Abstrakti
This doctoral dissertation consists of three essays that explore topics related to health policy for children. The first two essays examine the introduction of publicly provided universal child health services in Finland in the 1940s. The first essay focuses on the effects of these services on the Finnish child mortality transition, while the second essay considers their longer-run impacts on human capital accumulation. In contrast to these broad-based health services, the third essay zooms in on the human capital effects of one specific publicly provided health service: a mass vaccination campaign against the childhood disease measles in the United States. Specifically, the first essay examines the introduction of universal child health centers in every municipality in Finland in the 1940s. These centers offered regular child health counseling visits for children under school age, both on-site and at home. The essay uses newly collected, individuallevel child mortality data to estimate the effects of the reform on child mortality at different ages. For children aged between one month and one year—who were the most intensively targeted by the policy—the essay finds that access to rural child health centers reduced postneonatal mortality by 9 deaths per thousand live births (27 percent of baseline postneonatal mortality). This figure corresponds to approximately half of the overall decline in postneonatal mortality in Finland during 1945–1950 or approximately one-fourth of the overall decline in the mortality of children under age five. For children aged one to four, the essay finds a reduction in the mortality of boys of approximately 18 deaths per thousand live births (67 percent of baseline mortality for boys in this age range). In contrast, the survival benefits for girls remain uncertain. The second essay follows the impacts of the child health centers into adulthood. It finds that children who gained access to universal child health services in the 1940s were two percentage points more likely to complete either academic secondary school or a tertiary degree and earned approximately two percent more income in adulthood. These benefits were largest for children who gained access prior to birth but they also accrued to children who gained access up to age three. The estimated benefits appear clearer for girls than for boys. However, the benefits for boys may be underestimated because boys were more likely to survive due to the child health centers, according to the findings in the first essay. A bounding exercise suggests that the true effect on income is more likely to lie in the interval between two and five percent. The third essay, based on joint work with Philipp Barteska, Sonja Dobkowitz, and Michael Rieser, also focuses on the human capital effects of a health intervention. It suggests that the first nationwide mass vaccination campaign against measles increased educational attainment in the United States. Its empirical strategy exploits variation in exposure to the childhood disease across states right before the Measles Eradication Campaign of 1967–1968, which reduced reported measles incidence by 90 percent within two years. The essay finds that the reduction in measles exposure increased the years of education on average by approximately 0.1 years in the affected cohorts.
Julkaisun otsikon käännös | Essays on Health Policy and Human Capital |
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Alkuperäiskieli | Englanti |
Pätevyys | Tohtorintutkinto |
Myöntävä instituutio |
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Valvoja/neuvonantaja |
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Kustantaja | |
Painoksen ISBN | 978-952-64-2343-2 |
Sähköinen ISBN | 978-952-64-2344-9 |
Tila | Julkaistu - 2025 |
OKM-julkaisutyyppi | G5 Artikkeliväitöskirja |