Abstract
The Clean Water Act (CWA) significantly improved surface water quality, but at a cost exceeding the estimated benefits. We quantify the effect of the CWA on a direct measure of health and incorporate health benefits into a cost-benefit analysis. Using a difference-in-differences framework, we compare health upstream and downstream from wastewater treatment facilities before and after CWA grant receipt. Pollution only decreased downstream from facilities required to upgrade their treatment technology, and we leverage this additional variation with a triple difference. CWA grants increased average birth weight by 8 grams. A back-of-the-envelope calculation bounds infant health benefits below $29 billion.
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