Clean Water Makes You Dirty: Water Supply and Sanitation Behavior in Metro Cebu, the Philippines

Daniel Bennett, Brown University

This paper illustrates the unintended consequences of water supply improvements. By insulating households from prevailing sanitary conditions, water supply improvements reduce the incentive to be clean. Using data from Metro Cebu, the Philippines, I find that expansions of municipal piped water lead to declines in sanitation and health. Based on these results, I develop a simple model where sanitation is a local public good with multiple equilibrium levels of provision. The model has the stark prediction that the prevalence of piped water in the neighborhood, rather than the household's own water source, determines behavior. Empirical tests support this framework, pointing to an important role for social norms and community enforcement in sanitation behavior.

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Presented in Session 168: Determinants of Child Health in Developing Countries