IDEAS home Printed from https://ideas.repec.org/p/osf/osfxxx/b5cfs_v1.html
   My bibliography  Save this paper

The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality

Author

Listed:
  • Hollingsworth, Alex
  • Karbownik, Chris
  • Thomasson, Melissa
  • Wray, Anthony

Abstract

The past century witnessed a dramatic improvement in public health, the rise of modern medicine, and the transformation of the hospital from a fringe institution to one essential to the practice of medicine. Despite the central role of medicine in contemporary society, little is known about how hospitals and modern medicine contributed to this health transition. In this paper, we explore how access to the hospital and modern medicine affects mortality. We do so by leveraging a combination of novel data and a unique quasi-experiment: a large-scale hospital modernization program introduced by The Duke Endowment in the early twentieth century. The Endowment helped communities build and expand hospitals, obtain state-of-the-art medical technology, attract qualified medical personnel, and refine management practices. We find that access to a Duke-supported hospital reduced infant mortality by 10%, saving one life for every $20,000 (2017 dollars) spent. Effects were larger for Black infants (16%) than for White infants (7%), implying a reduction in the Black-White infant mortality gap by one-third. We show that the effect of Duke support persisted into later life with a 9% reduction in mortality between the ages of 56 and 65. We further provide evidence on the mechanisms that enabled these effects, finding that Endowment-supported hospitals attracted higher-quality physicians and were better able to take advantage of new medical innovations.

Suggested Citation

  • Hollingsworth, Alex & Karbownik, Chris & Thomasson, Melissa & Wray, Anthony, 2022. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," OSF Preprints b5cfs_v1, Center for Open Science.
  • Handle: RePEc:osf:osfxxx:b5cfs_v1
    DOI: 10.31219/osf.io/b5cfs_v1
    as

    Download full text from publisher

    File URL: https://osf.io/download/636d3d3264d67e082da07954/
    Download Restriction: no

    File URL: https://libkey.io/10.31219/osf.io/b5cfs_v1?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. K. John McConnell & Richard C. Lindrooth & Douglas R. Wholey & Thomas M. Maddox & Nick Bloom, 2016. "Modern Management Practices and Hospital Admissions," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 470-485, April.
    2. Volha Lazuka, 2020. "Infant Health and Later-Life Labor Market Outcomes: Evidence from the Introduction of Sulfa Antibiotics in Sweden," Journal of Human Resources, University of Wisconsin Press, vol. 55(2), pages 660-698.
    3. 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.
    4. 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).
    5. Katherine Eriksson, 2020. "Education and Incarceration in the Jim Crow South: Evidence from Rosenwald Schools," Journal of Human Resources, University of Wisconsin Press, vol. 55(1), pages 43-75.
    6. Sarah R. Cohodes & Daniel S. Grossman & Samuel A. Kleiner & Michael F. Lovenheim, 2016. "The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 727-759.
    7. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    8. Orley Ashenfelter & Michael Greenstone, 2004. "Using Mandated Speed Limits to Measure the Value of a Statistical Life," Journal of Political Economy, University of Chicago Press, vol. 112(S1), pages 226-267, February.
    9. Fishback, Price V. & Horrace, William C. & Kantor, Shawn, 2005. "Did New Deal Grant Programs Stimulate Local Economies? A Study of Federal Grants and Retail Sales During the Great Depression," The Journal of Economic History, Cambridge University Press, vol. 65(1), pages 36-71, March.
    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. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2024. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," American Economic Review, American Economic Association, vol. 114(7), pages 2201-2238, July.
    2. Noghanibehambari, Hamid, 2022. "Intergenerational health effects of Medicaid," Economics & Human Biology, Elsevier, vol. 45(C).
    3. Mindy Marks & Moonkyung Kate Choi, 2019. "Baby Boomlets and Baby Health: Hospital Crowdedness, Hospital Spending, and Infant Health," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 376-406, Summer.
    4. Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2023. "Multigenerational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation's Health," American Economic Review, American Economic Association, vol. 113(1), pages 98-135, January.
    5. Guldi, Melanie & Hamersma, Sarah, 2023. "The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health," Journal of Health Economics, Elsevier, vol. 87(C).
    6. Luechinger, Simon, 2014. "Air pollution and infant mortality: A natural experiment from power plant desulfurization," Journal of Health Economics, Elsevier, vol. 37(C), pages 219-231.
    7. Rucker C. Johnson, 2018. "Addressing Racial Health Disparities: Looking Back to Point the Way Forward," The ANNALS of the American Academy of Political and Social Science, , vol. 680(1), pages 132-171, November.
    8. Dmitry Arkhangelsky & Guido Imbens, 2023. "Causal Models for Longitudinal and Panel Data: A Survey," Papers 2311.15458, arXiv.org, revised Jun 2024.
    9. Janet Currie, 2020. "Child health as human capital," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 452-463, April.
    10. Cathy J. Bradley & Lindsay M. Sabik, 2019. "Medicaid expansions and labor supply among low-income childless adults: evidence from 2000 to 2013," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 235-272, December.
    11. Thompson, Owen, 2017. "The long-term health impacts of Medicaid and CHIP," Journal of Health Economics, Elsevier, vol. 51(C), pages 26-40.
    12. Adam Pilny & Felix Roesel, 2020. "Are Doctors Better Health Ministers?," American Journal of Health Economics, University of Chicago Press, vol. 6(4), pages 498-532.
    13. Janet Currie & Hannes Schwandt & Josselin Thuilliez, 2020. "Pauvreté, Egalité, Mortalité: mortality (in)equality in France and the United States," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(1), pages 197-231, January.
    14. Jacob Vogler, 2020. "Access to Healthcare and Criminal Behavior: Evidence from the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(4), pages 1166-1213, September.
    15. Watson, Tara, 2006. "Public health investments and the infant mortality gap: Evidence from federal sanitation interventions on U.S. Indian reservations," Journal of Public Economics, Elsevier, vol. 90(8-9), pages 1537-1560, September.
    16. O'Donnell, Owen, 2024. "Health and health system effects on poverty: A narrative review of global evidence," Health Policy, Elsevier, vol. 142(C).
    17. Andrew Goodman-Bacon, 2016. "The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes," NBER Working Papers 22899, National Bureau of Economic Research, Inc.
    18. Valerie Bostwick & Christopher Severen, 2022. "Driving, Dropouts, and Drive-Throughs: Mobility Restrictions and Teen Human Capita," Working Papers 22-22, Federal Reserve Bank of Philadelphia.
    19. Étienne Gaudette & Gwyn C. Pauley & Julie Zissimopoulos, 2016. "Long-term Individual and Population Consequences of Early-life Access to Health Insurance," Working Papers wp355, University of Michigan, Michigan Retirement Research Center.
    20. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-680, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    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:osf:osfxxx:b5cfs_v1. See general information about how to correct material in RePEc.

    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: OSF (email available below). General contact details of provider: https://osf.io/preprints/ .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.