Nurses, doctors, and mortality: the effectiveness of early health professionals in rural Finland, 1880-1938

Abstract

This article estimates the mortality effects of introducing modern health professionals in rural Finnish municipalities in the years 1880 to 1938 using panel data with approximately 25,000 observations over 423 population clusters. Our results show that ambulatory nurses had a more significant impact on mortality than municipal doctors. The effect of doctors depended on their proximity to the population. Qualitative evidence suggests that a superior capacity to influence behavior in communities mattered more than treatment or medical knowledge in the pre-biomedical context. Doctors consequently advocated for the hiring of more nurses. Their estimated contribution to mortality decline still remained modest.