Working Paper: NBER ID: w25846
Authors: Shari Eli; Trevon D. Logan; Boriana Miloucheva
Abstract: We estimate racial differences in longevity using records from cohorts of Union Army veterans. Since veterans received pensions based on proof of disability at medical exams, estimates of the causal effect of income on mortality may be biased, as sicker veterans received larger pensions. To circumvent endogeneity bias, we propose an exogenous source of variation in pension income: the judgment of the doctors who certified disability. We find that doctors appeared to discriminate against black veterans. The discrimination we observe is acute—we would not observe any racial mortality differences had physicians not been racially biased in determining pension awards. The effect of income on health was indeed large enough to close the black-white mortality gap in the period. Our work emphasizes that the large effects of physicians’ attitudes on racial differentials in health, which persist today amongst both veterans and the civilian population, were equally prominent in the past.
Keywords: racial disparities; health; veterans pensions; physician bias
JEL Codes: I14; I3; N11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| physician bias (I11) | pension income (H55) |
| pension income (H55) | longevity (C41) |
| physician bias (I11) | longevity (C41) |
| physician bias (I11) | racial disparities in health outcomes (I14) |
| pension income (H55) | racial disparities in mortality (I14) |
| physician bias (I11) | pension income for black veterans (H55) |