Another route by which health affects schooling is orphanhood. This has received a great deal of attention in the literature on the economic effects of AIDS. If orphans receive less education, then the intergenerational transmission of human capital can be interrupted, with important, and potentially disastrous, long-term effects (Bell, Devarajan, and Gersbach 2003). Case, Paxson, and Ableidinger (2002) use demographic and health surveys across 10 Sub-Saharan countries to examine the impact of orphanhood and find that orphans are significantly less likely than other children to be enrolled in school. In this study, however, the repeated cross-sectional nature of the data means that the interpretation of the results is not without ambiguity. Gertler, Levine, and Ames (2004) use panel data from Indonesia and find that a parental death doubles the probability that a child will drop out of school the same year. Neither of these two studies finds a gender effect, either at the parent or child level. Other studies find little impact of parental death on schooling, possibly because members of extended families take on the parenting function (Ainsworth, Beegle, and Koda 2002; Kamali and others 1996; Lloyd and Blanc 1996).<sup>8</sup> Consistent with this view, Fortson (2006: 26) reports that children in areas in southern Africa with high HIV prevalence are “less likely to attend school, [are] less likely to complete primary school, and progress more slowly through school.” Fortson shows that more than half of this impact on schooling can be attributed to the expectation of a shorter life of the parent and not to orphanhood itself; all children do badly when adults expect to die sooner. Reductions in adult mortality might lead to greater investment in children’s education, because of higher demand either by parents or by children themselves, who expect to reap the future returns for longer.

Another important dimension of poor health is the economic impact it has on other people. Thirumurthy, Graff Zivin, and Goldstein (2005), studying the impact of HIV/AIDS treatment in Kenya, find that the labor supply of other household members changes: young boys and women in the household work considerably less after the patient in their family starts treatment, although girls and men in the household do not change their labor supply. The authors highlight the important potential implications for schooling outcomes. Beegle, De Weerdt, and Dercoon (2006) study the impact of mortality from AIDS on the economic well-being of surviving household members, in both the short and long term, in a 13-year cohort of individuals in Tanzania. The authors find that households who have experienced an adult death due to AIDS see a reduction in their consumption of 7 percent after five years, while households not so affected see an increase in their consumption of 12 percent over the same period. Thus, vis-à-vis the average household, households who experience an adult death due to AIDS suffer a 19 percent fall in consumption after five years. There is some evidence that such losses are persistent, although they are estimated imprecisely, and the possibility that they are reversed in the long term cannot be rejected. An interesting finding is that losing a _female_ adult to AIDS leads to a particularly severe fall in consumption.

> 8. Evans and Miguel (2003), as discussed in Miguel (2005), use data from the randomized deworming project in western Kenya to address some of the identification issues that trouble cross-sectional and panel data studies. Their results on the impact of parental death on schooling mirror those of Case, Paxson, and Ableidinger (2002) and Gertler, Levine, and Ames (2004): parental death seems to reduce schooling, and there is little difference by gender.

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