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Early interventions and infant health: Evidence from the Danish home visiting program

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  • Wüst, Miriam

Abstract

This paper uses unique historical data from Denmark to estimate the effects of the introduction of a universal home visiting program for mothers and their infants from 1937 through 1949. To identify the effects of the program on infant survival rates, the paper exploits exogenous variation in the timing of program implementation across municipalities. Using data for all Danish towns, I find a significant and positive effect on infant survival rates of around 0.5–0.8% or around 5–8 lives saved per 1000 live births at the mean infant survival rate for the period. The program was effective in the great majority of relatively small Danish towns of the time, where the treatment constituted the first large-scale and publicly funded initiative to combat infant mortality. My main finding is robust to the inclusion of town-specific time trends, the control for time-varying socio-economic town characteristics, and the omission of towns with potentially confounding efforts to fight infant mortality. Using complementary data at higher levels of aggregation, I find some indication for the program contributing to the decrease of mortality from acute enteritis, a major cause of infant death at the time. This finding suggests that an important mechanism behind the program's effect was the nurses' promotion of breastfeeding and proper infant nutrition. Finally, a stylized analysis of the costs of the home visiting program shows that they were modest when compared to estimates from similar contexts, namely, home visiting in the U.S. and clean water supply. Future research should use comprehensive Danish register data to examine potential long-run returns to home visiting.

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Bibliographic Info

Article provided by Elsevier in its journal Labour Economics.

Volume (Year): 19 (2012)
Issue (Month): 4 ()
Pages: 484-495

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Handle: RePEc:eee:labeco:v:19:y:2012:i:4:p:484-495

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Web page: http://www.elsevier.com/locate/labeco

Related research

Keywords: Home visiting; Early origins; Program evaluation; Health policies;

References

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  1. Gerard J. van den Berg & Maarten Lindeboom & France Portrait, 2006. "Economic Conditions Early in Life and Individual Mortality," American Economic Review, American Economic Association, vol. 96(1), pages 290-302, March.
  2. Liam Delaney & Mark McGovern & James P. Smith, 2009. "From Angela's Ashes to the Celtic Tiger: Early Life Conditions and Adult Health in Ireland," Working Papers 200943, Geary Institute, University College Dublin.
  3. James Heckman & Pedro Carneiro & Flavio Cunha, 2004. "The Technology of Skill Formation," 2004 Meeting Papers 681, Society for Economic Dynamics.
  4. Sonia Bhalotra & Atheendar Venkataramani, 2011. "The Captain of the Men of Death and His Shadow: Long-Run Impacts of Early Life Pneumonia Exposure," The Centre for Market and Public Organisation 11/273, Department of Economics, University of Bristol, UK.
  5. Carolyn M. Moehling & Melissa A. Thomasson, 2012. "Saving Babies: The Contribution of Sheppard-Towner to the Decline in Infant Mortality in the 1920s," NBER Working Papers 17996, National Bureau of Economic Research, Inc.
  6. Pascaline Dupas, 2011. "Health Behavior in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 425-449, 09.
  7. Seema Jayachandran & Adriana Lleras-Muney & Kimberly V. Smith, 2010. "Modern Medicine and the Twentieth Century Decline in Mortality: Evidence on the Impact of Sulfa Drugs," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 118-46, April.
  8. Carlos Bozzoli & Angus Deaton & Climent Quintana-Domeque, 2007. "Child mortality, income and adult height," Working Papers 230, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
  9. David Cutler & Grant Miller, 2005. "The role of public health improvements in health advances: The twentieth-century United States," Demography, Springer, vol. 42(1), pages 1-22, February.
  10. Moehling, Carolyn M. & Thomasson, Melissa A., 2012. "The Political Economy of Saving Mothers and Babies: The Politics of State Participation in the Sheppard-Towner Program," The Journal of Economic History, Cambridge University Press, vol. 72(01), pages 75-103, March.
  11. Grant Miller, 2008. "Women's Suffrage, Political Responsiveness, and Child Survival in American History," The Quarterly Journal of Economics, MIT Press, vol. 123(3), pages 1287-1327, August.
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