Working Papers

The Long-term Impact of Public Health Measures Targeting Children (Job Market Paper)
Current Version: [ pdf ]

Abstract: This paper estimates the long-run impact of childhood exposure to public health initiatives on adult human capital. From 1908 to 1933, local governments in the United States instituted county-level health departments (CHDs) that provided sanitation and health services geared toward children. To estimate the long-term benefits, I exploit variation in the timing, location, and age of CHD exposure. Children treated under the age of five show later-life earnings improvements of two to five percent. Further, CHD boys not only perform better than later- and never-treated groups but, after adding household fixed effects, these children earn more than their brothers and their fathers. Finally, I investigate the mechanisms underlying this effect and demonstrate that higher earnings emerge from better adult health, measured by body mass index and the probability of living to age 80.

Explaining Declines in US Rural Mortality, 1910-1933: The Role of County Health Departments
Current Version: [ pdf | poster ]

Revision requested, Explorations in Economic History

Abstract: This study assesses the mortality decline associated with one of the first and most extensive rural public health efforts in the United States. Between 1908 and 1933, county governments enacted county health departments (CHDs) that provided sanitation and child-oriented health services. Using an event study design, I exploit variation in the location and timing of CHD arrival to measure the health effects. I find that CHD entry led to a decline in infant mortality, but provided little advantage to overall population health. For infants, CHDs prevented two deaths per 1,000 births, which accounts for 8-10% of the period-specific mortality decline. The effect is most substantial in rural-only counties where infant mortality declines by roughly three deaths per 1,000 births.

Taxation, Inequality, and the Provision of Local Public Health
Current Version: [ pdf ]

Abstract: This paper examines the factors that shaped the appropriation of rural public health through county health departments (CHDs) in the early twentieth century. Using digitized county-level records on property values and taxation, I find that adopting states had local governments centered around the county. Within state, I discover that counties implementing services were more urban and had higher per household property values and taxes. Based on these findings, I consider whether the CHDs were redistributive within county and find that CHDs operated in areas with higher levels of land and income inequality. These results suggest that public programs based on local revenue may help to mitigate inequality within the region of jurisdiction but may exacerbate disparities between adopting and non-adopting areas. External funding from higher levels of government as well as private donors helped to randomize the effort and spread the health services more evenly between counties.

Works In Progress

Public Health Spillovers: City Infrastructure Investments and the Nearest Neighbor Effect

Revisiting the Rural Mortality Decline in the United States, 1890-1930

The Household Bargaining Effects of Divorce Legalization: Evidence from Chile

Divorce Laws and Women’s Bargaining Power: A Combined Reduced Form-Structural Approach (with Jacob Penglase)