Water Infrastructure and Health in U.S. Cities

Abstract

Between 1900 and 1930 typhoid fever and other waterborne diseases were largely eradicated from U.S. cities. This achievement required a mix of technological, scientific, economic, and bureaucratic innovations. This article examines how the interaction of those forces influenced water and sanitary infrastructure provision during the 19th and early 20th centuries. I show the sharp link between infrastructure investments and declines in waterborne disease and discuss how that relationship informs the methodological approaches one should use to assess the impact of sanitary investments on urban development. Finally, I review the literature on the social returns to eliminating the threat of waterborne disease. The evidence suggests the benefits of infrastructure investment far exceeded the costs. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.