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Title: The Rise and Fall of Pellagra in the American South

Citation Type: Miscellaneous

Publication Year: 2019

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Abstract: No other nutrition-related disease in American history caused as many deaths as pellagra. The by-product of insufficient niacin consumption, pellagra reached epidemic proportions in the American South, killing roughly 7,000 Southerners annually at its peak in 1928. We document the rise and fall of pellagra in the American South and present three main findings. First, pellagra resulted, in part, from Southern agriculture’s heavy emphasis on cotton, which displaced local food production and effectively raised the price of niacin consumption. Evidence for this proposition derives in part from the arrival of the boll weevil. Although the boll weevil reduced Southern incomes and cotton production, it was also associated with increases in local food production and sharp reductions in pellagra. Second, pellagra was largely eliminated through voluntary fortification of cereal-grain products starting in 1937 and a series of state fortification laws passed in the 1940s. These laws, for the first time in Southern history, broke the strong positive correlation between cotton production and pellagra. Third, exposure to early-life interventions that reduced cotton production and/or increased niacin consumption were associated with improved stature and wages. These findings have important implications for our understanding of the economic history of the American South and economic development in general.

Url: http://www.eh.net/eha/wp-content/uploads/2016/08/ClayTroesken.pdf

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Authors: Clay, Karen; Schmick, Ethan; Troesken, Werner

Publisher: University of Pittsburgh

Data Collections: IPUMS USA

Topics: Health, Other

Countries: United States