Pandemics: Research from Economic History

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s the world grapples with a pandemic, informed views based on facts and evidence have become all the more important. Economic history is a uniquely well-suited discipline to provide insights into the costs and consequences of rare events, such as pandemics, as it combines the tools of an economist with the long perspective and attention to context of historians. The editors of the main journals in economic history have thus gathered a selection of the recently-published articles on pandemics, disease and public health, generously made available by publishers to the public, free of access, so that we may continue to learn from the decisions of humans and policy makers confronting earlier episodes of widespread disease and pandemics.

Generations of economic historians have studied disease and its impact on societies across history. However, as the discipline has continued to evolve with improvements in both data and methods, researchers have uncovered new evidence about episodes from the distant past, such as the Black Death, as well as more recent global pandemics, such as the Spanish Influenza of 1918.

Pandemics and the Economy

The ways in which societies and economies are affected by repeated pandemics is a question that historians have struggled to understand. Paolo Malanima provides a detailed analysis of how Renaissance Italy was shaped by the impact of plague in his 2018 essay, “Italy in the Renaissance: A Leading Economy in the European Context, 1350-1550, while Guido Alfani further demonstrates how the Italian peninsula struggled to recover after experiencing pervasive mortality during the seventeenth century.

Pandemics cause multiple changes to the economic environment which necessitates a multifaceted response by government. In his 2007 essay for the Economic History Review, Samuel Cohn examines the oppressive nature of these reactions in his luminous study of the way European governments sought to prevent workers benefiting from the increased demand for their labor following the Black Death.

Richard Easterlin’s panoramic overview of mortality shows that government policy was critical in reducing levels of mortality from the early nineteenth century. He demonstrates that economic growth by itself did not lift life expectancy. Easterlin’s major paper illuminates the essential contribution of public intervention to health in modern societies.

Does strict health regulation save lives? In their 2004 essay for The Journal of Economic History, Alan Olmstead and Paul Rhode respond to this question in the affirmative, showing how the US federal government succeeded in lowering the spread of tuberculosis by establishing controls on cattle in the early part of the twentieth century. Their analysis has considerable contemporary relevance: only robust and universal controls saved lives.

Human society has achieved enormous gains in life expectancy over the last two centuries. Part of the explanation for this improvement was improvements in key infrastructure. However, as Daniel Gallardo‐Albarrán demonstrates in his recent essay, “Sanitary infrastructures and the decline of mortality in Germany, 1877–1913,” this was not simply a question of ‘dig and save lives’, because it was the combination of types of structure — water and sewers — that mattered.

One of the big goals of economic historians has been to measure the multiple benefits of public health interventions. Brian Beach, Joseph Ferrie, Martin Saavedra, and Werner Troesken provide a brilliant example of how novel statistical techniques allow us to determine the gains from one such intervention: water purification. In their 2016 essay, “Typhoid Fever, Water Quality, and Human Capital Formation,” they show how the long-term impacts of reducing levels of disease by improving water quality were large when measured in education and income, and not just lives saved.

What was it that allowed European societies to largely defeat tuberculosis (TB) in the second half of the twentieth century? In an ambitious paper for the European Review of Economic History, Sue Bowden, João Tovar Jalles, Álvaro Santos Pereira, and Alex Sadler, show that a mix of factors explains the decline in TB: nutrition, living conditions, and the supply of healthcare.

Patterns of Mortality

The rich and complex body of historical work on pandemics is carefully surveyed by Guido Alfani and Tommy Murphy who provide an excellent guide to the economic, social, and demographic impact of plagues in human history in their 2017 essay, “Plague and Lethal Epidemics in the Pre-Industrial World.”

The impact of pandemics varies over time and few studies have shown this so clearly as the penetrating article by Neil Cummins, Morgan Kelly and Cormac Ó Gráda. In their 2016 article, “Living Standards and Plague in London, 1560–1665,” they provide a detailed map of how the plague evolved in sixteenth and seventeenth century London to reveal who was most heavily burdened by this contagion. Plagues shaped the history of nations and, indeed, global history, but we must not assume that the impact of plagues was as devastating as we might assume. In a classic piece of historical detective work, for instance, Ann Carlos and Frank Lewis show that mortality among native Americans in the Hudson Bay area was much lower than historians had suggested.

The effects of disease reflect a complex interaction of individual and social factors. In their 2018 paper, “Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic,” Karen Clay, Joshua Lewis and Edson Severnini explain how both air pollution and influenza were a deadly combination during the 1918 epidemic. They show how US cities that were heavy users of coal had all-age mortality rates that were approximately 10 percent higher than those with lower rates of coal use.

Romola Davenport, Leonard Schwarz and Jeremy Boulton provide a remarkable analysis of how one of the great killers, smallpox, evolved during the eighteenth century. In their 2011 essay, “The Decline of Adult Smallpox in Eighteenth‐Century London,” they concluded that it was a change in the transmissibility of the disease itself that mattered most for its impact.

The question of which sections of society experienced the heaviest burden of sickness during outbreaks of disease outbreaks has long troubled historians and epidemiologists. Outsiders and immigrants were often blamed for disease outbreaks. In their 1995 essay in Explorations in Economic History, Jonathan Pritchett and Insan Tunali show that poverty and immunisation, not immigration, explain who was infected during the Yellow Fever epidemic in 1853 New Orleans.

The Long Run Consequences of Pandemics

The way pandemics have affected families is complex. In his 2015 essay, “Childhood Health and Sibling Outcomes: Nurture Reinforcing Nature during the 1918 Influenza Pandemic,” John Parman wrestles with one of the most difficult issues — how parents respond to the harms caused by exposure to a pandemic. He shows that parents chose to concentrate resources on the children who were not affected by exposure to influenza in 1918, which reinforced the differences between their children.

Martin Saavedra addresses a related question: how did exposure to disease in early childhood affect life in the long run? In his paper, “Early-Life Disease Exposure and Occupational Status: The Impact of Yellow Fever during the 19th Century,” Saavedra uses US census data to show that children of immigrants who were exposed to yellow fever in the womb or early infancy, did less well in later life than their peers, because they were only able to secure lower-paid employment.

One of the great advantages of historical research is its ability to reveal how the experiences of disease over a lifetime generates cumulative harms. Javier Birchenall’s extraordinary paper, “Airborne Diseases: Tuberculosis in the Union Army,” shows how soldiers’ exposure to disease during the American Civil War increased the probability they would contract tuberculosis later in life.

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If you wish to read further, other papers on this topic are available on the journal websites:

Image: Emergency hospital during influenza epidemic, Camp Funston, Kansas. Available at Wikimedia Commons.

This article was originally published by The Long Run and is reprinted here with permission of the Economic History Society.