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The Rise and Fall of Pellagra in the American South

Listed author(s):
  • Karen Clay
  • Ethan Schmick
  • Werner Troesken

The result of insufficient niacin consumption, pellagra caused more deaths than any other nutrition-related disease in American history, and it reached epidemic proportions in the South during the early 1900s. In this paper, we explore the forces that drove the rise and fall of pellagra. Historical observers have long-believed that pellagra stemmed from the South’s monoculture in cotton, which displaced the local production of nutritionally-rich foods. To test this hypothesis, we begin by showing that, at the county level, pellagra rates are positively correlated with cotton production. We then exploit the arrival of the boll weevil—which prompted Southern farmers to begin planting food instead of cotton—to show that this correlation is likely causal. We close by studying how fortification laws passed during the 1940s helped to eliminate pellagra.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 23730.

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Date of creation: Aug 2017
Handle: RePEc:nbr:nberwo:23730
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  1. McGuire, Robert & Higgs, Robert, 1977. "Cotton, corn, and risk in the nineteenth century: Another view," Explorations in Economic History, Elsevier, vol. 14(2), pages 167-182, April.
  2. James Feyrer & Dimitra Politi & David N. Weil, 2017. "The Cognitive Effects of Micronutrient Deficiency: Evidence from Salt Iodization in the United States," Journal of the European Economic Association, European Economic Association, vol. 15(2), pages 355-387.
  3. Gregory T. Niemesh, 2015. "Ironing Out Deficiencies: Evidence from the United States on the Economic Effects of Iron Deficiency," Journal of Human Resources, University of Wisconsin Press, vol. 50(4), pages 910-958.
  4. Depew, Briggs & Fishback, Price V. & Rhode, Paul W., 2013. "New deal or no deal in the Cotton South: The effect of the AAA on the agricultural labor structure," Explorations in Economic History, Elsevier, vol. 50(4), pages 466-486.
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  8. DeCanio, Stephen, 1973. "Cotton “Overproduction” in Late Nineteenth-Century Southern Agriculture," The Journal of Economic History, Cambridge University Press, vol. 33(03), pages 608-633, September.
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  10. Biddle, Jeff E., 2011. "Making Consumers Comfortable: The Early Decades of Air Conditioning in the United States," The Journal of Economic History, Cambridge University Press, vol. 71(04), pages 1078-1094, December.
  11. Kitchens, Carl, 2013. "The effects of the Works Progress Administration's anti-malaria programs in Georgia 1932–1947," Explorations in Economic History, Elsevier, vol. 50(4), pages 567-581.
  12. Karen Clay & Joshua Lewis & Edson Severnini, 2015. "Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic," NBER Working Papers 21635, National Bureau of Economic Research, Inc.
  13. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 73-117.
  14. Cormac Ó Gráda, 1995. "The great Irish famine," Open Access publications 10197/363, School of Economics, University College Dublin.
  15. Dan A. Black & Seth G. Sanders & Evan J. Taylor & Lowell J. Taylor, 2015. "The Impact of the Great Migration on Mortality of African Americans: Evidence from the Deep South," American Economic Review, American Economic Association, vol. 105(2), pages 477-503, February.
  16. Wright, Gavin & Kunreuther, Howard, 1977. "Cotton, corn, and risk in the nineteenth century: A reply," Explorations in Economic History, Elsevier, vol. 14(2), pages 183-195, April.
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