Lazuka, V., forthcoming. It’s a long walk: Lasting effects of the openings of maternity wards on labour market performance. Accepted in the Review of Economics and Statistics.  Accepted version Lazuka Maternity wards 2021 , Appendix 

Abstract: Being born in a hospital versus having a traditional birth attendant at home represents the most common early life policy change worldwide. By applying a difference-in-differences approach to register-based individual-level data on the total population, this paper explores the long-term economic effects of the opening of new maternity wards as an early life quasi-experiment. It first finds that the reform substantially increased the share of hospital births and reduced early neonatal mortality. It then shows sizable long-term effects on labour income, unemployment, health-related disability and schooling. Small-scale local maternity wards yield a larger social rate of return than large-scale hospitals.

Lazuka, V. 2020. Infant health and later-life labour market outcomes : Evidence from the introduction of sulfa antibiotics in Sweden. The Journal of Human Resources 55(2), pp. 660-698. Accepted version: Lazuka Long-term sulfa Accepted 2018  doi:10.3368/jhr.55.3.0817-9016R 

Abstract: This paper studies the effects of improvements in infant health produced by the introduction of sulphapyridine in the late-1930s as treatment against pneumonia on outcomes in adulthood. Based on longitudinal individual data for the whole population of Sweden 1968–2012 and archival data on the availability of sulphapyridine and applying a difference-in-differences approach, it finds that mitigation of pneumonia infection in infancy increased labour income in late adulthood by 2.8–5.3 percent. The beneficial effects are strong for health, measured by length of stay in hospital, and weaker for years of schooling. These effects are similar between men and women.

Lazuka, V. 2019. Early life assets in oldest-old age: Evidence from primary care reform in early 20th-century Sweden. Demography 56(2), pp 679–706. Open Access, doi: 10.1007/s13524-018-0758-4

Abstract: Do early-life effects of investments in public health persist to the oldest-old ages? This article answers 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. Providing pioneering evidence for such a distal relationship (ages 78–95), this study finds that treatment through primary care in the year of birth leads to a significant reduction in all-cause mortality (4 % to 6%) and mortality from cardiovascular diseases (5 % to 6 %) and to an increase in average incomes (2 % to 3 %). The effects are universal and somewhat stronger among individuals from poor socioeconomic backgrounds and at higher baseline levels of disease burden.

Andersson, J, and Lazuka, V. 2019. Long-term Drivers of Taxation in Francophone West Africa 1893-2010. World Development, 114, pp. 294-313.

Abstract: Which factors have driven fiscal revenue in Sub-Saharan Africa in the long run? We address this question by studying quantitatively the long-term relationship between fiscal outcomes, economic expansion and external dependency in four francophone West African countries – Benin, Côte d’Ivoire, Niger and Senegal – between 1893 and 2010. Using panel co-integration modelling we find a long-term relationship between, on the one hand, tax revenue and local economic development, proxied by international trade, and, on the other hand, tax revenue and developments of the economy and taxation in the former colonizing power France. The results indicate that economic expansion has been a significant factor in driving the long-term development of tax revenue in West Africa, just as it was in historical Europe, but also point to the historical vulnerability and external dependency of the fiscal systems of the four West African countries. We suggest that the wider implication of these results is that they point to the importance of deepening our understanding of how domestic contexts interact with external economic and institutional external forces to shape African fiscal systems, in contrast to factors such as inter-state warfare that are ubiquitous in narratives of historical European taxation and state development.

Lazuka, V., 2018, The long-term health benefits of receiving treatment from qualified midwives at birth, Journal of Development Economics 133, pp.415-433. Accepted version: Lazuka Long-term midwifery 2018 accepted version.  Online Appendix

Abstract: This paper explores the long-term effects of being born with the assistance of a qualified midwife on health and skills, using longitudinal register-based data for individuals born in rural Swedish parishes between 1881 and 1930 and followed from birth until age 80. In the setting of home deliveries, midwives strictly followed hygiene instructions and monitored the health of the mothers and newborns for 3 weeks after birth, and the study observes these individual-level treatments. The results from empirical strategies controlling for observables, using instrumental variables and mother fixed effects are consistent. This paper first finds that treatment by qualified midwives at birth reduced neonatal mortality. It further concludes that individuals treated by qualified midwives at birth had substantially lower mortality from cardiovascular diseases and diabetes at ages 40–80 and that males had lower morbidity and better skills at ages 19–21 than those treated by traditional birth attendants.

Lazuka, V. 2016, Fighting infectious disease: Evidence from Sweden 1870-1940, Population and Development Review 42(1), pp.27–52 (with Quaranta, L. and Bengtsson, T). DOI 10.1111/j.1728-4457.2016.00108.x

Abstract: Even more than in developing countries today, public health strategies to fight infectious disease in the past focused on the prevention of new infections by stopping their spread. These strategies were motivated by new insights into the causes of disease and the modes of transmission in the mid-nineteenth century. By combining longitudinal individual-level data on 17,000 children in a rural/semi-urban region in southern Sweden with local community data on public health investments, we explore the effects of the establishment of isolation hospitals and improved midwifery on mortality before the age 15. Using a difference-in-differences approach, we find that the establishment of isolation hospitals in the mid-1890s was successful in reducing child mortality, while increases in the number of qualified midwives after the 1900s led to a decrease in infant mortality. In both cases, rates fell by more than 50 percent.

Lazuka, V., 2017. Defeating Disease: The Lasting Effects of Public Health and Medical Breakthroughs between 1880 and 1945 on Health and Income in Sweden. Doctoral Dissertation. Lund: Media-Tryck, Lund University. Doctoral Dissertation Lazuka

Abstract: This thesis has the general aim of exploring the role of public health and medical innovations between 1880 and 1945, targeting infectious diseases, in health and income improvements in Sweden throughout the twentieth century. It applies methods of causal inference to longitudinal individual-level data from both local and national datasets combined with multisource archival data on the implementation of reforms. The bacteriological discoveries of the latter part of the nineteenth century helped the public to target infectious diseases through isolation, disinfection and treatment with antibiotics. The studies of this thesis show that health interventions have had a sizable role in the contemporaneous decline in infectious disease rates. Moreover, these studies find that by reducing the likelihood of infection, societal health measures led to beneficial consequences for the income and long-term health of the affected cohorts, extending through old age.

This thesis therefore supports the endogenous growth theory, which posits an interaction between health improvements in early childhood and health technology, based on application of the germ theory of disease, as a determinant of economic growth in the long run. Although the health benefits due to this dynamic process cannot be viewed as a main driver of economic growth, societal health investments nonetheless led to income growth sufficient to yield a high rate of return on the investment. The cause – that is, the reforms under study that are targeting infectious disease – and the consequence, reductions in the rates of specific chronic diseases in adulthood and old age, point to the inflammation mechanisms behind the lasting effects. The studies also suggest that the early neonatal period and infancy are the critical period for intervening such processes.