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Controlling Tuberculosis? Evidence from the First Community-Wide Health Experiment

Author

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  • Karen Clay
  • Peter Juul Egedesø
  • Casper Worm Hansen
  • Peter Sandholt Jensen
  • Avery Calkins
Abstract
This paper studies the immediate and long-run mortality effects of the first community-based health intervention in the world – the Framingham Health and Tuberculosis Demonstration, 1917-1923. The official evaluation committee and the historical narrative suggest that the demonstration was highly successful in controlling tuberculosis and reducing mortality. Using newly digitized annual cause-of-death data for municipalities in Massachusetts, 1901-1934, and different empirical strategies, we find little evidence to support this positive assessment. In fact, we find that the demonstration did not reduce tuberculosis mortality, all-age mortality, nor infant mortality. These findings contribute to the ongoing debate on whether public-health interventions mattered for the decline in (tuberculosis) mortality prior to modern medicine. At a more fundamental level, our study questions this particular type of community-based setup with non-random treatment assignment as a method of evaluating policy interventions.

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  • Karen Clay & Peter Juul Egedesø & Casper Worm Hansen & Peter Sandholt Jensen & Avery Calkins, 2019. "Controlling Tuberculosis? Evidence from the First Community-Wide Health Experiment," NBER Working Papers 25884, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:25884
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    1. Katherine Eriksson & Gregory T. Niemesh & Melissa Thomasson, 2017. "Revising Infant Mortality Rates for the Early 20th Century United States," NBER Working Papers 23263, National Bureau of Economic Research, Inc.
    2. Anderson, D. Mark & Charles, Kerwin Kofi & Rees, Daniel I., 2018. "Public Health Efforts and the Decline in Urban Mortality," IZA Discussion Papers 11773, Institute of Labor Economics (IZA).
    3. Alberto Abadie & Javier Gardeazabal, 2003. "The Economic Costs of Conflict: A Case Study of the Basque Country," American Economic Review, American Economic Association, vol. 93(1), pages 113-132, March.
    4. Nikolay Doudchenko & Guido W. Imbens, 2016. "Balancing, Regression, Difference-In-Differences and Synthetic Control Methods: A Synthesis," NBER Working Papers 22791, National Bureau of Economic Research, Inc.
    5. Peter Juul Egedesø & Casper Worm Hansen & Peter Sandholt Jensen, 2020. "Preventing the White Death: Tuberculosis Dispensaries," The Economic Journal, Royal Economic Society, vol. 130(629), pages 1288-1316.
    6. Karen Clay & Werner Troesken & Michael Haines, 2014. "Lead and Mortality," The Review of Economics and Statistics, MIT Press, vol. 96(3), pages 458-470, July.
    7. Marcella Alsan & Claudia Goldin, 2019. "Watersheds in Child Mortality: The Role of Effective Water and Sewerage Infrastructure, 1880–1920," Journal of Political Economy, University of Chicago Press, vol. 127(2), pages 586-638.
    8. Michael A. Clemens & Gabriel Demombynes, 2011. "When does rigorous impact evaluation make a difference? The case of the Millennium Villages," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 3(3), pages 305-339, September.
    9. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    10. David M. Cutler & Ellen Meara, 2004. "Changes in the Age Distribution of Mortality over the Twentieth Century," NBER Chapters, in: Perspectives on the Economics of Aging, pages 333-366, National Bureau of Economic Research, Inc.
    11. Chad Turner & Robert Tamura & Sean Mulholland, 2013. "How important are human capital, physical capital and total factor productivity for determining state economic growth in the United States, 1840–2000?," Journal of Economic Growth, Springer, vol. 18(4), pages 319-371, December.
    12. David Cutler & Grant Miller, 2005. "The role of public health improvements in health advances: The twentieth-century United States," Demography, Springer;Population Association of America (PAA), vol. 42(1), pages 1-22, February.
    13. Fogel, Robert W, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," American Economic Review, American Economic Association, vol. 84(3), pages 369-395, June.
    14. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
    15. Ferrie, Joseph P. & Troesken, Werner, 2008. "Water and Chicago's mortality transition, 1850-1925," Explorations in Economic History, Elsevier, vol. 45(1), pages 1-16, January.
    16. Timothy G. Conley & Christopher R. Taber, 2011. "Inference with "Difference in Differences" with a Small Number of Policy Changes," The Review of Economics and Statistics, MIT Press, vol. 93(1), pages 113-125, February.
    17. Chen, Shaohua & Mu, Ren & Ravallion, Martin, 2009. "Are there lasting impacts of aid to poor areas?," Journal of Public Economics, Elsevier, vol. 93(3-4), pages 512-528, April.
    18. Lembke B., 1918. "√ a. p," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 111(1), pages 709-712, February.
    19. D. Mark Anderson & Kerwin Kofi Charles & Daniel I. Rees, 2018. "Public Health Efforts and the Decline in Urban Mortality," NBER Working Papers 25027, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2024. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," American Economic Review, American Economic Association, vol. 114(7), pages 2201-2238, July.
    2. Lazuka, Volha & Sandholt Jensen, Peter, 2021. "Multigenerational Effects of Smallpox Vaccination," Lund Papers in Economic History 232, Lund University, Department of Economic History.
    3. Philipp Ager & Casper Worm Hansen & Peter Z. Lin, 2023. "Medical Technology and Life Expectancy: Evidence from the Antitoxin Treatment of Diphtheria," Working Papers 0241, European Historical Economics Society (EHES).
    4. Marein, Brian, 2023. "Public health departments and the mortality transition in Latin America: Evidence from Puerto Rico," Journal of Development Economics, Elsevier, vol. 160(C).
    5. He, Ke & Wang, Yujie & Zhang, Junbiao & Wang, Qingbin, 2022. "Out of the shadows: Impact of SARS experience on Chinese netizens' willingness to donate for COVID-19 pandemic prevention and control," China Economic Review, Elsevier, vol. 73(C).

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    More about this item

    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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