Health inequality: evidence from 19th century Netherlands
dc.contributor.advisor
Thomas, Jonathan
dc.contributor.advisor
Nuevo-Chiquero, Ana
dc.contributor.advisor
Visschers, Ludo
dc.contributor.author
Holthaus Draaijers, Krista L. H.
dc.contributor.sponsor
School of Economics, University of Edinburgh: Graduate Research Scholarship
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dc.date.accessioned
2025-11-10T12:24:17Z
dc.date.available
2025-11-10T12:24:17Z
dc.date.issued
2025-11-10
dc.description.abstract
Persistent health inequality offers a significant opportunity to improve welfare and
productivity, and understanding its causal pathways is key to adequate policy design. In this
thesis, I first review the literature on health inequality in contemporaneous settings to
establish the contribution of studies using historical data such as the ones provided here.
Studying health shocks in a historical setting can illuminate their potentially different
consequences along the development path. Furthermore, the distribution of improvements to
health conditions within the family may play a key role in the evolution of inequality. Using
death, birth, and marriage certificates of two provinces of the Netherlands, I first analyse the
effect on health inequality of a health shock (an undetermined epidemic) in the early 19th
century. Lower socioeconomic status groups were not only more negatively affected by the
shock but also experienced worse health in the aftermath, worsening overall health inequality
among survivors. I also study the so-called birth-order effect (differences in outcomes
between siblings of different orders of birth) on survivability in the 19th and early 20th
centuries and found a small but significant negative effect of older siblings of the same
gender on survivability and a positive effect of older siblings of different gender. However,
this effect did not increase as life conditions improved, and it was not overly present among
any particular socioeconomic group, suggesting relatively equal access to improvements in
health.
en
dc.identifier.uri
https://hdl.handle.net/1842/44152
dc.identifier.uri
http://dx.doi.org/10.7488/era/6676
dc.language.iso
en
en
dc.publisher
The University of Edinburgh
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dc.subject
health inequality
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dc.subject
birth order effect
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dc.subject
Netherlands
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dc.subject
literature review
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dc.subject
19th century
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dc.title
Health inequality: evidence from 19th century Netherlands
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dc.title.alternative
Essays in health inequality: evidence from 19th century Netherlands
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dc.type
Thesis or Dissertation
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dc.type.qualificationlevel
Doctoral
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dc.type.qualificationname
PhD Doctor of Philosophy
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