TY - JOUR

T1 - Universal Early-Life Health Policies in the Nordic Countries

AU - Wüst, Miriam

N1 - Funding Information: In the early 1930s, the previously declining infant mortality rate stalled at around 3 percent in Norway and 5–6 percent in Denmark and Sweden (Bütikofer, Løken, and Salvanes 2019; Wüst 2012; Bhalotra, Karlsson, and Nilsson 2017), with a considerable share of mortality being post-neonatal and due to preventable causes related to improper infant care. To decrease infant mortality and to confront demographic concerns related to stagnating fertility rates, the Danish National Health Service initiated the Danish home visiting program, rolled out from 1937 onwards (following a small Danish trial funded by the US Rockefeller Foundation). The program provided around 10 visits in the first year of the child’s life for all families, during which nurses promoted proper infant nutrition (especially breastfeeding), educated parents in infant care, monitored child health and development, and referred ill infants to additional care. Sweden introduced a similar policy in an experiment in the 1931–1933 period in a set of 59 municipalities, selected to be broadly representative for Sweden. The trial introduced home visits and visits at health stations with physician and nurse staff. Cohort eligibility rules in the trial led to differential exposure of mothers and infants with either prenatal care, first-year well-infant care, or a combination of the two. In Norway, well-infant care centers, run by nongovernmental organizations and co-funded with local and state funding, were rolled-out. From 1914 onwards, centers expanded families’ access to health checks, immunizations, health information, and referrals of ill infants to doctors.8 Funding Information: ■ I thank Hans Henrik Sievertsen, Hanna Mühlrad, Timothy Taylor, and the editors Heidi Williams, Nina Pavcnik, and Erik Hurst for very helpful comments and suggestions. I gratefully acknowledge financial support from the Independent Research Fund Denmark, grant 8106-00003B.

PY - 2022

Y1 - 2022

N2 - Given mounting evidence on the negative impact of early-life shocks for the wellbeing of people over the life course, a growing economics literature studies whether early-life policies have symmetric positive effects. This paper zooms in on research on this topic from the Nordic countries, where all families have access to a comprehensive set of early-life health programs, including prenatal, maternity, and well-infant care. I describe this Nordic model of universal early-life health policies and discuss the existing evidence on its causal effects from two categories of studies. First, studying the introduction of universal policies, research has documented important short- and long-run benefits for the health, education, and labor market trajectories of treated cohorts. Second, exploiting modern-day changes to policy design, research for now documents short- and medium-run impacts of universal care on primarily maternal and child health as well as parental investment behaviors. I conclude with directions for future research.

AB - Given mounting evidence on the negative impact of early-life shocks for the wellbeing of people over the life course, a growing economics literature studies whether early-life policies have symmetric positive effects. This paper zooms in on research on this topic from the Nordic countries, where all families have access to a comprehensive set of early-life health programs, including prenatal, maternity, and well-infant care. I describe this Nordic model of universal early-life health policies and discuss the existing evidence on its causal effects from two categories of studies. First, studying the introduction of universal policies, research has documented important short- and long-run benefits for the health, education, and labor market trajectories of treated cohorts. Second, exploiting modern-day changes to policy design, research for now documents short- and medium-run impacts of universal care on primarily maternal and child health as well as parental investment behaviors. I conclude with directions for future research.

KW - Faculty of Social Sciences

KW - National government expenditures and health

KW - health behavior

KW - Fertility

U2 - 10.1257/jep.36.2.175

DO - 10.1257/jep.36.2.175

M3 - Journal article

AN - SCOPUS:85131414038

VL - 36

SP - 175

EP - 198

JO - Journal of Economic Perspectives

JF - Journal of Economic Perspectives

SN - 0895-3309

IS - 2

ER -