Good Nurses

Abstract

This paper examines the importance of provider effectiveness in preventive care. We study a 1960s infant home visiting program and use variation in nurse effectiveness in the promotion of breastfeeding early in the infant’s life. Exploiting arbitrary allocation of nurses to families, we show that effective nurses increase mothers' probability of first month exclusive breastfeeding and breastfeeding duration. In the short run, effective nurses impact healthy infant weight development. In the long run, we find no statistically or economically significant impacts of effective nurses on education, labor market and adult health outcomes of children. We find suggestive evidence for (i) small positive impacts for disadvantaged children, and (ii) positive long-run effects of nurses thatincrease breastfeeding at later ages. While nurses may impact families along multiple margins beyond breastfeeding initiation and duration, our results suggest no positive impacts of small increases in breastfeeding duration on long-run outcomes even in a setting with poor counterfactual modes of infant nutrition. Joint paper with Emil Sørensen.