IDEAS home Printed from https://ideas.repec.org/p/boc/bocoec/919.html
   My bibliography  Save this paper

Explaining Declines in US Rural Mortality, 1910-1933: The Role of County Health Departments

Author

Listed:
  • Lauren Hoehn Velasco

    (Boston College)

Abstract

This study estimates the impact of an American rural public health program on child mortality over 1908 to 1933. Due to the absence of sanitation and child-oriented health services outside of urban areas, public and private agencies sponsored county-level health departments (CHDs) throughout the US. Variation in the location and timing of the CHDs identifies improvements in population health, which are captured entirely by children. Mortality declines emerge in infancy and gradually decay through childhood. Adversely affected areas with either an ample population of nonwhites or greater levels of preexisting infectious disease undergo larger reductions in mortality.

Suggested Citation

  • Lauren Hoehn Velasco, 2016. "Explaining Declines in US Rural Mortality, 1910-1933: The Role of County Health Departments," Boston College Working Papers in Economics 919, Boston College Department of Economics.
    • Handle: RePEc:boc:bocoec:919
    as

    Download full text from publisher

    File URL: http://fmwww.bc.edu/EC-P/wp919.pdf
    File Function: main text
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Karen Clay & Werner Troesken & Michael Haines, 2014. "Lead and Mortality," The Review of Economics and Statistics, MIT Press, vol. 96(3), pages 458-470, July.
    2. Stefania Albanesi & Claudia Olivetti, 2016. "Gender Roles and Medical Progress," Journal of Political Economy, University of Chicago Press, vol. 124(3), pages 650-695.
    3. Michael R. Haines, 2001. "The Urban Mortality Transition in the United States, 1800-1940," NBER Historical Working Papers 0134, National Bureau of Economic Research, Inc.
    4. Seema Jayachandran & Adriana Lleras-Muney & Kimberly V. Smith, 2010. "Modern Medicine and the Twentieth Century Decline in Mortality: Evidence on the Impact of Sulfa Drugs," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 118-146, April.
    5. Gamper-Rabindran, Shanti & Khan, Shakeeb & Timmins, Christopher, 2010. "The impact of piped water provision on infant mortality in Brazil: A quantile panel data approach," Journal of Development Economics, Elsevier, vol. 92(2), pages 188-200, July.
    6. Sebastian Galiani & Paul Gertler & Ernesto Schargrodsky, 2005. "Water for Life: The Impact of the Privatization of Water Services on Child Mortality," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 83-120, February.
    7. Rappaport, Jordan, 2007. "Moving to nice weather," Regional Science and Urban Economics, Elsevier, vol. 37(3), pages 375-398, May.
    8. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
    9. Daron Acemoglu & Simon Johnson, 2007. "Disease and Development: The Effect of Life Expectancy on Economic Growth," Journal of Political Economy, University of Chicago Press, vol. 115(6), pages 925-985, December.
    10. Olmstead, Alan L. & Rhode, Paul W., 2004. "An Impossible Undertaking: The Eradication of Bovine Tuberculosis in the United States," The Journal of Economic History, Cambridge University Press, vol. 64(3), pages 734-772, September.
    11. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    12. Higgs, Robert, 1973. "Mortality in rural America, 1870-1920: Estimates and conjectures," Explorations in Economic History, Elsevier, vol. 10(2), pages 177-195.
    13. Dora L. Costa & Matthew E. Kahn, 2015. "Declining Mortality Inequality within Cities during the Health Transition," American Economic Review, American Economic Association, vol. 105(5), pages 564-569, May.
    14. Stefania Albanesi & Claudia Olivetti, 2014. "Maternal health and the baby boom," Quantitative Economics, Econometric Society, vol. 5, pages 225-269, July.
    15. Werner Troesken, 2003. "Municipalizing American Waterworks, 1897--1915," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 19(2), pages 373-400, October.
    16. Vollrath, Dietrich, 2013. "Inequality and school funding in the rural United States, 1890," Explorations in Economic History, Elsevier, vol. 50(2), pages 267-284.
    17. Moehling, Carolyn M. & Thomasson, Melissa A., 2012. "The Political Economy of Saving Mothers and Babies: The Politics of State Participation in the Sheppard-Towner Program," The Journal of Economic History, Cambridge University Press, vol. 72(1), pages 75-103, March.
    18. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    19. David Cutler & Grant Miller, 2005. "The role of public health improvements in health advances: The twentieth-century United States," Demography, Springer;Population Association of America (PAA), vol. 42(1), pages 1-22, February.
