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Disease and development : Evidence from hookworm eradication in the American South

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  • Disease and development
  • Bleakley, Hoyt
  • NIH Public Access


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Title Disease and development
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Sub Title

Evidence from hookworm eradication in the American South

Material Type Reports
Author(English)

Bleakley, Hoyt

Publisher

Chicago : NIH Public Access

Date 2018
Journal Title; Vol./Issue Q J Econ:vol.122(no.1)
Pages 58
Subject Country United States(Americas)
Language English
File Type Link
Subject Social Development < Health
Holding NIH Public Access
License

Abstract

This study evaluates the economic consequences of the successful eradication of hookworm disease from the American South. The hookworm-eradication campaign (c. 1910) began soon after (i) the discovery that a variety of health problems among Southerners could be attributed to the disease and (ii) the donation by John D. Rockefeller of a substantial sum to the effort. The Rockefeller Sanitary Commission (RSC) surveyed infection rates in the affected areas (eleven southern states) and found that an average of forty percent of school-aged children were infected with hookworm. The RSC then sponsored treatment and education campaigns across the region. Follow-up studies indicate that this campaign substantially reduced hookworm disease almost
immediately. The sudden introduction of this treatment combines with the cross-area differences in pre-treatment infection rates to form the basis of the identification strategy. Areas with higher levels of hookworm infection prior to the RSC experienced greater increases in school enrollment, attendance, and literacy after the intervention. This result is robust to controlling for a variety of alternative factors, including differential trends across areas, changing crop prices, shifts in certain educational and health policies, and the effect of malaria eradication. No significant contemporaneous results are found for adults, who should have benefited less from the intervention owing to their substantially lower (prior) infection rates. A long-term follow-up of affected cohorts indicates a substantial gain in income that coincided with exposure to hookworm eradication. I also find evidence that eradication increased the return to schooling.