Kritische Blicke auf die Coronakrise und ihre Folgen
Kritische Blicke auf die Coronakrise und ihre Folgen

Did the Great Influenza Change Healthcare?

Rui Esteves, Kris James Mitchener, Peter Nencka, Melissa A. Thomasson: Do Pandemics Change Healthcare? Evidence from the Great Influenza, in: NBER Working Paper Series 30643 (November 2022), online in:


Using newly digitized U.S. city-level data on hospitals, the authors explored how pandemics alter preferences for healthcare. They found 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. The authors did 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.

Link to the article on the site of the National Bureau of Economic Research (NBER).

Link to download the article as a PDF file from the NBER site