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Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Epidemic
Abstract below; full text is at http://www.nber.org/papers/w21635.pdf
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.