Do pandemics change healthcare? : Evidence from the Great Influenza

Author / Creator

Esteves, Rui Pedro, author

Available as

Online

Summary

Using newly digitized U.S. city-level data on hospitals, we explore how pandemics alter preferences for healthcare. We find that cities with higher levels of mortality during the Great Influenza of...

Using newly digitized U.S. city-level data on hospitals, we explore how pandemics alter preferences for healthcare. We find that cities with higher levels of mortality during the Great Influenza of 1918-1919 subsequently expanded hospital capacity by more than cities experiencing less influenza mortality: cities in the top half of the mortality distribution increased their count of hospitals by 8-10 percent in the years after the pandemic. This effect persisted to 1960 and was driven by increases in non-governmental hospitals. Growth responded most in richer cities, exacerbating existing inequalities in access to healthcare. We do not find evidence that government-run hospitals or other types of city-level spending related to healthcare responded to pandemic intensity, suggesting that large health shocks do not necessarily lead to increased public provision of health services.

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