Public Health Movements, Local Poor Relief, and Child Mortality in American Cities: 1923-1932

Jonathan Fox, Max Planck Institute for Demographic Research

This paper examines the effectiveness of the health education and poverty relief programs prior to the New Deal. Prior researchers have speculated that these programs contributed to the declining mortality rates during the 1920s, but have been unable to econometrically estimate their impact. This paper uses new data on municipal health education and poverty relief expenditures to separately estimate how effective each of these different types of programs were at reducing child mortality. A panel of 67 cities over 10 years is used to identify the effects based on variation within cities over time and control for nation-wide shocks to the system. Fixed effects estimations suggest that spending on both health education and poverty relief were relatively low cost ways to reduce mortality for infants and school age children. However, after controlling for linear mortality trends within the cities, the estimated effectiveness of these public health education programs is attenuated.