Journal of Political Economy,
2006, vol. 114, no. 4]
2006 by The University of Chicago. All rights reserved. 0022-3808/2006/11404-0003$10.00
Is the 1918 Infuenza Pandemic Over? Long-
Term EFFects oF
Infuenza Exposure in
the Post-1940 U.S. Population
Columbia University and National Bureau of Economic Research
This paper uses the 1918 inFuenza pandemic as a natural experiment
for testing the fetal origins hypothesis. The pandemic arrived unex-
pectedly in the fall of 1918 and had largely subsided by January 1919,
generating sharp predictions for long-term effects. Data from the
1960–80 decennial U.S. Census indicate that cohorts in utero during
the pandemic displayed reduced educational attainment, increased
rates of physical disability, lower income, lower socioeconomic status,
and higher transfer payments compared with other birth cohorts.
These results indicate that investments in fetal health can increase
According to the fetal origins hypothesis (Barker 1992), certain chronic
health conditions can be traced to the course of fetal development.
Randomized experiments with animals have supported the hypothesis,
but its relevance for humans remains controversial because of obstacles
to evaluation. Chief among these are (i) omitted factors, such as genetic
I am indebted to Kenneth Chay, my dissertation advisor. I also wish to thank Alan
Auerbach, David Card, Dexter Chu, Dora Costa, Lena Edlund, Michael Greenstone,
George Lamson, Ronald Lee, Bhashkar Mazumder, Cristian Pop-Eleches, and Steven Levitt.
±inancial support from the National Institutes of Health (NIA grant 5R03AG23939-2),
suggestions from seminar participants, particularly those at the Center for Health and
Wellbeing, Princeton University, and anonymous referee comments are gratefully ac-
Journal of the American Medical Association
’s blithe 1918 editorial was
discovered courtesy of Alfred Crosby. Stein et al.’s (1975) study of the Dutch famine has
been an inspiring example. All errors are my own.