Preventing the White Death : Tuberculosis Dispensaries

Tuberculosis (TB) is a leading cause of death worldwide and, while treatable by antibiotics since the 1940s, drug resistant strains have emerged. This paper estimates the effects of the establishment of a pre-antibiotic era 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 across Danish cities led to a 19 percent decline in the TB mortality rate, but exhibits no significant impacts on other diseases in placebo regressions. We next take advantage of the dispensaries' explicit targeting on TB to set up a triple-differences model which exploits other diseases as controls and obtain a similar magnitude of the effect. Using monthly mortality data in a similar strategy leads to the same conclusion. In addition, we find small positive spillover effects of the dispensaries on productivity as measured by annual income per taxpayer at the city level, digitized from historical tax-assessment records. Overall, the evidence highlights the provision of personalized information on infectious diseases as a cost-effective cause of the historical mortality decline