Causes of mortality and development: Evidence from large health shocks in 20th century America

Exploiting pre-intervention variation in flu/pneumonia, tuberculosis and maternal mortality, together with time variation arising from medical breakthroughs starting in the late 1930s, this paper studies the aggregate impact of large health shocks across US states. The analysis demonstrates that the shocks influenced income per capita in different ways. While the shock to flu/pneumonia mortality has been conductive for development, the large reduction in the incidence of tuberculosis deaths has been a negative force in the development of US states over the second-half of 20th century. In addition, the decline in maternal mortality has a fragile, but positive relationship with income per capita. Because these specific health shocks affected mortality across the life cycle differently, the evidence here underscores the general tenet of regarding health as multifaceted.