IDEAS home Printed from
   My bibliography  Save this paper

Disease Surveillance, Mortality and Race: The Case of HIV/AIDS in the United States


  • Kristensen, Frederikke
  • Sharp, Paul


The importance of testing and reporting has frequently been stated during the COVID-19 pandemic, but studies on the effectiveness of surveillance are still lacking. We thus turn to the last great epidemic, HIV/AIDS. In 1985 the first blood test for HIV became available, but prior to 1996 no effective medical treatment was available. We exploit the differential rollout of HIV surveillance across US states between 1985 and 2008 and find that HIV reporting helped reduce both AIDS cases and mortality. After the introduction of the effective treatment, HAART, there is no longer a significant effect on mortality, but the effect on reducing cases remains. For blacks, however, the impact on mortality is apparent even after 1996. Surveillance is therefore an important tool for combating epidemics, even in the presence of effective treatments, perhaps due to its impact on the avoidance of risky behavior.

Suggested Citation

  • Kristensen, Frederikke & Sharp, Paul, 2021. "Disease Surveillance, Mortality and Race: The Case of HIV/AIDS in the United States," CEPR Discussion Papers 15984, C.E.P.R. Discussion Papers.
  • Handle: RePEc:cpr:ceprdp:15984

    Download full text from publisher

    File URL:
    Download Restriction: CEPR Discussion Papers are free to download for our researchers, subscribers and members. If you fall into one of these categories but have trouble downloading our papers, please contact us at

