Volha Lazuka’s research while affiliated with Lund University and other places

Exposure to infectious diseases in early life has been linked to increased mortality risk in later life in high-disease settings, such as eighteenth- and nineteenth-century Europe. Less is known about the long-term effects of early-life disease exposure in milder disease environments. This study estimates heterogeneous effects from disease exposure in infancy on later-life mortality in twentieth-century Sweden, by socioeconomic status at birth and sex. Using historical population data for southern Sweden, we study 11,515 individuals who were born in 1905–1929 from age 1 until age 85. We measure exposure to disease using the local post–early neonatal mortality rate in the first 12 months after birth and apply flexible parametric survival models. For females, we find a negative effect on life expectancy (scarring) at ages 1–85 following high disease exposure in infancy, particularly for those born to unskilled workers. For males, we find no negative effect on later-life survival, likely because stronger mortality selection in infancy outweighs scarring. Thus, even as the incidence of infectious diseases declined at the start of the twentieth century, early-life disease exposure generated long-lasting negative but heterogeneous population health effects.

Using data from southern Sweden, this work analyses the development of maternal and infant health in five rural parishes and the town of Landskrona in Scania, Sweden, in the last 110 years. First, we address the overall development of maternal, perinatal and infant health using a range of indicators, such as maternal mortality, neonatal mortality, and stillbirth rates. We also describe how institutional and medical changes reached the town of Landskrona and the surrounding rural areas. Second, we relate the development of maternal and infant health to the institutions and medical innovations available in the area, such as the expansion of hospital facilities, availability of antibiotics and the opening of maternity wards and neonatal intensive care units. We estimate the magnitude of the impact on a range of indicators of mother and infant health using time series analysis.

This study provides new evidence regarding the extent to which medical care mitigates the economic consequences of various health shocks. To obtain causal effects, I focus on the role of medical scientific discoveries and leverage the longitudinal dimension of unique administrative data on adults in Sweden, their partners, and their working-age children. The results indicate that medical innovations strongly mitigate the negative economic consequences of a health shock, including subsequent losses for the individual and close relatives, and income inequalities within these groups. Such mitigating effects are highly heterogeneous across diseases that cause health shocks. These results support the view that the economic repercussions of health shocks have been overlooked, and there is a lack of focus on the efficiency of medical care for specific health conditions.

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.