When Externalities Collide: Influenza and Pollution
Joshua Graff Zivin
Nicholas J. Sanders
- American Economic Journal: Applied Economics (Forthcoming)
Influenza and air pollution each pose significant health risks with global economic consequences.
Their shared etiological pathways present a case of compounding health risk via interacting externalities.
Using instrumental variables based on changing wind direction, we show increased levels
of contemporaneous pollution increase influenza hospitalizations. We exploit random variation in
effectiveness of the influenza vaccine as an additional instrument to show vaccine protection neutralizes
this relationship. Thus, pollution control and vaccination campaigns jointly provide greater
returns than those implied by addressing either in isolation. We show the importance of this consideration
in addressing observed gaps in influenza incidence by race.
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