Sometimes It Takes a Village: Collective Efficacy and Children's Use of Preventive Health Care

PWP-CCPR-2004-028

Abstract

This paper addresses the question of whether collective efficacy affects children’s use of preventive health care. In a low- income setting collective efficacy at the community level is shown to increase parental investments in young children. The context for the research is Indonesia before and during the major economic downturn of the late 1990s—a period during which unexpected and substantial changes in neighborhood characteristics took place. Before the crisis collective efficacy has a stronger impact on the use of preventive care by children from socioeconomically disadvantaged households than on children who are better off. During the crisis parental investments in preventive health care for young children were protected in communities where collective efficacy was relatively high. The results are robust to inclusion of a number of other time-varying community factors, as well as to community- level fixed effects. Similar results emerge in a model of individual- level changes in use of care over time.