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Disease Control and Inequality Reduction: Evidence from a Tuberculosis Testing and Vaccination Campaign

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  • Aline Bütikofer
  • Kjell G Salvanes

Abstract

This article examines the economic impact of a tuberculosis control program launched in Norway in 1948. In the 1940s, Norway had one of the highest tuberculosis infection rates in Europe, affecting about 85% of the inhabitants. To lower the disease burden, the Norwegian government launched a large-scale tuberculosis testing and vaccination campaign that substantially reduced tuberculosis infection rates among children. We find that cohorts in school during and after the campaign in municipalities with high tuberculosis prevalence gained more in terms of education, earnings, longevity, and height following this public health intervention. Furthermore, the gains from the disease control program are not limited to the initially treated cohorts but also affect their children. The results also suggest that individuals from a low socioeconomic background benefited more from the intervention and we present new evidence that a narrowing of the gap in childhood health can lead to a reduction in socioeconomic inequalities in adulthood.

Suggested Citation

  • Aline Bütikofer & Kjell G Salvanes, 2020. "Disease Control and Inequality Reduction: Evidence from a Tuberculosis Testing and Vaccination Campaign," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 87(5), pages 2087-2125.
    • Handle: RePEc:oup:restud:v:87:y:2020:i:5:p:2087-2125.
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    File URL: http://hdl.handle.net/10.1093/restud/rdaa022
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    Cited by:

    1. Petter Lundborg & Dan-Olof Rooth & Jesper Alex-Petersen, 2022. "Long-Term Effects of Childhood Nutrition: Evidence from a School Lunch Reform," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 89(2), pages 876-908.
    2. Oskorouchi, Hamid R. & Sousa-Poza, Alfonso & Bloom, David E., 2024. "The long-term cognitive and schooling effects of childhood vaccinations in China," China Economic Review, Elsevier, vol. 88(C).
    3. Gabriella Conti, 2013. "The Developmental Origins of Health Inequality," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 285-309, Emerald Group Publishing Limited.
    4. N. Meltem Daysal & Hui Ding & Maya Rossin-Slater & Hannes Schwandt, 2021. "Germs in the Family: The Short- and Long-Term Consequences of Intra-Household Disease Spread," NBER Working Papers 29524, National Bureau of Economic Research, Inc.
    5. Gerard J. van den Berg & Stephanie von Hinke & Nicolai Vitt, 2023. "Early life exposure to measles and later-life outcomes: Evidence from the introduction of a vaccine," Papers 2301.10558, arXiv.org.
    6. Barteska, Philipp & Dobkowitz, Sonja & Olkkola, Maarit & Rieser, Michael, 2023. "Mass vaccination and educational attainment: Evidence from the 1967–68 Measles Eradication Campaign," Journal of Health Economics, Elsevier, vol. 92(C).
    7. Aline Bütikofer & René Karadakic & Kjell G. Salvanes, 2021. "Income Inequality and Mortality: A Norwegian Perspective," Fiscal Studies, John Wiley & Sons, vol. 42(1), pages 193-221, March.
    8. Garrouste, Clémentine & Juet, Arthur & Samson, Anne-Laure, 2023. "Direct and crowding-out effects of a Hepatitis B vaccination campaign," Economics & Human Biology, Elsevier, vol. 51(C).
    9. Huang, Wei & Liu, Hong, 2023. "Early childhood exposure to health insurance and adolescent outcomes: Evidence from rural China," Journal of Development Economics, Elsevier, vol. 160(C).
    10. Mayanka Ambade & Nidhiya Menon & S. V. Subramanian, 2024. "The impact of early-life access to oral polio vaccines on disability: evidence from India," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(1), pages 1-25, March.
    11. Corey White, 2021. "Measuring Social and Externality Benefits of Influenza Vaccination," Journal of Human Resources, University of Wisconsin Press, vol. 56(3), pages 749-785.
    12. Ager, Philipp & Hansen, Casper Worm & Lin, Peter Z., 2023. "Medical Technology and Life Expectancy: Evidence from the Antitoxin Treatment of Diphtheria," CEPR Discussion Papers 18350, C.E.P.R. Discussion Papers.
    13. Cattan, Sarah & Salvanes, Kjell G. & Tominey, Emma, 2022. "First Generation Elite: The Role of School Networks," IZA Discussion Papers 15560, Institute of Labor Economics (IZA).
    14. Kirsten I.M. Rohde & Job van Exel & Merel A.J. van Hulsen, 2021. "Weighting the Waiting: Intertemporal Social Preferences," Tinbergen Institute Discussion Papers 22-023/I, Tinbergen Institute, revised 01 Mar 2024.
    15. de Vries, Sander & Ketel, Nadine & Lindeboom, Maarten, 2024. "From Parents' Cradle to Children's Career: Intergenerational Effects of Parental Investments," IZA Discussion Papers 17570, Institute of Labor Economics (IZA).
    16. Aline Bütikofer & Rita Ginja & Krzysztof Karbownik & Fanny Landaud, 2024. "(Breaking) Intergenerational Transmission of Mental Health," Journal of Human Resources, University of Wisconsin Press, vol. 59(S), pages 108-151.
    17. Zhang, Junsen & Zhou, Kang, 2023. "Quota removal, destination-specific export shocks, and skill acquisition in China," Journal of Development Economics, Elsevier, vol. 165(C).
    18. 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.
    19. Tommy Krieger, 2024. "Elites and health infrastructure improvements in industrializing regimes," Journal of Economic Growth, Springer, vol. 29(3), pages 433-468, September.
    20. Liu, Kai & Prommawin, Benjapon & Schroyen, Fred, 2024. "Health insurance, agricultural production and investments," Journal of Health Economics, Elsevier, vol. 97(C).
    21. Lazuka, Volha & Sandholt Jensen, Peter, 2021. "Multigenerational Effects of Smallpox Vaccination," Lund Papers in Economic History 232, Lund University, Department of Economic History.
    22. Krzysztof Karbownik & Anthony Wray, 2019. "Educational, Labor-market and Intergenerational Consequences of Poor Childhood Health," NBER Working Papers 26368, National Bureau of Economic Research, Inc.
    23. Shen, Xiuheng & Sun, Yucheng & Zhou, Xianbo, 2025. "The political legacy of disease control: Evidence from a polio vaccination campaign in China," China Economic Review, Elsevier, vol. 93(C).

    More about this item

    Keywords

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    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I24 - Health, Education, and Welfare - - Education - - - Education and Inequality

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