Epidemiology Seminar

Monday, September 21, 2015 16:00to17:00
McIntyre Medical Building Room 521, Meakins, 3655 promenade Sir William Osler, Montreal, QC, H3G 1Y6, CA


Pollution, Infectious Disease, and Infant Mortality: Evidence from the 1918 Spanish Influenza Pandemic

Josh Lewis, PhD

Assistant Professor, Department of Economics, Université de Montréal


This paper studies how air pollution affected the severity of the 1918 influenza pandemic. The empirical analysis combines newly digitized data on infant mortality with information on air pollution caused by coal-fired electricity generation for a panel of 195 American cities. We estimate a significant positive effect of local emissions on pandemic-related mortality, but find no relationship between the outbreak and local water quality. These results are consistent with the epidemiology of the influenza virus, which targeted lung function. The estimates imply that differences in air quality can account for roughly one third of the cross-city variation in pandemic severity. We re-evaluate the impact of the pandemic on infant mortality in a counterfactual setting in which all above-median cities reduced pollution to median levels. The results highlight the importance of health interaction effects, and suggest that pollution abatement policies may offer large indirect benefits to health.


1) Describe the methodological challenges involved in estimating the relationship between air pollution and infectious illness

2) Discuss the history of the 1918 influenza pandemic, and describe how it can be used as a ‘natural experiment’ to shed light on this question 

3) Provide causal evidence on the relationship between air pollution and excess mortality during the 1918 influenza pandemic



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