Long-Term Effects of Access to Health Care: Medical Missions in Colonial India

We study the long-term effect of access to health care on individuals’ health status by investigating the relationship between the proximity to a Protestant medical mission in colonial India and current health outcomes. We use individuals’ anthropometric indicators to measure health status and geocoding tools to calculate the distance between the location of individuals today and Protestant health facilities founded in the nineteenth century. We exploit variation in activities of missionary societies and use an instrumental variable approach to show that proximity to a Protestant medical mission has a causal effect on individuals’ health status. We find that a 50 percent reduction in the distance from a historical medical facility increases current individuals’ body mass index by 0.4. We investigate some potential transmission channels and we find that the long-run effect of access to health care is not driven by persistence of infrastructure, but by improvements in individuals’ health potential and changes in hygiene and health habits.