Abstract

This study examines the impact of historical disease burden on the development of contemporary China. Using historical records spanning nearly six centuries, we construct a county-level dataset for the distribution of epidemics in China. Our results indicate that historical disease pressure has a positive impact on long-term economic development. This positive association withstands rigorous testing through a series of robustness checks. Furthermore, we find that earlier institutional development in disease control and the improvement in human capital are effective channels. The establishment of disease prevention centers facilitated the early adoption of modern disease control systems, which, in turn, enhanced public health, education, and productive activities.

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