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What Explains Cross-City Variation in Mortality During the 1918 Influenza Pandemic? Evidence from 438 U.S. Cities

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  • Clay, Karen

    (Carnegie Mellon University)

  • Lewis, Joshua

    (University of Montreal)

  • Severnini, Edson R.

    (Carnegie Mellon University)

Abstract

Disparities in cross-city pandemic severity during the 1918 Influenza Pandemic remain poorly understood. This paper uses newly assembled historical data on annual mortality across 438 U.S. cities to explore the determinants of pandemic mortality. We assess the role of three broad factors: i) pre-pandemic population health and poverty, ii) air pollution, and iii) the timing of onset and proximity to military bases. Using regression analysis, we find that cities in the top tercile of the distribution of pre-pandemic infant mortality had 21 excess deaths per 10,000 residents in 1918 relative to cities in the bottom tercile. Similarly, cities in the top tercile of the distribution of proportion of illiterate residents had 21.3 excess deaths per 10,000 residents during the pandemic relative to cities in the bottom tercile. Cities in the top tercile of the distribution of coal-fired electricity generating capacity, an important source of urban air pollution, had 9.1 excess deaths per 10,000 residents in 1918 relative to cities in the bottom tercile. There was no statistically significant relationship between excess mortality and city proximity to World War I bases or the timing of onset. Together the three statistically significant factors accounted for 50 percent of cross-city variation in excess mortality in 1918.

Suggested Citation

  • Clay, Karen & Lewis, Joshua & Severnini, Edson R., 2019. "What Explains Cross-City Variation in Mortality During the 1918 Influenza Pandemic? Evidence from 438 U.S. Cities," IZA Discussion Papers 12177, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp12177
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    References listed on IDEAS

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    Cited by:

    1. Clay, Karen & Lewis, Joshua & Severnini, Edson R. & Wang, Xiao, 2020. "The Value of Health Insurance during a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality," IZA Discussion Papers 13200, Institute of Labor Economics (IZA).
    2. Slusky, David J.G. & Zeckhauser, Richard J., 2021. "Sunlight and Protection Against Influenza," Economics & Human Biology, Elsevier, vol. 40(C).
    3. Arthi, Vellore & Parman, John, 2021. "Disease, downturns, and wellbeing: Economic history and the long-run impacts of COVID-19," Explorations in Economic History, Elsevier, vol. 79(C).
    4. Brzezinski, Michal, 2021. "The impact of past pandemics on economic and gender inequalities," Economics & Human Biology, Elsevier, vol. 43(C).
    5. Bruna Morais Guidetti & Paula Carvalho Pereda, Edson Roberto Severnini, 2021. "Health Shocks under Hospital Capacity Constraints: Evidence from Air Pollution in São Paulo, Brazil," Working Papers, Department of Economics 2021_05, University of São Paulo (FEA-USP).
    6. Remi Jedwab & Noel D. Johnson & Mark Koyama, 2020. "The Economic Impact of the Black Death," Working Papers 2020-14, The George Washington University, Institute for International Economic Policy.
    7. Guidetti, Bruna & Pereda, Paula & Severnini, Edson R., 2020. "Health Shocks under Hospital Capacity Constraint: Evidence from Air Pollution in Sao Paulo, Brazil," IZA Discussion Papers 13211, Institute of Labor Economics (IZA).
    8. Basco, Sergi & Domenech, Jordi & Rosés, Joan R., 2021. "Unequal Mortality during the Spanish Flu," CEPR Discussion Papers 15783, C.E.P.R. Discussion Papers.
    9. Basco, Sergi & Domenech, Jordi & Rosés, Joan R., 2021. "Unequal Mortality during the Spanish Flu," CEPR Discussion Papers 15783, C.E.P.R. Discussion Papers.
    10. Scott A. Carson, 2020. "Biological Differences between Late 19th and Early 20th Century Urban and Rural Residence," CESifo Working Paper Series 8523, CESifo.
    11. Brian Beach & Karen Clay & Martin H. Saavedra, 2020. "The 1918 Influenza Pandemic and its Lessons for COVID-19," NBER Working Papers 27673, National Bureau of Economic Research, Inc.
    12. Armillei, Francesco & Filippucci, Francesco & Fletcher, Thomas, 2021. "Did Covid-19 hit harder in peripheral areas? The case of Italian municipalities," Economics & Human Biology, Elsevier, vol. 42(C).
    13. Scott A. Carson, 2020. "Female and Male Body Mass, Height, and Weight during US Economic Development: 1860s-1930s," CESifo Working Paper Series 8447, CESifo.
    14. Daniel L. Mendoza & Tabitha M. Benney & Rajive Ganguli & Rambabu Pothina & Benjamin Krick & Cheryl S. Pirozzi & Erik T. Crosman & Yue Zhang, 2020. "Understanding the Relationship between Social Distancing Policies, Traffic Volume, Air Quality, and the Prevalence of COVID-19 Outcomes in Urban Neighborhoods," Papers 2008.01828, arXiv.org.
    15. David Benatia & Raphael Godefroy & Joshua Lewis, 2020. "Estimating COVID-19 Prevalence in the United States: A Sample Selection Model Approach," Cahiers de recherche 08-2020, Centre interuniversitaire de recherche en économie quantitative, CIREQ.
    16. Colvin, Christopher L. & McLaughlin, Eoin, 2021. "Death, demography and the denominator: Age-adjusted Influenza-18 mortality in Ireland," Economics & Human Biology, Elsevier, vol. 41(C).
    17. Tamara Power & Denise Wilson & Odette Best & Teresa Brockie & Lisa Bourque Bearskin & Eugenia Millender & John Lowe, 2020. "COVID‐19 and Indigenous Peoples: An imperative for action," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(15-16), pages 2737-2741, August.
    18. Amanda Guimbeau & Nidhiya Menon & Aldo Musacchio, 2020. "The Brazilian Bombshell? The Long-Term Impact of the 1918 Influenza Pandemic the South American Way," NBER Working Papers 26929, National Bureau of Economic Research, Inc.
    19. Amuedo-Dorantes, Catalina & Borra, Cristina & Rivera-Garrido, Noelia & Sevilla, Almudena, 2021. "Early adoption of non-pharmaceutical interventions and COVID-19 mortality," Economics & Human Biology, Elsevier, vol. 42(C).
    20. Franke, Richard, 2021. "Poverty, pollution, and mortality: The 1918 influenza pandemic in a developing German economy," MPRA Paper 107570, University Library of Munich, Germany.

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    More about this item

    Keywords

    influenza; pandemic; mortality; air pollution;
    All these keywords.

    JEL classification:

    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-
    • N52 - Economic History - - Agriculture, Natural Resources, Environment and Extractive Industries - - - U.S.; Canada: 1913-
    • N72 - Economic History - - Economic History: Transport, International and Domestic Trade, Energy, and Other Services - - - U.S.; Canada: 1913-
    • Q40 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Energy - - - General
    • Q53 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Air Pollution; Water Pollution; Noise; Hazardous Waste; Solid Waste; Recycling
    • O13 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Agriculture; Natural Resources; Environment; Other Primary Products

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