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Do Pandemics Change Healthcare? Evidence from the Great Influenza

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  • Rui Esteves
  • Kris James Mitchener
  • Peter Nencka
  • Melissa A. Thomasson

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.

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  • Rui Esteves & Kris James Mitchener & Peter Nencka & Melissa A. Thomasson, 2022. "Do Pandemics Change Healthcare? Evidence from the Great Influenza," NBER Working Papers 30643, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:30643
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    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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