(previously titled "Hospital Expansion and Health Outcomes: Evidence from the Hill-Burton Program")
This study examines how large-scale public investment in the health care capital stock shapes local health and economic outcomes. I exploit the Hill-Burton Act of 1946–the largest federal program to expand and modernize United States medical facilities–as a quasi-experimental setting. Using newly digitized archival data, I show that Hill-Burton causally increased both the capacity and quality of local hospitals, leading to higher patient utilization and greater physician staffing. Expanded access to care improved mortality rates among the general and infant populations. This investment generated broader spillovers, fostering growth in non-medical employment, patenting, and academic publications. These results demonstrate that public investment in health care capital can improve population health and promote local economic development, highlighting the policy relevance of efforts to improve healthcare infrastructure.
This chapter explores the effect of the Space Race on local economies from 1958 to 1992. Econometric analysis of Space Race expenditures finds that NASA’s research and development produced statistically significant increases in manufacturing value added, employment, and capital accumulation within the space sector on the order of 35-50% across these measures. The effect was concentrated in space-related technologies and did not extend to general-purpose technologies. Despite the increases to these measures, space-sector manufacturers did not experience any productivity gains because manufacturing inputs increased at the same proportion as output. Consequently, the estimated spending multiplier from NASA activity is a modest 0.4, which falls in the range of previous estimates of public expenditure multipliers. The chapter sheds light on the economic effects of the relationship between government-sponsored R&D, technological innovation, and economic growth and offers historical insights into the New Space Economy.
I study how investment in the medical capital stock impacts local innovation. I exploit the Hill-Burton Act of 1946–the largest federal program to expand and modernize United States medical facilities–as a quasi-experimental setting. Using newly digitized archival data, I show that Hill-Burton causally increased patenting applications and the number of academic publications. These results are robust to pre-existing levels of innovation activity and the presence of a top research university.
I study how investment in the medical capital stock impacts the flow of the local and neighboring labor market for medical professionals.