Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic
The 1918 Influenza Pandemic killed millions worldwide and hundreds of thousands in the United States. This paper studies the impact of air pollution on pandemic mortality. The analysis combines a panel dataset on infant and all-age mortality with a novel measure of air pollution based on the burning of coal in a large sample of U.S. cities. We estimate that air pollution contributed significantly to pandemic mortality. Cities that used more coal experienced tens of thousands of excess deaths in 1918 relative to cities that used less coal with similar pre-pandemic socioeconomic conditions and baseline health. Factors related to poverty, public health, and the timing of onset also affected pandemic mortality. The findings support recent medical evidence on the link between air pollution and influenza infection, and suggest that poor air quality was an important cause of mortality during the pandemic.
We thank Martha Bailey, Antonio Bento, Christian Dippel, Walker Hanlon, and seminar participants at the 2015 NBER DAE Summer Meetings, the 2015 CNEH Meetings, the 2015 AERE Summer Conference, the 2015 Annual Meeting of the Population Association of America, McGill, Carnegie Mellon, and USC for valuable comments and suggestions. Edson Severnini thanks the Energy Policy Institute at the University of Chicago for research support and its generous hospitality during his semester-long visit, when part of this project was executed. Clay and Severnini acknowledge financial support from Heinz College and the Berkman Fund at Carnegie Mellon. Lewis acknowledges financial support from the University of Montreal. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
Karen Clay & Joshua Lewis & Edson Severnini, 2018. "Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic," The Journal of Economic History, vol 78(04), pages 1179-1209. citation courtesy of