Working Paper: NBER ID: w23730
Authors: Karen Clay; Ethan Schmick; Werner Troesken
Abstract: We explore the rise and fall of pellagra, a disease caused by inadequate niacin consumption, in the American South, focusing on the first half of the twentieth century. 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.
Keywords: Pellagra; Cotton Monoculture; Niacin Deficiency; Public Health; Agricultural Economics
JEL Codes: I18; N32; N52; Q12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| arrival of the boll weevil (N91) | reductions in pellagra mortality (I12) |
| arrival of the boll weevil (N91) | increased production of niacin-rich foods (L66) |
| high levels of cotton production (L67) | reductions in pellagra mortality (I12) |
| high pellagra mortality (I12) | reductions in pellagra mortality (I12) |
| improved medical understanding of pellagra (I12) | reductions in pellagra mortality (I12) |
| implementation of state fortification laws (D18) | reductions in pellagra mortality (I12) |