Medical technology and mortality transition: the diphtheria antitoxin and childhood mortality in the United States, 1880-1910

Abstract

Diphtheria was a deadly infectious disease in the late 19th and early 20th centuries, particularly among children. In 1895, an antitoxin was developed that could effectively treat the disease. This was the first and only infectious disease in the United States at the time with a scientifically-based treatment. To gauge the impact of access to the antitoxin on child mortality, I leverage large and stable differences in physicians per capita rates across 38 U.S. cities. Physicians were the primary distributors of the antitoxin at the time. For every percentage point increase in the rate of physicians per capita prior to the antitoxin's availability, there is a corresponding one percent reduction in child mortality. These findings suggest that the introduction of the antitoxin played an important role in saving children's lives and had a significant impact on the course of medical technology and child health in the United States.