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    1. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    2. Aburto, José Manuel & Kristensen, Frederikke Frehr & Sharp, Paul, 2021. "Black-white disparities during an epidemic: Life expectancy and lifespan disparity in the US, 1980–2000," Economics & Human Biology, Elsevier, vol. 40(C).
    3. Sonenstein, F.L. & Ku, L. & Lindberg, L.D. & Turner, C.F. & Pleck, J.H., 1998. "Changes in sexual behavior and condom use among teenaged males: 1988 to 1995," American Journal of Public Health, American Public Health Association, vol. 88(6), pages 956-959.
    4. Moran, J.S. & Janes, H.R. & Peterman, T.A. & Stone, K.M., 1990. "Increase in condom sales following AIDS education and publicity, United States," American Journal of Public Health, American Public Health Association, vol. 80(5), pages 607-608.
    5. Peter Juul Egedesø & Casper Worm Hansen & Peter Sandholt Jensen, 2020. "Preventing the White Death: Tuberculosis Dispensaries," Economic Journal, Royal Economic Society, vol. 130(629), pages 1288-1316.
    6. Doruk Cengiz & Arindrajit Dube & Attila Lindner & Ben Zipperer, 2019. "The Effect of Minimum Wages on Low-Wage Jobs," The Quarterly Journal of Economics, Oxford University Press, vol. 134(3), pages 1405-1454.
    7. Diane Coffey & Michael Geruso & Dean Spears, 2018. "Sanitation, Disease Externalities and Anaemia: Evidence From Nepal," Economic Journal, Royal Economic Society, vol. 128(611), pages 1395-1432, June.
    8. Dan Black & Gary Gates & Seth Sanders & Lowell Taylor, 2000. "Demographics of the gay and lesbian population in the United States: Evidence from available systematic data sources," Demography, Springer;Population Association of America (PAA), vol. 37(2), pages 139-154, May.
    9. Brodeur, Abel & Haddad, Joanne, 2021. "Institutions, attitudes and LGBT: Evidence from the gold rush," Journal of Economic Behavior & Organization, Elsevier, vol. 187(C), pages 92-110.
    10. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    11. Whetten, K. & Leserman, J. & Whetten, R. & Ostermann, J. & Thielman, N. & Swartz, M. & Stangl, D., 2006. "Exploring lack of trust in care providers and the government as a barrier to health service use," American Journal of Public Health, American Public Health Association, vol. 96(4), pages 716-721.
    12. Anderson, J.E., 2003. "Condom Use and HIV Risk among US Adults," American Journal of Public Health, American Public Health Association, vol. 93(6), pages 912-914.
    13. David Cutler & Grant Miller, 2005. "The role of public health improvements in health advances: The twentieth-century United States," Demography, Springer;Population Association of America (PAA), vol. 42(1), pages 1-22, February.
    14. Baird, Sarah & Gong, Erick & McIntosh, Craig & Özler, Berk, 2014. "The heterogeneous effects of HIV testing," Journal of Health Economics, Elsevier, vol. 37(C), pages 98-112.
    15. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bas Scheer & Wiljan van den Berge & Maarten Goos & Alan Manning & Anna Salomons, 2022. "Alternative Work Arrangements and Worker Outcomes: Evidence from Payrolling," CPB Discussion Paper 435, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Dami'an Vergara, 2022. "Minimum Wages and Optimal Redistribution in the Presence of Taxes and Transfers," Papers 2202.00839,, revised May 2022.
    3. Elisa Facchetti & Lorenzo Neri & Marco Ovidi, 2021. "Should you Meet The Parents? The impact of information on non-test score attributes on school choice," DISCE - Working Papers del Dipartimento di Economia e Finanza def113, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    4. Maclean, J. Catherine & Pichler, Stefan & Ziebarth, Nicolas R., 2020. "Mandated Sick Pay: Coverage, Utilization, and Welfare Effects," IZA Discussion Papers 13132, Institute of Labor Economics (IZA).
    5. Kai Fischer & J. James Reade & W. Benedikt Schmal, 2021. "The Long Shadow of an Infection: COVID-19 and Performance at Work," Economics Discussion Papers em-dp2021-17, Department of Economics, University of Reading.
    6. Rösner, Anja & Haucap, Justus & Heimeshoff, Ulrich, 2020. "The impact of consumer protection in the digital age: Evidence from the European Union," International Journal of Industrial Organization, Elsevier, vol. 73(C).
    7. Athey, Susan & Imbens, Guido W., 2022. "Design-based analysis in Difference-In-Differences settings with staggered adoption," Journal of Econometrics, Elsevier, vol. 226(1), pages 62-79.
    8. Thompson, Paul N. & Ward, Jason, 2021. "Only a Matter of Time? The Role of Time in School on Four-Day School Week Achievement Impacts," IZA Discussion Papers 14461, Institute of Labor Economics (IZA).
    9. Sumit Agarwal & Slava Mikhed & Barry Scholnick & Man Zhang, 2021. "Reducing Strategic Default in a Financial Crisis," Working Papers 21-36, Federal Reserve Bank of Philadelphia.
    10. Christine Benesch & Rino L. Heim & Mark Schelker & Lukas D. Schmid, 2021. "Voting Advice Applications and Elections," CESifo Working Paper Series 8868, CESifo.
    11. Georgic, Will & Klaiber, H. Allen, 2022. "Stocks, flows, and flood insurance: A nationwide analysis of the capitalized impact of annual premium discounts on housing values," Journal of Environmental Economics and Management, Elsevier, vol. 111(C).
    12. Lauren Hoehn‐Velasco & Elizabeth Wrigley‐Field, 2022. "City health departments, public health expenditures, and urban mortality over 1910–1940," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 929-953, April.
    13. Al-Karablieh, Yazan & Koumanakos, Evangelos & Stantcheva, Stefanie, 2021. "Clearing the bar: Improving tax compliance for small firms through target setting," Journal of International Economics, Elsevier, vol. 130(C).
    14. Joop Age Harm Adema & Cevat Giray Aksoy & Panu Poutvaara, 2021. "Mobile Internet Access and the Desire to Emigrate," ifo Working Paper Series 365, ifo Institute - Leibniz Institute for Economic Research at the University of Munich.
    15. Adhikari, Bibek & Alm, James & Collins, Brett & Sebastiani, Michael & Wilking, Eleanor, 2022. "Using a natural experiment in the taxicab industry to analyze the effects of third-party income reporting," Journal of Economic Behavior & Organization, Elsevier, vol. 193(C), pages 312-333.
    16. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    17. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    18. Arold, W. Benjamin & Woessmann, Ludger & Zierow, Larissa, 2022. "Can Schools Change Religious Attitudes? Evidence from German State Reforms of Compulsory Religious Education," IZA Discussion Papers 14989, Institute of Labor Economics (IZA).
    19. Cl'ement de Chaisemartin & Xavier D'Haultfoeuille, 2021. "Two-Way Fixed Effects and Differences-in-Differences with Heterogeneous Treatment Effects: A Survey," Papers 2112.04565,, revised May 2022.
    20. Portillo, Javier E. & Wagner, Gary A., 2021. "Do cultural districts spur urban revitalization: Evidence from Louisiana," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 651-673.

    More about this item


    AIDS; HIV; surveillance; United States;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cpr:ceprdp:15984. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.