Patrick Agte

Job Market Paper 

Fighting Silent Killers: How India’s Public Healthcare Staffing Expansion Saves Lives by Improving Access and Market Quality (joint with Jitendra Kumar Soni). 

Millions of adults in low- and middle-income countries die from treatable conditions every year. This paper highlights that an understaffed public healthcare system contributes to high premature mortality, both directly by affecting public provision and indirectly by allowing low-quality private providers to remain competitive.  We evaluate a large-scale reform to India's public healthcare system that adds a mid-level healthcare worker to village clinics. Exploiting quasi-experimental variation due to assignment rules, we find that adding a worker reduces all-age mortality in the catchment area by 10% within two years, making the reform highly cost-effective. Eighty percent of the decline is attributable to a decrease in deaths of adults aged 56+, increasing their life expectancy by at least three months. We conduct audit visits, patient exit interviews, and provider surveys to study mechanisms and find that the program improves performance and service availability in the public sector and also induces private providers to increase their quality. To quantify the importance of each of these channels and evaluate counterfactual policies, we estimate a structural model of patient demand. Ten percent of the decrease in all-age mortality can be attributed to the private sector response, while the remaining 90% is due to simultaneous improvements in public sector quality and access. Only improving public sector quality or access in isolation has limited effects. Model estimates further demonstrate large heterogeneity in predicted treatment gains; we show that an optimal reallocation of the new providers that accounts for local market conditions could achieve a substantially greater reduction in mortality. 

Publications

Investing in the Next Generation: The Long-Run Impacts of a Liquidity Shock (joint with Arielle Bernhardt, Erica Field, Rohini Pande, and Natalia Rigol). American Economic Review, Sep 2024, Vol 114 (9): 2792-2824. Slides VoxDev

Poor entrepreneurs must frequently choose between business investment and children's education. To examine this trade-off, we exploit experimental variation in short-run microenterprise growth among a sample of Indian households and track schooling and business outcomes over eleven years. Treated households, who experience higher initial microenterprise growth, are on average one-third more likely to send children to college. However, educational investment and schooling gains are concentrated among literate-parent households, whose enterprises eventually stagnate. In contrast, illiterate-parent households experience long-run business gains but declines in children's education. Our findings suggest that microenterprise growth has the potential to reduce relative intergenerational educational mobility.

Working Papers

Search and Biased Beliefs in Education Markets (joint with Claudia Allende, Adam Kapor, Christopher Neilson, and Fernando Ochoa). R&R at Econometrica. Slides

When learning about schools requires costly search, search decisions depend on families' beliefs about the returns. This paper asks how families' (limited) awareness of schools and (inaccurate) beliefs about schools' prices, quality ratings, and placement chances distort their search efforts and application decisions in the context of Chile's nationwide centralized school choice process. We combine novel data on search activity with a panel of household surveys, administrative application data, randomized information experiments, and a model of demand for schools. We find that households are unaware of many relevant schools, and hold inaccurate beliefs about admissions chances, prices, and quality scores, affecting their search decisions and application decisions. Most importantly, households' perceptions systematically overstate the quality ratings of schools that they know and like. Correcting misperceptions about known schools causes students to match to schools with higher quality, equal to what can be achieved under a full-information benchmark, and closes the quality gap between low-SES and high-SES applicants.

The Economics of Purity Norms: Caste, Social Interaction, and Women's Work in India (joint with Arielle Bernhardt). Slides

Caste norms, the religious and social rules that underpin the Hindu caste system, impose strong constraints on behavior: women should stay secluded within the home, caste groups should stay segregated, and certain foods should not be eaten. This paper shows that caste norms are weakened when Hindus live alongside Adivasis, an indigenous minority outside of the caste system. Using a number of estimation strategies, including a historical natural experiment that led to local variation in Adivasi population share, we show that having more Adivasi neighbors decreases Hindus' adherence to a wide range of caste rules. Hindu women in Adivasi-majority villages are 50% more likely to work and have substantially higher earnings. Individuals higher on the caste hierarchy are less likely to practice "untouchability" towards those lower than them and villages are more likely to be integrated. We argue that Hindus adhere to caste norms as an investment in status within the caste system, and that this investment is less valuable when Adivasis - a lower-status out-group - form a larger share of the village population. Consistent with this explanation, caste norms are weaker in areas where British colonial policy led Adivasis to hold more land and political power, increasing the returns to social and economic interactions with Adivasis independent of their population share.

The Making of a Public Sector Worker: The Causal Effects of Temporary Work Assignments to Poor Areas (joint with Mariel Bedoya). 

Can temporary work assignments to poor areas affect worker preferences, beliefs, and career choices? We provide evidence on this question using random variation in the assignment of psychologists within a one-year mandatory rural service program in Peru. Psychologists who completed the program in poorer places are later 17% more likely to work for the public sector and 59% more likely to work in the poorest districts in the country. We provide survey evidence that points to increased prosociality as an important mechanism. Additional findings suggest that the results are not driven by inertia or differences in hireability.

Work in Progress

Optimal Teacher Allocations When Identity Matters: Evidence from a Large-Scale Teacher Lottery in India (joint with Arielle Bernhardt, S.K. Ritadhi, and Rohit Joseph).

Heterogeneity in Hospital Value Added and Delivery Choices: Evidence from 1.5 Million Births in India (joint with Sagar Saxena).

Research Information and the Last-Mile: Evidence from a Scale-Up Experiment with Secondary Schools in the Dominican Republic (joint with Daniel Morales, Christopher Neilson, and Sebastian Otero). 

Additional Work

Lessons from the Covid Care Centers in West Bengal (joint with Abhijit Chowdhury, Jishnu Das, Parthasarathi Mukherjee, and Satyarup Siddhanta). Center for Policy Research Working Paper.

Gender Gaps and Economic Growth: Why Haven’t Women Won Globally (Yet)? (joint with Orazio Attanasio, Pinelopi Goldberg, Aishwarya Lakshmi Ratan, Rohini Pande, Michael Peters, Charity Troyer Moore, and Fabrizio Zilibotti). EGC Discussion Paper.

Broadening the Horizon: Female Representation on Editorial Boards and Gender-related Publications (joint with Carmen Arbaizar and Rohini Pande). VoxDev Blog.