Abstract

US cities invested heavily in water and sewer infrastructure throughout the late nineteenth and early twentieth centuries. These investments improved public health and quality of life by helping US cities control typhoid fever and other waterborne diseases. We show that segregated cities invested in water infrastructure earlier but were slower to reach universal access and slower to eliminate typhoid fever. We develop a theoretical model that illustrates how segregation, by facilitating the exclusion of Black households from water and sewer systems, explains these seemingly paradoxical findings.

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