husbands. Since the imbalance has made women more valuable in the marriage market, it would follow that their participation in the labor force would drop by lack of necessity to support themselves, and the second gender imbalance that exists in the labor force will widen. 

Are there specific public health policies that could be enacted to help reverse the trend?

  This is a hard issue to target through public health efforts. If there’s a concern that girls aren’t receiving proper medical treatment, governments can’t do much more than increase the amount of available vaccinations or health services in general. This might help those girls, but not necessarily – research has shown that if you introduce the option of vaccination into a population that before had none available, the first ones that people bring to be vaccinated are their sons, long considered their most valuable children. However, as girls become considered more valuable, we might see more girls being vaccinated. Governments also have the option of introducing vaccines only for girls, but that can be politically unpalatable. Although public health solutions may help the girls they target, they are at best topical solutions for one effect of the gender imbalance, and do nothing to actually help reverse it. Instead, governments are trying to give people incentives to make them value their daughters more. For example, the Indian government has instituted a number of financial incentive policies aimed at fixing the gender imbalance, including a financial “bonus” for parents who have female children, and subsidies for female schooling. 

Given the self-correcting theory, which conflicts with the data you’ve found, how do you think we might see the gender balance change in the future?

 That’s hard to say. In one of my earlier studies, I found that an exposure to western values and morals, mainly through television, tends to improve a woman’s status in a number of ways. Given this, it is likely that a progressive westernization could help mitigate the gender imbalance. On the other hand, ultrasound and other gender-determination and sex- selective technologies have become more advanced and accessible in recent years, which could help the imbalance continue growing. Many economic incentives to have male children, such as their potential to support aging parents, are still in place. The One Child Policy in China has clearly contributed to the problem, and is not likely to be repealed soon. In the short run, then, it is unlikely for the trend to reverse itself. Perhaps in the long run, though, these westernizing forces will have a greater impact than we can now predict.

You have done a significant amount of work concerning HIV in Africa. What are your current thoughts on the subject?

There’s an economic theory called the Competing Mortality Risk hypothesis, which is due mostly to the work of economist David Meltzer. It states that, since you can only die once, if you are at high risk to die early from one thing, that gives you less of an incentive to vigilantly protect yourself from early death by other factors. You also have much less of an incentive to invest time or money in a variety of other things, such as education, job training, or investing in healthcare. We can see this in the context of HIV in this way: people who live in certain parts of Africa have other early mortality risks. Therefore, they may be less likely to give up the pleasures of unprotected sex with many partners in exchange for possibly living longer, given that they may die early anyway. However, HIV is a somewhat weak test of this hypothesis, as the rate of contraction is nowhere near 100%. It is uncertain that you will contract it and even if you do, it is uncertain that you will die early. In contrast, Huntington’s Disease presents a strong test of the Competing Mortality Risk hypothesis. In this case, you have a set of people, each with a 50% chance that they carry a gene that will kill them in midlife. This represents a very sharp drop in possible life expectancy, and has the expected negative implications in preventative health measures, job training, and education taken by those who believe they may have the disease. If we could collect data about how people are behaving, and what sort of choices they’re making, we could test out these theories in a much sharper context. I am working with several doctors and neurologists to field a survey on people’s investments in healthcare, job training, education, and so on. We’re also looking in that same population for information about their insurance policies, which would also be an indicative behavior. Although we have not yet begun collecting data, we would be very surprised if we do not find evidence that they’re investing less, in following with the hypothesis. 

Do you think that people at risk for Huntington’s will become more selective in their reproductive choices?

Obviously, it’s a personal decision. There are many factors that come into play here. Early death might make some want to have children young so they can enjoy them before they die; others might not want to have any at all because they don’t want to leave them alone after their death. Empirically, men at risk for Huntington’s tend to have more children than average. Children can also be seen as a different form of investment. If Huntington’s sufferers haven’t invested properly in healthcare or retirement, and they don’t die early, having had children can ensure that there is someone to look after them. Also, since the children will also be carriers of Huntington’s Disease, there is a chance that they will also die young. From a genetic standpoint, then, having many children ensures that someone will be around to carry on the gene line. But that’s a tough question.

In which areas are you going to focus next?

 One issue in many developing countries is girls’ access to menstrual supplies. Girls tend to miss a lot of school during their period because they don’t have access to western menstrual technologies such as sanitary pads or tampons. Instead, they use cloth, which is much less effective. My colleagues and I conducted a study in Nepal to see if access to better menstrual supplies positively affects school attendance rates for girls. We randomly distributed menstrual cups – small, silicone cups inserted internally, and reusable for years – to girls in rural Nepal. We then looked to see whether access to this technology affected their school attendance. We found that girls who used menstrual cups did miss less school, and the effect intensified with the number of their friends who also used menstrual cups. Perhaps this finding could encourage public health officials in developing countries to distribute menstrual supplies such as menstrual cups to girls in rural areas.