Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic

53 Pages Posted: 12 Oct 2015 Last revised: 12 Feb 2022

See all articles by Karen Clay

Karen Clay

Carnegie Mellon University - H. John Heinz III School of Public Policy and Management; National Bureau of Economic Research (NBER)

Joshua Lewis

University of Montreal

Edson Severnini

Carnegie Mellon University

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Date Written: October 2015

Abstract

The 1918 Influenza Pandemic killed millions worldwide and hundreds of thousands in the United States. This paper studies the impact of air pollution on pandemic mortality. The analysis combines a panel dataset on infant and all-age mortality with a novel measure of air pollution based on the burning of coal in a large sample of U.S. cities. We estimate that air pollution contributed significantly to pandemic mortality. Cities that used more coal experienced tens of thousands of excess deaths in 1918 relative to cities that used less coal with similar pre-pandemic socioeconomic conditions and baseline health. Factors related to poverty, public health, and the timing of onset also affected pandemic mortality. The findings support recent medical evidence on the link between air pollution and influenza infection, and suggest that poor air quality was an important cause of mortality during the pandemic.

Suggested Citation

Clay, Karen B. and Lewis, Joshua and Severnini, Edson, Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic (October 2015). NBER Working Paper No. w21635, Available at SSRN: https://ssrn.com/abstract=2672748

Karen B. Clay (Contact Author)

Carnegie Mellon University - H. John Heinz III School of Public Policy and Management ( email )

Pittsburgh, PA 15213-3890
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Joshua Lewis

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Edson Severnini

Carnegie Mellon University

Pittsburgh, PA 15213-3890
United States

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