Infant health impacts of freshwater algal blooms: Evidence from an invasive species natural experiment

Economists are increasingly interested in causally interpretable estimates of environmental health externalities, particularly on infant health. This paper focuses on a specific case by investigating microcystin, a toxin produced by freshwater blue-green algal blooms. We exploit a natural experiment caused by a zebra mussel die-off in a large lake located in the state of Michigan, USA to identify changes in microcystin-related infant outcomes surrounding the lake. Using both the synthetic control method and a difference-in-differences strategy, we find that instances of low birth weight around the lake fell by 1.4 percentage points after lake water quality improved. Along the intensive margin, birth weight and length of gestation increased by 17.1 g and 0.47 weeks, respectively. Improvements to low birth weight result in $768,500 in average annual hospitalization cost savings. Many robustness and falsification tests are performed including using both annual and monthly data and accounting for possible weather confounders and seasonality. Results suggest that microcystin can affect infant health at levels below current water advisory guidelines.