A core challenge for healthcare systems is ensuring timely care for critical conditions while efficiently managing lower-complexity cases. Hospitals, often overburdened by both, struggle to balance these demands and allocate resources effectively. Many countries have responded by introducing alternative 24/7 facilities to relieve hospital strain and improve patient outcomes, yet evidence on their impact remains limited. We evaluate the introduction of freestanding Emergency Care Centers (UPAs) within Brazil’s publicly funded health system, leveraging rich administrative data. We find that UPAs reduced hospital outpatient procedures by 30% and hospital admissions for ambulatory-sensitive conditions by 24–37%, enabling hospitals to focus on more complex cases, such as surgeries and obstetric admissions, which increased by 25%. We see a 13% reduction in inpatient mortality, particularly in intensive care and for conditions best suited to hospital treatment. While some deaths were displaced to UPAs, there was a decline in population-level mortality of 1.8%, albeit this is not statistically significant. Our findings show how an intermediate tier of emergency care reshapes patient sorting, alleviates hospital congestion, and improves hospital performance in an overstretched public health system.

We leverage the introduction of the first antibiotic therapies in 1937 to examine the long run effects of early childhood pneumonia on adult educational attainment, employment, income, and work-related disability. Using census data, we document large average gains on all outcomes, alongside substantial heterogeneity by race and gender. On average, Black men exhibit smaller schooling gains than white men but larger employment and earnings gains. Among Black men (and women), we identify a pronounced gradient in gains linked to systemic racial discrimination in the pre–Civil Rights era: individuals born in more discriminatory Jim Crow states realized much smaller gains than those born in less discriminatory states. There is no similar gradient among white Americans. Women of both races exhibit smaller education and earnings gains than men on average, consistent with cultural and institutional barriers to women’s work. Our findings highlight the role of opportunities in shaping the extent to which investments in early-life health translate into longer run economic gains.

Mental health disorders tend to emerge in childhood, with half starting by age 14. This makes early intervention important, but treatment rates are low, and antidepressant treatment for children remains controversial since an FDA warning in 2004 that highlighted adverse effects. Linking individuals across Danish administrative registers, we provide some of the first evidence of impacts of antidepressant treatment in childhood on objectively measured mental health indicators and economic outcomes over time, and the first attempt to investigate under- vs overtreatment. Leveraging conditional random assignment of patients to psychiatrists with different prescribing tendencies, we find that treatment during ages 8-15 improves test scores at age 16, particularly in Math, increases enrollment in post-compulsory education at age 18, and that it leads to higher employment and earnings and lower welfare dependence at ages 25–30. We demonstrate, on average, a reduction in suicide attempts, self-harm, and hospital visits following AD initiation. The gains to treatment are, in general, larger for low SES children, but they are less likely to be treated. Using a marginal treatment effects framework and Math scores as the focal outcome, we show positive returns to treatment among the untreated. Policy simulations confirm that expanding treatment among low SES children (and boys) generates substantial net benefits, consistent with under-treatment in these groups. Our findings underscore the potential of early mental health treatment to improve longer term economics outcomes and reducing inequality.