    20. William J. Collins & Melissa A. Thomasson, 2004. "The Declining Contribution of Socioeconomic Disparities to the Racial Gap in Infant Mortality Rates, 1920–1970," Southern Economic Journal, John Wiley & Sons, vol. 70(4), pages 746-776, April.
    21. Michael Geruso & Dean Spears, 2018. "Neighborhood Sanitation and Infant Mortality," American Economic Journal: Applied Economics, American Economic Association, vol. 10(2), pages 125-162, April.
    22. Esther Duflo & Michael Greenstone & Raymond Guiteras & Thomas Clasen, 2015. "Toilets Can Work: Short and Medium Run Health Impacts of Addressing Complementarities and Externalities in Water and Sanitation," NBER Working Papers 21521, National Bureau of Economic Research, Inc.
    23. Fogel, Robert W, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," American Economic Review, American Economic Association, vol. 84(3), pages 369-395, June.
    24. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    25. Marcella Alsan & Claudia Goldin, 2019. "Watersheds in Child Mortality: The Role of Effective Water and Sewerage Infrastructure, 1880–1920," Journal of Political Economy, University of Chicago Press, vol. 127(2), pages 586-638.
    26. Hoyt Bleakley, 2010. "Malaria Eradication in the Americas: A Retrospective Analysis of Childhood Exposure," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 1-45, April.
    27. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 73-117.
    28. Price V. Fishback & Werner Troesken & Trevor Kollmann & Michael Haines & Paul W. Rhode & Melissa Thomasson, 2011. "Information and the Impact of Climate and Weather on Mortality Rates during the Great Depression," NBER Chapters, in: The Economics of Climate Change: Adaptations Past and Present, pages 131-167, National Bureau of Economic Research, Inc.
    29. Headey, Derek & Hoddinott, John & Ali, Disha & Tesfaye, Roman & Dereje, Mekdim, 2015. "The Other Asian Enigma: Explaining the Rapid Reduction of Undernutrition in Bangladesh," World Development, Elsevier, vol. 66(C), pages 749-761.
    30. David M. Cutler & Grant Miller, 2006. "Water, Water Everywhere. Municipal Finance and Water Supply in American Cities," NBER Chapters, in: Corruption and Reform: Lessons from America's Economic History, pages 153-183, National Bureau of Economic Research, Inc.
    31. Carolyn Moehling & Melissa Thomasson, 2014. "Saving Babies: The Impact of Public Education Programs on Infant Mortality," Demography, Springer;Population Association of America (PAA), vol. 51(2), pages 367-386, April.
    32. Terris, M., 1976. "The epidemiologic revolution, national health insurance and the role of health departments," American Journal of Public Health, American Public Health Association, vol. 66(12), pages 1155-1164.
    33. Dora L. Costa & Matthew E. Kahn, 2008. "Learning from the Past," NBER Chapters, in: Heroes and Cowards: The Social Face of War, National Bureau of Economic Research, Inc.
    34. Troesken, Werner, 2001. "Race, Disease, And The Provision Of Water In American Cities, 1889–1921," The Journal of Economic History, Cambridge University Press, vol. 61(3), pages 750-776, September.
    35. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    36. Kitchens, Carl, 2013. "A Dam Problem: TVA's Fight Against Malaria, 1926–1951," The Journal of Economic History, Cambridge University Press, vol. 73(3), pages 694-724, September.
    37. Troesken, Werner, 1999. "Typhoid Rates and the Public Acquisition of Private Waterwork, 1880–1920," The Journal of Economic History, Cambridge University Press, vol. 59(4), pages 927-948, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2024. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," American Economic Review, American Economic Association, vol. 114(7), pages 2201-2238, July.
    2. Liam Delaney & Mark E. McGovern & James P. Smith, 2024. "Infant Mortality in Mother and Baby Homes in 20th Century Ireland," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 43(5), pages 1-22, October.
    3. Galofré Vilà, Gregori, 2020. "Quantifying the impact of aid to dependent children: An epidemiological framework⁎," Explorations in Economic History, Elsevier, vol. 77(C).
    4. Philipp Ager & James J Feigenbaum & Casper W Hansen & Hui Ren Tan, 2024. "How the Other Half Died: Immigration and Mortality in U.S. Cities," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(1), pages 1-44.
