The Effectiveness of Early Health Professionals in Rural Finland, 1880-1938

Sakari Saaritsa, University of Helsinki
Eero Simanainen, University of Helsinki
Markus Ristola, University of Helsinki

This paper analyses the mortality effects of different types of early health professionals introduced in Finnish rural municipalities in 1880-1938 using a new panel data with c. 25 000 observations. Our results suggest that female ambulatory nurses had a more significant role in reducing overall mortality than doctors. The effectiveness of doctors depended on the proximity of the service involved, with resident municipal doctors showing an effect, but those shared between several municipalities or state hired regional doctors working in peripheral areas showing none. The value of working under the supervision of a doctor for a nurse likewise depended on the type of doctor. Controlling for local mortality trends removes all association of mortality decline with doctors, but not with nurses. Drawing on qualitative evidence, we explain this by the capacity of the nurses to influence behavior in communities, which mattered more than treatment or impersonal public information campaigns in the pre-biomedical context.

No extended abstract or paper available

 Presented in Session 120. Health, Public Intervention and Insurance