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Controlling Tuberculosis? Evidence from the First Community-Wide Health Experiment
Authors: --- --- --- ---
Year: 2019 Publisher: Cambridge, Mass. National Bureau of Economic Research

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Abstract

This paper studies the immediate and long-run mortality effects of the first community-based health intervention in the world - the Framingham Health and Tuberculosis Demonstration, 1917-1923. The official evaluation committee and the historical narrative suggest that the demonstration was highly successful in controlling tuberculosis and reducing mortality. Using newly digitized annual cause-of-death data for municipalities in Massachusetts, 1901-1934, and different empirical strategies, we find little evidence to support this positive assessment. In fact, we find that the demonstration did not reduce tuberculosis mortality, all-age mortality, nor infant mortality. These findings contribute to the ongoing debate on whether public-health interventions mattered for the decline in (tuberculosis) mortality prior to modern medicine. At a more fundamental level, our study questions this particular type of community-based setup with non-random treatment assignment as a method of evaluating policy interventions.


Book
Controlling Tuberculosis? Evidence from the First Community-Wide Health Experiment
Authors: --- --- --- --- --- et al.
Year: 2019 Publisher: Cambridge, Mass. National Bureau of Economic Research

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Abstract

This paper studies the immediate and long-run mortality effects of the first community-based health intervention in the world - the Framingham Health and Tuberculosis Demonstration, 1917-1923. The official evaluation committee and the historical narrative suggest that the demonstration was highly successful in controlling tuberculosis and reducing mortality. Using newly digitized annual cause-of-death data for municipalities in Massachusetts, 1901-1934, and different empirical strategies, we find little evidence to support this positive assessment. In fact, we find that the demonstration did not reduce tuberculosis mortality, all-age mortality, nor infant mortality. These findings contribute to the ongoing debate on whether public-health interventions mattered for the decline in (tuberculosis) mortality prior to modern medicine. At a more fundamental level, our study questions this particular type of community-based setup with non-random treatment assignment as a method of evaluating policy interventions.

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