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. 2020 Oct:78:101341.
doi: 10.1016/j.eeh.2020.101341. Epub 2020 Jun 19.

The phenomenon of summer diarrhea and its waning, 1910-1930

D Mark Anderson  1 , Daniel I Rees  2 , Tianyi Wang  3
Affiliations

The phenomenon of summer diarrhea and its waning, 1910-1930

D Mark Anderson et al. Explor Econ Hist. 2020 Oct.

Abstract

During the first two decades of the 20th century, diarrheal deaths among American infants and children surged every summer. Although we still do not know what pathogen (or pathogens) caused this phenomenon, the consensus view is that it was eventually controlled through public health efforts at the municipal level. Using data from 26 major American cities for the period 1910-1930, we document the phenomenon of summer diarrhea and explore its dissipation. We find that water filtration is associated with a 15 percent reduction in diarrheal mortality among children under the age of two during the non-summer months, but does not seem to have had an effect on diarrheal mortality during the summer. In general, we find little evidence to suggest that public health interventions undertaken at the municipal level contributed to the dissipation of summer diarrhea.

Keywords: I10; I18; N3; Q54.

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Conflict of interest statement

Declarations of Competing Interest None

Figures

Figure 1.
Figure 1.. Diarrheal Mortality among Children Under the Age of Two.
Notes: Based on data from Mortality Statistics for the 26 cities under study, published by the U.S. Census Bureau. The summer months are defined as June-September.
Figure 2.
Figure 2.. Monthly Diarrheal Mortality Among Children Under the Age of Two per 100,000 Population.
Notes: Based on data from Mortality Statistics for the 26 cities under study, published by the U.S. Census Bureau. The shaded vertical bars indicate the summer months (June-September).
Figure 3.
Figure 3.. Pre- and Post-Filtration Trends in Diarrheal Mortality among Children Under the Age of Two.
Notes: OLS coefficient estimates (and their 90% confidence intervals) are reported, where the omitted category is one year before treatment. The dependent variable is equal to the natural log of the number of diarrheal deaths among children under the age of two per 100,000 population in city c and month t. Controls include the city characteristics listed in Appendix Table 1, interactions between the remaining public health interventions and the Summer and Non-Summer indicators, city fixed effects, month-by-year fixed effects, and city-specific linear trends. Regressions are weighted by city population. Standard errors are corrected for clustering at the city level.
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