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

Wednesday, 21st of October 2015

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

This paper uses the 1918 influenza pandemic as a natural experiment to examine whether air pollution

affects susceptibility to infectious disease. The empirical analysis combines the sharp timing of the

pandemic with large cross-city differences in baseline pollution measures based on coal-fired electricity

generating capacity for a sample 183 American cities. The findings suggest that air pollution exacerbated

the impact of the pandemic. Proximity to World War I military bases and baseline city health conditions

also contributed to pandemic severity. The effects of air pollution are quantitatively important. Had

coal-fired capacity in above-median cities been reduced to the median level, 3,400-5,860 pandemic-

related infant deaths and 15,575-23,686 pandemic-related all-age deaths would have been averted.

These results highlight the complementarity between air pollution and infectious disease on health,

and suggest that there may be large co-benefits associated with pollution abatement policies.

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