Factors determining health status: An analysis of diarrhea in the Union Army, 1861--1920

Canavese, Paula N.

     This paper empirically examines the role of socioeconomic and environmental factors in explaining longevity with diarrhea for adults by using detailed health data for the Union Army veterans of the United States Civil War. Prevalence rates calculated from current data show that, since the late nineteenth century, diarrhea, as is the case with many other health conditions, has gone from one of the most prevalent and fatal diseases to generally an inconsequential one for adults in rich countries. However, diarrhea is a widespread disease in developing countries and among some segments of the population in developed countries, since many of its causes are related to socioeconomic and environmental factors. Using a health supply equation, I test which particular factors were responsible for determining the time lived from onset of this disease. Results from survival analysis suggest that nutrition, place of birth, improvements in sanitary conditions, and changes in labor conditions and occupational distribution were responsible for reducing the vulnerability to this disease in the U.S. during the late nineteenth century. The life span of Union Army veterans was reduced for immigrants, those with lower nutritional status, and those who were born in overcrowded regions, while farmers had a lower risk of dying from this disease. Given that diarrhea is a prevalent disease within poor populations today, factors determining survival time with diarrhea, based on historical data, can indicate how to allocate resources and prioritize developmental policies in developing areas. Data from Bangladesh help to demonstrate that the importance of socioeconomic factors has been reduced over the last century.

Fogel, Robert W.