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

Citation Type: Working Paper

Publication Year: 2019

DOI: 10.3386/w25884

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.

Url: http://www.nber.org/papers/w25884.pdf

User Submitted?: No

Authors: Clay, Karen; Egedesø, Peter Juul; Hansen, Casper Worm; Jensen, Peter Sandholt; Calkins, Avery

Series Title: NBER Working Paper Series

Publication Number: 25884

Institution: National Bureau of Economic Research

Pages:

Publisher Location: Cambridge, MA

Data Collections: IPUMS USA

Topics: Health, Other, Population Health and Health Systems

Countries:

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