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Pandemics’ Backlash: The Effects of the 1918 Influenza on Health Attitudes and Behavior

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  • Christian Ochsner
  • Lukas Schmid

Abstract

We study the effects of the largest adverse health shock in modern medicine - the 1918 influenza pandemic - on subsequent shifts in health-related attitudes and behavior and future-oriented policies. Our analysis builds upon self-digitized, individual-level death-register excerpts, vaccination records, and popular vote counts. We find that greater exposure to influenza leads to a decline in societal support for public health measures at the aggregate level, mainly triggered by deceased peers. However, individual-level data reveal increased vaccination rates in families who experienced influenza-related deaths. These differences did not exist before the pandemic. Our findings link to a U-shaped relationship between suffering from the pandemic and support for effective health policies. Places with predominantly indirectly-affected families drive the aggregate backlash. This challenges the idea that past health shocks improve life expectancy through societal learning.

Suggested Citation

  • Christian Ochsner & Lukas Schmid, 2025. "Pandemics’ Backlash: The Effects of the 1918 Influenza on Health Attitudes and Behavior," CESifo Working Paper Series 11903, CESifo.
    • Handle: RePEc:ces:ceswps:_11903
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    More about this item

    Keywords

    health behavior; health attitudes; 1918 influenza pandemic; mistrust;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • N34 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Europe: 1913-

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