Long-Term Health and Human Capital Effects of Universal Health Care and Mass Literacy: Evidence from Cuba

Giovanni Mellace and Rok Spruk

Papers from arXiv.org

Abstract: We estimate long-run effects of Cuba's 1961 National Health Service and contemporaneous National Literacy Campaign using synthetic-control methods on newly assembled series for 21 former European colonies in the Americas, 1900--2022. Relative to synthetic Cuba, infant mortality falls 15--29 percent and average years of schooling rise 1.5--2 years; both effects are large, persistent, and robust to augmented SCM, synthetic difference-in-differences, interactive fixed effects, and matrix completion. Life-expectancy gains attenuate after 1990, consistent with the post-Soviet Special Period, suggesting that bundled health and literacy reforms permanently raise early-life survival and human capital, with smaller and less robust effects on adult longevity.

Date: 2026-05
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