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Preventing the White Death: Tuberculosis Dispensaries

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  • Peter Juul Egedesø
  • Casper Worm Hansen
  • Peter Sandholt Jensen

Abstract

Tuberculosis (TB) is a leading cause of death worldwide and while treatable by antibiotics since the 1940s, drug resistant strains have emerged. This article estimates the effects of the establishment of a pre-antibiotic public health institution, known as a TB dispensary, designed to prevent the spread of the disease. Our annual difference-in-differences estimation reveals that the rollout of the dispensaries across Danish cities led to a 19% decline in the TB mortality rate, but no significant impacts on other diseases when performing placebo regressions. We next take advantage of the dispensaries explicit targeting on TB to setup a triple-differences model which exploits other diseases as controls and obtain a similar magnitude of the effect. As for the mechanism, the evidence highlights the dispensaries’ preventive actions, such as information provision. At an estimated cost as low as 68 dollars per saved life-year, this particular public-health institution was extraordinarily cost effective. Overall, our evidence suggests a policy for developing countries to combat drug resistant TB.

Suggested Citation

  • 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.
  • Handle: RePEc:oup:econjl:v:130:y:2020:i:629:p:1288-1316.
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    Cited by:

    1. 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).
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    3. Sara Lowes & Eduardo Montero, 2021. "The Legacy of Colonial Medicine in Central Africa," American Economic Review, American Economic Association, vol. 111(4), pages 1284-1314, April.
    4. Kristensen, Frederikke Frehr & Sharp, Paul, 2021. "Disease Surveillance, Mortality and Race: The Case of HIV/AIDS in the United States," CAGE Online Working Paper Series 553, Competitive Advantage in the Global Economy (CAGE).
    5. Clay, Karen & Egedesø, Peter Juul & Hansen, Casper Worm & Jensen, Peter Sandholt & Calkins, Avery, 2020. "Controlling tuberculosis? Evidence from the first community-wide health experiment," Journal of Development Economics, Elsevier, vol. 146(C).
    6. Anderson, D. Mark & Charles, Kerwin Kofi & Las Heras Olivares, Claudio & Rees, Daniel I., 2017. "Was the First Public Health Campaign Successful? The Tuberculosis Movement and its Effect on Mortality," IZA Discussion Papers 10590, Institute of Labor Economics (IZA).
    7. D. Mark Anderson & Kerwin Kofi Charles & Claudio Las Heras Olivares & Daniel I. Rees, 2017. "Was The First Public Health Campaign Successful? The Tuberculosis Movement and Its Effect on Mortality," NBER Working Papers 23219, National Bureau of Economic Research, Inc.
    8. D. Mark Anderson & Kerwin Kofi Charles & Claudio Las Heras Olivares & Daniel I. Rees, 2019. "Was the First Public Health Campaign Successful?," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 143-175, April.
    9. Christian Møller Dahl & Casper Worm Hansen & Peter Sandholt Jensen, 2022. "The 1918 epidemic and a V‐shaped recession: evidence from historical tax records," Scandinavian Journal of Economics, Wiley Blackwell, vol. 124(1), pages 139-163, January.
    10. Volha Lazuka & Peter Sandholt Jensen, 2024. "Multigenerational Effects of Smallpox Vaccination," Working Papers 0251, European Historical Economics Society (EHES).

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    More about this item

    JEL classification:

    • D62 - Microeconomics - - Welfare Economics - - - Externalities
    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • N34 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Europe: 1913-

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