NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Watersheds in Child Mortality: The Role of Effective Water and Sewerage Infrastructure, 1880 to 1920

Marcella Alsan, Claudia Goldin

NBER Working Paper No. 21263
Issued in June 2015, Revised in May 2018
NBER Program(s):Development of the American Economy, Development Economics

We explore the first period of sustained decline in child mortality in the U.S. and provide estimates of the independent and combined effects of clean water and effective sewerage systems on under-five mortality. Our case is Massachusetts, 1880 to 1920, when authorities developed a sewerage and water district in the Boston area. We find the two interventions were complementary and together account for approximately one-third of the decline in log child mortality during the 41 years. Our findings are relevant to the developing world and suggest that a piecemeal approach to infrastructure investments is unlikely to significantly improve child health.

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Document Object Identifier (DOI): 10.3386/w21263

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