This paper studies the effect of sulfa drugs, the first widely used antibiotic, on mortality and exploits the introduction of sulfa drugs to identify the causal impact of exposure to pneumonia in infancy on later life outcomes in Chile during the first half of the twentieth century. Using new yearly data by province, which include causes of deaths, I estimate the effect of sulfa drug adoption on mortality. I find that sulfa drugs resulted in an important drop in maternal mortality, pneumonia mortality, and meningitis mortality. Additionally, I exploit the introduction of sulfa drugs to identify the impact of exposure to pneumonia in infancy on later life outcomes, using an intensity of treatment research design. My results show that exposure to sulfa drugs, and thereby less exposure to pneumonia during the year of one's birth, led to a statistically significant improvement in education and employment for men. For years of schooling, one standard deviation decrease in pneumonia exposure (mortality) is estimated to have resulted in an increase of 0.5 years in schooling for men, an increase of seven percentage points in the probability of completing primary school and a three percentage points in completing secondary school. For employment, being born in an environment with less incidence of pneumonia is associated with a 2.8 percent increase in the likelihood of being employed.
Infant mortality and health care access: evidence from Chile in 1933-1960
Infant and maternal rates are one of the most critical health outcomes. These variables are not only important as health outcomes but as a social and economic development indicator. Both of these indicators saw significant declines during the 20th century, a reason for which is the childbirth professionalization, i.e., the use of highly skilled medical personnel to attend deliveries. In this paper, I examine the role of health personnel on infant mortality in Chile for the period 1933-1960. In particular, I explore the effects of physicians and midwives assistance during birth and the impact of shifting of childbirth from home to hospitals on the infant and maternal mortality rates. Using the yearly hand-collected panel data from the Demographic and Social Assistance Yearbooks of the National Institute of Statistics that include information for infant mortality, maternal mortality, births, illegitimate births, the number of hospitals, the number of deliveries occurring in a hospital/at home, and the number of deliveries with the assistance of a midwife/physician, for the period 1933-1960, I estimate a fixed-effect model of the impact of access to health care on infant mortality rates. Results show that being born in a hospital reduces neonatal mortality. However, it doesn't have the same strong effects in reducing total infant mortality, and it shows no effect on maternal mortality. The same holds for more presence of doctors or midwives. Also, results are stronger for urban than rural areas.
Infant mortality gap in the US in 1940-1960
WORK IN PROGRESS
Sex ratios and infant mortality
Long-term impacts of health insurance coverage