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Modern Medicine and the 20th Century Decline in Mortality: Evidence on the Impact of Sulfa Drugs

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  • Seema Jayachandran
  • Adriana Lleras-Muney
  • Kimberly V. Smith

Abstract

This paper studies the contribution of sulfa drugs, a groundbreaking medical innovation in the 1930s, to declines in U.S. mortality. For several often-fatal infectious diseases, sulfa drugs represented the first effective treatment. Using time-series and difference-in-differences methods (with diseases unaffected by sulfa drugs as a comparison group), we find that sulfa drugs led to a 25 to 40 percent decline in maternal mortality, 17 to 36 percent decline in pneumonia mortality, and 52 to 67 percent decline in scarlet-fever mortality between 1937 and 1943. Altogether, they reduced mortality by 2 to 4 percent and increased life expectancy by 0.4 to 0.8 years. We also find that sulfa drugs benefited whites more than blacks.

Suggested Citation

  • Seema Jayachandran & Adriana Lleras-Muney & Kimberly V. Smith, 2009. "Modern Medicine and the 20th Century Decline in Mortality: Evidence on the Impact of Sulfa Drugs," NBER Working Papers 15089, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:15089
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    References listed on IDEAS

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    1. Sherry Glied & Adriana Lleras-Muney, 2008. "Technological innovation and inequality in health," Demography, Springer;Population Association of America (PAA), vol. 45(3), pages 741-761, August.
    2. Donald W. K. Andrews, 2003. "Tests for Parameter Instability and Structural Change with Unknown Change Point: A Corrigendum," Econometrica, Econometric Society, vol. 71(1), pages 395-397, January.
    3. 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.
    4. Melissa A. Thomasson & Jaret Treber, 2004. "From Home to Hospital: The Evolution of Childbirth in the United States, 1927-1940," NBER Working Papers 10873, National Bureau of Economic Research, Inc.
    5. Fogel, Robert W, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," American Economic Review, American Economic Association, vol. 84(3), pages 369-395, June.
    6. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    7. Perron, P, 1993. "Erratum [The Great Crash, the Oil Price Shock and the Unit Root Hypothesis]," Econometrica, Econometric Society, vol. 61(1), pages 248-249, January.
    8. Samuel H. Preston & Michael R. Haines, 1991. "Fatal Years: Child Mortality in Late Nineteenth-Century America," NBER Books, National Bureau of Economic Research, Inc, number pres91-1, July.
    9. Perron, Pierre, 1989. "The Great Crash, the Oil Price Shock, and the Unit Root Hypothesis," Econometrica, Econometric Society, vol. 57(6), pages 1361-1401, November.
    10. Andrews, Donald W K, 1993. "Tests for Parameter Instability and Structural Change with Unknown Change Point," Econometrica, Econometric Society, vol. 61(4), pages 821-856, July.
    11. William D. Nordhaus, 2002. "The Health of Nations: The Contribution of Improved Health to Living Standards," NBER Working Papers 8818, National Bureau of Economic Research, Inc.
    12. Thomasson, Melissa A. & Treber, Jaret, 2008. "From home to hospital: The evolution of childbirth in the United States, 1928-1940," Explorations in Economic History, Elsevier, vol. 45(1), pages 76-99, January.
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    Citations

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    Cited by:

    1. Stefania Albanesi & Claudia Olivetti, 2014. "Maternal health and the baby boom," Quantitative Economics, Econometric Society, vol. 5, pages 225-269, July.
    2. Bhalotra, Sonia & Venkataramani, Atheendar, 2011. "Is The Captain of the Men of Death Still At Play? Long-Run Impacts of Early Life Pneumonia Exposure during Sulfa Drug Revolution in America," Proceedings of the German Development Economics Conference, Berlin 2011 10, Verein für Socialpolitik, Research Committee Development Economics.
    3. 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, The Centre for Market and Public Organisation, University of Bristol, UK.
    4. Esther Duflo, 2012. "Women Empowerment and Economic Development," Journal of Economic Literature, American Economic Association, vol. 50(4), pages 1051-1079, December.
    5. repec:hka:wpaper:2013-05 is not listed on IDEAS
    6. Stefania Albanesi, 2012. "Maternal Health and Fertility : An International Perspective," World Bank Publications - Reports 9168, The World Bank Group.
    7. Bhalotra, Sonia R. & Venkataramani, Atheendar, 2013. "Cognitive Development and Infectious Disease: Gender Differences in Investments and Outcomes," IZA Discussion Papers 7833, Institute of Labor Economics (IZA).
    8. repec:hka:wpaper:2013-03 is not listed on IDEAS
    9. repec:esx:essedp:745 is not listed on IDEAS
    10. Grant Miller & B. Piedad Urdinola, 2010. "Cyclicality, Mortality, and the Value of Time: The Case of Coffee Price Fluctuations and Child Survival in Colombia," Journal of Political Economy, University of Chicago Press, vol. 118(1), pages 113-155, February.

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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-

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