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American Economic Review Vol. 114 No. 7 2024

The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality

Alex Hollingsworth1; Krzysztof Karbownik2; Melissa A. Thomasson3; Anthony Wray4

1 Department of Agricultural, Environmental, and Development Economics; Department of Economics; and John Glenn College of Public Affairs, the Ohio State University and NBER (email: ) · 2 Department of Economics, Emory University and NBER (email: ) · 3 Department of Economics, Miami University and NBER (email: ) · 4 Department of Economics, University of Southern Denmark (email: )

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.

DOI
10.1257/aer.20230008
Volume
114
Issue
7
Pages
2201-2238
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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