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

57 Pages Posted: 28 May 2019

See all articles by Karen Clay

Karen Clay

Carnegie Mellon University - H. John Heinz III School of Public Policy and Management; National Bureau of Economic Research (NBER)

Peter Egedesø

University of Southern Denmark

Casper Worm Hansen

University of Copenhagen - Department of Economics; University of Copenhagen

Peter S. Jensen

University of Southern Denmark - Department of Business and Economics

Avery Calkins

University of Michigan

Date Written: May 2019

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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Suggested Citation

Clay, Karen B. and Egedesø, Peter and Hansen, Casper Worm and Jensen, Peter S. and Calkins, Avery, Controlling Tuberculosis? Evidence from the First Community-Wide Health Experiment (May 2019). NBER Working Paper No. w25884. Available at SSRN: https://ssrn.com/abstract=3394673

Karen B. Clay (Contact Author)

Carnegie Mellon University - H. John Heinz III School of Public Policy and Management ( email )

Pittsburgh, PA 15213-3890
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Peter Egedesø

University of Southern Denmark ( email )

Campusvej 55
DK-5230 Odense, 5000
Denmark

Casper Worm Hansen

University of Copenhagen - Department of Economics ( email )

Øster Farimagsgade 5
Copenhagen K, DK 1153
Denmark

University of Copenhagen ( email )

Nørregade 10
Copenhagen, København DK-1165
Denmark

Peter S. Jensen

University of Southern Denmark - Department of Business and Economics ( email )

Campusvej 55
DK-5230 Odense M, 5230
Denmark

HOME PAGE: http://www.sam.sdu.dk/staff/psj

Avery Calkins

University of Michigan

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