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Do Pandemics Change Healthcare? Evidence from the Great Influenza

Author

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  • Mitchener, Kris
  • Esteves, Rui
  • Nencka, Peter
  • Thomasson, Melissa A

Abstract

Using newly digitized U.S. city-level data on hospitals, we explore how pandemics alter preferences for healthcare. We find that cities with higher levels of mortality during the Great Influenza of 1918-1919 subsequently expanded hospital capacity by more than cities experiencing less influenza mortality: cities in the top half of the mortality distribution increased their count of hospitals by 8-10 percent in the years after the pandemic. This effect persisted to 1960 and was driven by increases in non-governmental hospitals. Growth responded most in richer cities, exacerbating existing inequalities in access to healthcare. We do not find evidence that government- run hospitals or other types of city-level spending related to healthcare responded to pandemic intensity, suggesting that large health shocks do not necessarily lead to increased public provision of health services.

Suggested Citation

  • Mitchener, Kris & Esteves, Rui & Nencka, Peter & Thomasson, Melissa A, 2022. "Do Pandemics Change Healthcare? Evidence from the Great Influenza," CEPR Discussion Papers 17666, C.E.P.R. Discussion Papers.
    • Handle: RePEc:cpr:ceprdp:17666
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    Cited by:

    1. is not listed on IDEAS
    2. Christian Ochsner & Lukas Schmid, 2025. "Pandemics' backlash: The effects of the 1918 influenza on health attitudes and behavior," CERGE-EI Working Papers wp796, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    3. Mona Foertsch & Felix Roesel, 2023. "Public Infrastructure and Regional Resilience: Evidence from the 1918 Spanish Flu in Germany," CESifo Working Paper Series 10705, CESifo.
    4. Dahl, Christian Møller & Hansen, Casper Worm & Jensen, Peter Sandholdt & Karlsson, Martin & Kühnle, Daniel, 2023. "School Closures, Mortality, and Human Capital: Evidence from the Universe of Closures during the 1918 Pandemic in Sweden," CEPR Discussion Papers 18399, C.E.P.R. Discussion Papers.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-

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