Abstract:
This paper examines the effects pellagra, a disease caused by insufficient niacin consumption, on a variety of health-related outcomes in the American South during the first half of the twentieth century. The analysis draws on detailed county level data spanning 1915-1950 and an intensity of treatment approach. We have three main findings. The first two findings build off an historical literature that says the arrival of the boll weevil improved Southern diets, particularly in high cotton producing. First, in North Carolina counties, the arrival of the boll weevil between 1919 and 1922 caused pellagra mortality, infant mortality and all age mortality to fall. The effects were larger for counties with higher pre-boll weevil pellagra mortality rates and higher pre-boll weevil shares of land in cotton production. Second, over the period 1915-1921, the heights of white, southern born men who were drafted into the Army during World War II, rose after the boll weevil arrived in counties and rose more in boll weevil counties with higher shares of land in cotton production. Third, in Southern states the passage of mandatory fortification laws during the 1940s caused pellagra mortality, infant mortality, and all age mortality to fall. Fortification saved 2,030 infants per year. These results suggest that nutritional interventions played an important role in short and longer run improvements in Southern health.