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

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.