The impact of infrastructure investment on resilience to environmental shocks: Evidence from Ecuador

Increasing climate variability has direct impacts on health--particularly through vector-borne diseases. Sanitation infrastructure may have a mitigating impact on these effects. We investigate the impact of infrastructure investments on health following major weather events using a novel dataset that links information from a broad range of sources from 2001 to 2019 in Ecuador. We find that particularly high levels of precipitation increase hospitalizations from vector-borne diseases and improvements in sanitation infrastructure decrease hospitalizations. The decrease in hospitalizations from sanitation infrastructure is particularly pronounced in months when cantons (counties) have high precipitation. These effects are also largest in the cantons with the highest population density. The findings suggest that improving sanitation infrastructure is a key element in building resilience to climate change, and densely populated areas differentially benefit from improved infrastructure.