Water Infrastructure and Health in U.S. Cities
Between 1900 and 1930 typhoid fever and other waterborne diseases were largely eradicated from U.S. cities. This achievement required a mix of technological, scientific, economic, and bureaucratic innovations. This article examines how the interaction of those forces influenced water and sanitary infrastructure provision during the 19th and early 20th centuries. I show the sharp link between infrastructure investments and declines in waterborne disease and discuss how that relationship informs the methodological approaches one should use to assess the impact of sanitary investments on urban development. Finally, I review the literature on the social returns to eliminating the threat of waterborne disease. The evidence suggests the benefits of infrastructure investment far exceeded the costs.
This article indirectly benefited from many conversations that I had with Werner Troesken. Werner's enthusiasm for sanitation and health was infectious, and I am grateful to have had the opportunity to work with him. I am also thankful for feedback from Walker Hanlon, Martin Saavedra, the editor (Laurent Gobillon) and two anonymous referees. The views expressed herein are those of the author and do not necessarily reflect the views of the National Bureau of Economic Research.