Working Paper: NBER ID: w30663
Authors: Alex Hollingsworth; Krzysztof Karbownik; Melissa A. Thomasson; Anthony Wray
Abstract: We explore how access to modern hospitals and medicine affects mortality by leveraging efforts of The Duke Endowment to modernize hospitals in the early-twentieth century. The Endowment helped communities build and expand hospitals, obtain state-of-the-art medical technology, attract qualified medical personnel, and refine management practices. We find that Duke support increased the size and quality of the medical sector, fostering growth in not-for-profit hospitals and high-quality physicians. Duke funding reduced both infant mortality - with larger effects for Black infants than White infants - and long-run mortality. Finally, we find that communities aided by Duke benefited more from medical innovations.
Keywords: hospital modernization; infant mortality; racial disparities; Duke Endowment; healthcare access
JEL Codes: I14; J13; N32
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Duke-supported hospital access (I19) | reduced infant mortality (J13) |
| Duke-supported hospital access (I19) | reduced infant mortality for black infants (I14) |
| Duke-supported hospital access (I19) | reduced infant mortality for white infants (I14) |
| Duke-supported hospital access (I19) | reduction in black-white infant mortality gap (I14) |
| Duke-supported hospital access (I19) | reduced mortality for individuals aged 56 to 65 (J26) |
| Duke-supported hospitals (I29) | increased stock of qualified medical personnel (I11) |
| Duke-supported hospitals (I29) | reduced poorly trained physicians (I11) |
| Duke-supported hospitals (I29) | improved health outcomes in communities with higher baseline infectious disease mortality (I14) |