The Rise and Fall of Pellagra in the American South

Abstract

Focusing on the first half of the twentieth century, we explore the rise and fall of pellagra (a disease caused by inadequate niacin consumption) in the American South. We first consider the hypothesis that the South’s monoculture in cotton undermined nutrition by displacing local food production. Consistent with this hypothesis, a difference in differences estimation shows that after the arrival of the boll weevil, food production in affected counties rose while cotton production and pellagra rates fell. The results also suggest that after 1937 improved medical understanding and state fortification laws helped eliminate pellagra.

Long-run Impacts of Agricultural Shocks on Educational Attainment: Evidence from the Boll Weevil

“…A third mechanism is suggested by the work of Clay, Schmick, and Troesken (2017), who claim that the diversification of crops following the boll weevil infestation reduced the incidence of a pellagra, a disease caused by having insufficient niacin, by increasing the availability of locally grown vegetables that had higher niacin content than imported foods. If those susceptible to the disease were randomly selected from the population or the disease was not commonly fatal, then we would expect increased health might have some positive effect on educational attainment on average for those surviving to adulthood.…”

Long-Run Impacts of Agricultural Shocks on Educational Attainment: Evidence from the Boll Weevil

“…A third potential mechanism is suggested by the work of Clay, Schmick, and Troesken (2017), who claim that the diversification of crops following the boll weevil infestation reduced the incidence of pellagra, a disease caused by having insufficient niacin, by increasing the availability of locally-grown vegetables that had higher niacin content than imported foods. If those susceptible to the disease were randomly selected from the population or the disease was not commonly fatal, then we would expect increased health might have some positive effect on educational attainment on average for those surviving to adulthood.…”

Chronic Diarrhea in a Drinker: A Breakthrough Case of Pellagra in the US South

“…2 Though pellagra is within the differential diagnosis for chronic diarrhea, it is infrequently the cause and rarely reported in the United Staes. [4][5][6][7] Pellagra is defined as a medical disorder caused by a nutritional deficiency of niacin (vitamin B 3 ). 4,6,8,9 Niacin deficiency may result from inadequate consumption, malabsorption, excess loss, medication side effect, or metabolic derangements.…”