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Controlling Tuberculosis? Evidence from the Mother of all Community-Wide Health Experiments

Author

Listed:
  • Karen Clay

    (Carnegie Mellon University)

  • Peter Juul Egedes

    (University of Southern Denmark)

  • Casper Worm Hansen

    (Department of Economics, University of Copenhagen)

  • Peter Sandholt Jensen

    (University of Southern Denmark)

Abstract
This paper studies the immediate and long-run mortality effects of the first communitybased health intervention in the world, which had a particular focus on controlling tuberculosis - the so-called Framingham Health and Tuberculosis Demonstration. Comparing death and TB-mortality rates between Framingham and seven (pre-selected) control towns during the Demonstration period between 1917 and 1923, the contemporary offcial evaluation committee concluded that the Demonstration was highly successful in controlling TB and reducing mortality The Framingham Demonstration subsequently became a health example for the world. The findings in our paper question this very positive assessment. We collected and digitized causes-of-death data for towns/cities in Massachusetts and the United States for the period 1901-1934, allowing us to extend the number of control towns (or cities) and study whether the Demonstration reduced mortality in the long run.Compared to the official seven controls towns, we find that TB mortality in Framingham was on average lower between 1917 and 1923. In the extended control samples, these immediate TB mortality differences are smaller and often more than reversed by 1934.However, we do find robust evidence that the Demonstration reduced infant mortality, and these improvements persisted even after the Demonstration ended.

Suggested Citation

  • Karen Clay & Peter Juul Egedes & Casper Worm Hansen & Peter Sandholt Jensen, 2018. "Controlling Tuberculosis? Evidence from the Mother of all Community-Wide Health Experiments," Discussion Papers 18-03, University of Copenhagen. Department of Economics.
    • Handle: RePEc:kud:kuiedp:1803
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    File URL: https://www.economics.ku.dk/research/publications/wp/dp_2018/papers/1803.pdf
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    References listed on IDEAS

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    Cited by:

    1. Lauren Hoehn‐Velasco & Elizabeth Wrigley‐Field, 2022. "City health departments, public health expenditures, and urban mortality over 1910–1940," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 929-953, April.

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    More about this item

    Keywords

    Public Health; Health Demonstration; Tuberculosis Mortality; Infant Mortality;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-

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