Deprivation and Disease in Early Twentieth-Century America

Abstract

This paper explores how early life exposure to poverty and want adversely affects later life health outcomes. In particular, it examines how exposure to crowded housing conditions and impure drinking water undermines long-term health prospects and increases the risk of age-related pathologies such as cancer, heart disease, kidney disease, and stroke. Exploiting city-level data from early-twentieth century America, evidence is presented that cities with unusually high rates of typhoid fever in 1900 had elevated rates of heart and kidney disease fifteen years later; also cities with unusually high rates of tuberculosis in 1900 had elevated rates of cancer and stroke fifteen years later. The estimated coefficients suggest that eradicating typhoid fever (through water purification) and tuberculosis (through improved housing and nutrition) would have reduced later death rates from heart disease, cancer, stroke, and kidney disease by 23 to 35 percent.

Long-run effects on longevity of a nutritional shock early in life: The Dutch Potato famine of 1846–1847

“…Economic conditions may be related to adverse work and housing conditions at birth, to possible social disruptions or to a poorer public health environment. For instance, Clay and Troesken (2006) show evidence of adverse effects of crowded housing and impure drink water on later life health outcomes.…”

The Engine and the Reaper: Industrialization and Mortality in Late Nineteenth Century Japan

“…12 Countering these studies is research that finds no causal link between income and life expectancy starting in the nineteenth century (Lindert 1983), and the interplay between nutritional intake and diseases regardless of how the latter are carried (Preston and van de Walle 1978). Around the turn of the twentieth century, despite a relative undersupply of water treatment and physicians, American mortality rates in rural areas declined (Komlos 1998;Higgs 1973) population and housing density (Meeker 1972;Preston and van de Walle 1978;Clay and Troesken 2006). Healthier living environments via improved hygienic practices in Europe over the same period contributed more strongly to adult heights compared with increased income and education (Szreter and Mooney 1998;Millward and Baten 2010;Hatton 2014).…”