Early life assets in oldest-old age: Evidence from primary care reform in early 20th-century Sweden

Research output: Contribution to journalArticle


Do early-life effects due to investments in public health prolong as far as to the oldest-old ages? This paper answers positively to this question by using the primary care reform in rural Sweden that between 1890 and 1917 led to the establishment of local health districts, together with openings of hospitals and recruitments of medical personnel, as a natural experiment in early-life environmental conditions. The initiatives undertaken within these districts targeted control of infectious diseases, including various isolation and disinfection measures. This study applies a difference-in-differences method combined with propensity score matching to register-based individual-level data for Sweden from 1968 to 2012 and to multisource purposely-collected data on the reform implementation. Pioneering evidence for such a distal relationship (ages 78-95), it finds that treatment through primary care in year of birth leads to a significant reduction in all-cause mortality (4-6%), mortality from cardiovascular diseases (5-6%) and to an increase in average incomes (2-3%). The effects are universal and somewhat stronger among individuals from poor socio-economic backgrounds and at higher baseline levels of disease burden.


Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Economic History
Original languageEnglish
Publication statusAccepted/In press - 2019 Apr
Publication categoryResearch

Related research output

Volha Lazuka, 2017 Oct 6, Lund: Media-Tryck, Lund University. 363 p.

Research output: ThesisDoctoral Thesis (compilation)

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