Tuberculosis Dispensaries∗
Preventing the White Death: Tuberculosis Dispensaries∗ Casper Worm Hansen Peter Sandholt Jensen Peter Egedesø Madseny [Latest version: February 2017] Abstract Tuberculosis (TB) is a leading cause of death worldwide and while treatable by antibiotics since the 1940s, drug resistant strains have started to emerge. This paper estimates the effects of the establishment of a pre-antibiotic public health institution, known as a TB dispensary designed to prevent the spread of the disease. Our annual difference- in-differences estimation reveals that the rollout of the dispensaries in cities in Denmark led to a 17 percent decline in the TB mortality rate, but no significant impacts on other diseases when performing placebo regressions. We next take advantage of the dispensaries explicit targeting on TB to setup a triple-differences model which exploits other diseases as controls and obtain a very similar magnitude of the effect. Using monthly mortality data, in a similar strategy, leads to the same conclusion. As for the mechanism, the evidence highlights the dispensaries' preventive actions, such as information provision. At an estimated cost of 76 dollars per saved life-year, this particular public-health institution was extraordinarily cost effective. In addition, we find small positive spillover effects of the dispensaries on productivity, as measured by annual income per tax payer at the city level, digitized from historical tax-assessment records. Keywords: Tuberculosis, mortality, disease prevention, information, rollout, productivity. JEL codes: D62, H23, I15, I18, N34. ∗Acknowledgements: We would like to thank J´er^omeAdda, Philipp Ager, Marcella Alsan, Martha Bailey, Sonia Bhalotra, Marianne Bitler, Steve Broadberry, Aline B¨utikofer, Nicola Gennaioli, Greg Clark, Janet Currie, Carl-Johan Dalgaard, Meltem Daysal, Dave Donaldson, James Fenske, Walker Hanlon, Ingrid Henriksen, Erik Hornung, Aja H øy-Nielsen, Martin Karlsson, Lars Lønstrup, Bentley MacLeod, Grant Miller, Myra Mohnen, Petra Moser, Adriana Lleras-Muney, Nathan Nunn, Per Petterson- Lidbom, Samuel H.
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