Working Paper: NBER ID: w21263
Authors: Marcella Alsan; Claudia Goldin
Abstract: We explore the first period of sustained decline in child mortality in the U.S. and provide estimates of the independent and combined effects of clean water and effective sewerage systems on under-five mortality. Our case is Massachusetts, 1880 to 1920, when authorities developed a sewerage and water district in the Boston area. We find the two interventions were complementary and together account for approximately one-third of the decline in log child mortality during the 41 years. Our findings are relevant to the developing world and suggest that a piecemeal approach to infrastructure investments is unlikely to significantly improve child health.
Keywords: Child Mortality; Water Infrastructure; Sewerage Systems; Public Health
JEL Codes: H51; I15; J1; N3
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Safe water systems + Sewerage interventions (Q25) | Child under-five mortality (J13) |
| Sewerage interventions (H76) | Child under-five mortality (J13) |
| Safe water systems (Q25) | Child under-five mortality (J13) |
| Safe water systems + Sewerage interventions (Q25) | Child mortality reduction in municipalities with higher population growth (J11) |
| Safe water systems + Sewerage interventions (Q25) | Child mortality reduction in certain foreign-born groups (J11) |
| Safe water systems + Sewerage interventions (Q25) | Decline in child mortality from gastrointestinal diseases (I12) |
| Safe water systems + Sewerage interventions (Q25) | Negligible effects on non-waterborne disease mortality (I12) |