Epidemics and the Economy- An Economic Analysis of the 1918 Spanish Flu Pandemic in Scandinavia

一个多世纪以来，大多数西方社会的预期寿命一直在增加，欠发达国家也在效仿。一种快速发展的文献表明，早期生活条件的影响程度比以前认为的要大得多。因此，子宫内和儿童时期的疾病环境可能对整个生命周期甚至后代产生严重后果。然而，在以前的文献中很大程度上被忽视的一个方面是与子宫内暴露于疾病相关的基本识别问题。儿童是社会中最脆弱的成员，孕妇也是如此，众所周知，母亲及其子女的健康和社会经济成果彼此之间存在着复杂的关系。因此，确定子宫内疾病环境确实有影响，并不足以理解其影响的原因和方式。为了研究这个问题，我们把注意力集中在所谓的西班牙流感大流行上。由于几个原因，1918年至1920年期间在世界各地流行的这场大流行为这项分析提供了一个理想的背景。首先，大流行的大多数长期影响已经经过了足够的时间，才得以充分发挥作用。其次，西班牙流感大流行造成的死亡人数大到足以对经济产生影响。第三，有人声称这种疾病是盲目的，因为它没有明显的社会经济梯度，这意味着这种大流行形成了一个很好的自然实验。特别是，我们旨在利用来自斯堪的纳维亚的高质量数据分析三组不同的研究问题1)分析大流行传播的空间和社会经济模式与大流行相关的死亡率和发病率是否存在社会经济梯度？鉴于这一时期的特点是工作年龄人口在不同地点之间大量流动，疫情是否导致了回避行为和国内移徙流动中断？2)流感暴露的短期和长期影响子宫内暴露对儿童死亡率和成人结局（教育、收入、就业）有什么影响，父母背景因素和选择性死亡率是否对先前研究的估计有偏倚？子宫内感染是否主要通过母亲的健康休克（妊娠疤痕）而不是孩子可能经历的健康休克（胎儿暴露），或者是否有第三种机制影响养育质量，但与怀孕期间的流感无关（妊娠疤痕）？3)大流行对宏观经济的影响大流行对工资、资本回报和贫困率等宏观经济结果的短期和中期影响是什么？在劳动力供给和人力资本遭受一次重大冲击后，经济如何调整到一个新的长期均衡？

For more than a century, life expectancy has been increasing in most Western societies, and less developed countries follow path. One rapidly evolving strand of the literature suggests that early life conditions matter to a much larger extent than previously acknowledged. Accordingly, the disease environment in utero and during childhood may have severe consequences throughout the life cycle and even for subsequent generations.However, one aspect which has been largely overlooked in the previous literature is the fundamental identification problem associated with an in utero exposure to disease. Beside children, who belong to the most vulnerable members of Society- pregnant women do as well, and it is well-known that health and socio-economic outcomes of mothers and their children stand in a complex relationship to each other. Thus, establishing that the in utero disease environment does matter is not sufficient to understand why and how it matters.In order to study this issue, we focus our attention on the so-called Spanish flu pandemic. This pandemic, which travelled the world between 1918 and 1920 forms an ideal setting for this analysis, for several reasons. First, sufficient time has elapsed for most of the long term effects of the pandemic to have worked out fully. Second, the Spanish flu pandemic claimed a death toll large enough to have had repercussions on the economy. Third, it has been claimed that the disease was blind in the sense that it did not have a clear socioeconomic gradient which would mean that the pandemic forms an excellent natural experiment. In particular, we aim at analyzing three distinct groups of research questions with high-quality data from Scandinavia 1) Analyzing spatial and socioeconomic patterns in the spread of the pandemicWas there a socioeconomic gradient in the mortality and morbidity related to the pandemic?Since the time period was characterized by large flows of working-age people moving between locations, did the pandemic lead to avoidance behaviour and disrupted internal migration flows?2) Short- and long-term effects of influenza exposureWhat are effects of in utero exposure on child mortality and adult outcomes (educational, incomes, employment) and did parental background factors and selective mortality bias estimates of previous studies?Did the in utero exposure run primarily through the mother's health shock (pregnancy scarring) as opposed to the health shock possibly experienced by the child (fetal exposure) or is there are third mechanism that influences the quality of parenting but have little to do with influenza during pregnancy (maternal scarring)?3) Macroeconomic implications of the pandemicWhat were the short- and medium-term effects of the pandemic on macroeconomic outcomes such as wages, capital returns and poverty rates?How does the economy adjust to a new long run equilibrium after a substantial one period shock to labor supply and human capital?