Beyond Treatment Exposure: The Timing of Early Interventions and Children’s Health

Beyond Treatment Exposure: The Timing of Early Interventions and Children’s Health

Hans Sievertsen¹⁻² (with Jonas Lau-Hensen Hirani²⁻³ and Miriam Wüst²⁻³)

1 University of Bristol

2 The Danish Center for Social Sciene Research - VIVE

3 University of Copenhagen

This paper analyzes the impact of the timing of nurse home visiting (NHV) on infant and maternal health. We study universal NHV in Denmark, where nurses (i) monitor and screen infant and post-partum maternal health, (ii) provide information and counselling to new parents, and (iii) refer families with identified problems to other health care professionals. We exploit exogenous variation in the timing of forgone visits induced by the 2008 national nurse strike. Using data on the population of children born in Copenhagen in the period up to the strike and in control years, we show that children (and mothers) who missed early nurse visits after birth have more general practitioner contacts in their first five years of life compared to those who missed visits later. We speak to mechanism for these effects by showing (i) that nurses in control years perform well in identifying health risks during early home visits, and (ii) that children of parents with no educational background in health and childcare and first-parity children drive the health effects. Taken together, our findings provide evidence for the importance of universal screening and timely provision of information and counselling to new parents. A stylized cost-effectiveness calculation confirms that early universal NHV is worth the while.