Disease and Development: Evidence from Hookworm Eradication in the American South

Abstract

This study evaluates the economic consequences of the successful eradication of hookworm disease from the American South, which started circa 1910. The Rockefeller Sanitary Commission (RSC) surveyed infection rates and found that 40 percent of school-aged children in the South were infected with hookworm. The RSC then sponsored treatment and education campaigns across the region. Follow-up studies indicate that this campaign substantially reduced hookworm disease almost immediately. Areas with higher levels of hookworm infection prior to the RSC experienced greater increases in school enrollment, attendance, and literacy after the intervention. No significant contemporaneous results are found for literacy or occupational shifts among adults, who had negligible prior infection rates. A long-term follow-up indicates a substantial gain in income that coincided with exposure to hookworm eradication. I also find evidence that the return to schooling increased with eradication.