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Fertility and Early-Life Mortality: Evidence from Smallpox Vaccination in Sweden

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  • Philipp Ager
  • Casper Worm Hansen
  • Peter Sandholt Jensen

Abstract

The smallpox vaccination method was the paramount medical innovation of the late 18th and early 19th centuries. We exploit the introduction of the smallpox vaccine in Sweden to identify the causal effect of early-life mortality on fertility. Our analysis shows that parishes in counties with higher levels of smallpox mortality prior to the introduction of vaccination experienced greater declines in infant mortality afterward. Exploiting this finding in an instrumental-variable approach reveals that the decline in infant mortality had a negative effect on the number of children born, whereas we find a small insignificant effect on the number of surviving children and natural population growth.

Suggested Citation

  • Philipp Ager & Casper Worm Hansen & Peter Sandholt Jensen, 2018. "Fertility and Early-Life Mortality: Evidence from Smallpox Vaccination in Sweden," Journal of the European Economic Association, European Economic Association, vol. 16(2), pages 487-521.
  • Handle: RePEc:oup:jeurec:v:16:y:2018:i:2:p:487-521.
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    Cited by:

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    2. Stefan Bauernschuster & Anastasia Driva & Erik Hornung, 2020. "Bismarck’s Health Insurance and the Mortality Decline [Disease and Development: The Effect of Life Expectancy on Economic Growth]," Journal of the European Economic Association, European Economic Association, vol. 18(5), pages 2561-2607.
    3. Rangel, Marcos & Nobles, Jenna & Hamoudi, Amar, 2019. "Brazil's Missing Infants: Zika Risk Changes Reproductive Behavior," SocArXiv fu8bp, Center for Open Science.
    4. Matthias Collischon & Kamila Cygan-Rehm & Regina T. Riphahn, 2021. "Employment effects of payroll tax subsidies," Small Business Economics, Springer, vol. 57(3), pages 1201-1219, October.
    5. Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.
    6. Brian Beach & W. Walker Hanlon, 2019. "Censorship, Family Planning, and the Historical Fertility Transition," NBER Working Papers 25752, National Bureau of Economic Research, Inc.
    7. 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.
    8. Katharina Mühlhoff, 2022. "Darwin beats malthus: evolutionary anthropology, human capital and the demographic transition," Cliometrica, Springer;Cliometric Society (Association Francaise de Cliométrie), vol. 16(3), pages 575-614, September.
    9. Mühlhoff, Katharina, 2022. "Convincing the “Herd” of immunity: Lessons from smallpox vaccination in 19th century Germany," Economics & Human Biology, Elsevier, vol. 47(C).
    10. Schneider, Eric & Edvinsson, Sören & Ogasawara, Kota, 2022. "Did Smallpox Cause Stillbirths? Maternal Smallpox Infection, Vaccination and Stillbirths in Sweden, 1780-1839," CEPR Discussion Papers 17274, C.E.P.R. Discussion Papers.
    11. Santos Silva, Manuel & Alexander, Amy C. & Klasen, Stephan & Welzel, Christian, 2023. "The roots of female emancipation: Initializing role of Cool Water," Journal of Comparative Economics, Elsevier, vol. 51(1), pages 133-159.
    12. Mounir Karadja & Erik Prawitz, 2019. "Exit, Voice, and Political Change: Evidence from Swedish Mass Migration to the United States," Journal of Political Economy, University of Chicago Press, vol. 127(4), pages 1864-1925.

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    More about this item

    JEL classification:

    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • N33 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Europe: Pre-1913

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