    5. D. Mark Anderson & Kerwin Kofi Charles & Michael McKelligott & Daniel I. Rees, 2022. "Safeguarding Consumers Through Minimum Quality Standards: Milk Inspections and Urban Mortality, 1880-1910," NBER Working Papers 30063, National Bureau of Economic Research, Inc.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    2. Lauren Hoehn‐Velasco & Elizabeth Wrigley‐Field, 2022. "City health departments, public health expenditures, and urban mortality over 1910–1940," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 929-953, April.
    3. Peter Juul Egedesø & Casper Worm Hansen & Peter Sandholt Jensen, 2020. "Preventing the White Death: Tuberculosis Dispensaries," The Economic Journal, Royal Economic Society, vol. 130(629), pages 1288-1316.
    4. James J. Feigenbaum & Christopher Muller & Elizabeth Wrigley-Field, 2019. "Regional and Racial Inequality in Infectious Disease Mortality in U.S. Cities, 1900–1948," Demography, Springer;Population Association of America (PAA), vol. 56(4), pages 1371-1388, August.
    5. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2024. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," American Economic Review, American Economic Association, vol. 114(7), pages 2201-2238, July.
    6. Philipp Ager & James J Feigenbaum & Casper W Hansen & Hui Ren Tan, 2024. "How the Other Half Died: Immigration and Mortality in U.S. Cities," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(1), pages 1-44.
    7. Sonia R. Bhalotra & Alberto Diaz-Cayeros & Grant Miller & Alfonso Miranda & Atheendar S. Venkataramani, 2017. "Urban Water Disinfection and Mortality Decline in Developing Countries," Working Papers 467, Center for Global Development.
    8. Prados de la Escosura, Leandro, 2023. "Health, income, and the preston curve: A long view," Economics & Human Biology, Elsevier, vol. 48(C).
    9. Anderson, D. Mark & Charles, Kerwin Kofi & Rees, Daniel I., 2018. "Public Health Efforts and the Decline in Urban Mortality," IZA Discussion Papers 11773, Institute of Labor Economics (IZA).
    10. Weil, David N., 2014. "Health and Economic Growth," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 2, chapter 3, pages 623-682, Elsevier.
    11. Brian Beach & Werner Troesken & Nicola Tynan, 2016. "Who Should Own and Control Urban Water Systems? Historical Evidence from England and Wales," NBER Working Papers 22553, National Bureau of Economic Research, Inc.
    12. Marein, Brian, 2023. "Public health departments and the mortality transition in Latin America: Evidence from Puerto Rico," Journal of Development Economics, Elsevier, vol. 160(C).
    13. D. Mark Anderson & Ryan Brown & Kerwin Kofi Charles & Daniel I. Rees, 2016. "The Effect of Occupational Licensing on Consumer Welfare: Early Midwifery Laws and Maternal Mortality," NBER Working Papers 22456, National Bureau of Economic Research, Inc.
    14. Kesztenbaum, Lionel & Rosenthal, Jean-Laurent, 2017. "Sewers’ diffusion and the decline of mortality: The case of Paris, 1880–1914," Journal of Urban Economics, Elsevier, vol. 98(C), pages 174-186.
    15. Gallardo Albarrán, Daniel, 2024. "The Global Sanitary Revolution in Historical Perspective," CEPR Discussion Papers 18754, C.E.P.R. Discussion Papers.
    16. Stefan Bauernschuster & Anastasia Driva & Erik Hornung, 2020. "Bismarck’s Health Insurance and the Mortality Decline [Disease and Development: The Effect of Life Expectancy on Economic Growth]," Journal of the European Economic Association, European Economic Association, vol. 18(5), pages 2561-2607.
    17. Leandro Prados de la Escosura, 2015. "World Human Development: 1870–2007," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 61(2), pages 220-247, June.
    18. Spears, Dean, 2020. "Exposure to open defecation can account for the Indian enigma of child height," Journal of Development Economics, Elsevier, vol. 146(C).
    19. D. Mark Anderson & Kerwin Kofi Charles & Daniel I. Rees, 2018. "Public Health Efforts and the Decline in Urban Mortality," NBER Working Papers 25027, National Bureau of Economic Research, Inc.
    20. Lawson, Nicholas & Spears, Dean, 2016. "What doesn't kill you makes you poorer: Adult wages and early-life mortality in India," Economics & Human Biology, Elsevier, vol. 21(C), pages 1-16.

    More about this item

    Keywords

    mortality; health; development; rural population; demographic transition;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • N31 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: Pre-1913
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O18 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Urban, Rural, Regional, and Transportation Analysis; Housing; Infrastructure

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:boc:bocoec:919. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Christopher F Baum (email available below). General contact details of provider: https://edirc.repec.org/data/debocus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.