The Long View on Epidemics, Disease and Public Health: Research from Economic History, Part A

This piece is the result of a collaboration between the Economic History Review, the Journal of Economic History, Explorations in Economic History and the European Review of Economic History. More details and special thanks below.


Exhibit depicting a miniature from a 14th century Belgium manuscript at the Diaspora Museum, Tel Aviv. Available at Wikimedia Commons.

As the world grapples with a pandemic, informed views based on facts and evidence have become all the more important. Economic history is a uniquely well-suited discipline to provide insights into the costs and consequences of rare events, such as pandemics, as it combines the tools of an economist with the long perspective and attention to context of historians. The editors of the main journals in economic history have thus gathered a selection of the recently-published articles on epidemics, disease and public health, generously made available by publishers to the public, free of access, so that we may continue to learn from the decisions of humans and policy makers confronting earlier episodes of widespread disease and pandemics.

Emergency hospital during influenza epidemic, Camp Funston, Kansas. Available at Wikimedia Commons.

Generations of economic historians have studied disease and its impact on societies across history. However, as the discipline has continued to evolve with improvements in both data and methods, researchers have uncovered new evidence about episodes from the distant past, such as the Black Death, as well as more recent global pandemics, such as the Spanish Influenza of 1918. We begin with a recent overview of scholarship on the history of premodern epidemics, and group the remaining articles thematically, into two short reading lists. The first consists of research exploring the impact of diseases in the most direct sense: the patterns of mortality they produce. The second group of articles explores the longer-term consequences of diseases for people’s health later in life.

L0025221 Plague doctor
Plague doctor. Available at Wellcome Collection.


L0001879 Two men discovering a dead woman in the street during the gr
Two men discovering a dead woman in the street during the Great Plague of London, 1665. Available at Wellcome Collection.


Patterns of Mortality

Emblems of mortality: death seizing all ranks and degrees of people, 1789. Available at Wikimedia Commons.

The rich and complex body of historical work on epidemics is carefully surveyed by Guido Alfani and Tommy Murphy who provide an excellent  guide to the economic, social, and  demographic impact of plagues in human history: ‘Plague and Lethal Epidemics in the Pre-Industrial World’.  The Journal of Economic History 77, no. 1 (2017): 314–43.  The impact of epidemics varies over time and few studies have shown this so clearly as the penetrating article by Neil Cummins, Morgan Kelly and Cormac  Ó Gráda, who provide a finely-detailed map of how the plague evolved  in 16th and 17th century London to reveal who was most heavily burdened by this contagion.  ‘Living Standards and Plague in London, 1560–1665’. Economic History Review 69, no. 1 (2016): 3-34. .  Plagues shaped the history of nations  and, indeed, global history, but we must not assume that the impact of  plagues was as devastating as we might assume: in a classic piece of historical detective work, Ann  Carlos and Frank Lewis show that mortality among native Americans in the Hudson Bay area  was much lower than historians had suggested: ‘Smallpox and Native American Mortality: The 1780s Epidemic in the Hudson Bay Region’.  Explorations in Economic History 49, no. 3 (2012): 277-90.

The effects of disease reflect a complex interaction of individual and social factors.  A paper by Karen Clay, Joshua Lewis and Edson Severnini  explains  how the combination of air pollution and influenza was particularly deadly in the 1918 epidemic, and that  cities in the US which were heavy users of coal had all-age mortality  rates that were approximately  10 per cent higher than  those with lower rates of coal use:  ‘Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic’.  The Journal of Economic History 78, no. 4 (2018): 1179–1209.  A remarkable analysis of how one of the great killers, smallpox, evolved during the 18th century, is provided by Romola Davenport, Leonard Schwarz and Jeremy Boulton, who concluded that it was a change in the transmissibility of the disease itself that mattered most for its impact: “The Decline of Adult Smallpox in Eighteenth‐century London.” Economic History Review 64, no. 4 (2011): 1289-314.   The question of which sections of society experienced the heaviest burden of sickness during outbreaks of disease outbreaks has long troubled historians and epidemiologists. Outsiders and immigrants have often been blamed for disease outbreaks. Jonathan Pritchett and Insan Tunali show that poverty and immunisation, not immigration, explain who was infected during the Yellow Fever epidemic in 1853 New Orleans: ‘Strangers’ Disease: Determinants of Yellow Fever Mortality during the New Orleans Epidemic of 1853’. Explorations in Economic History 32, no. 4 (1995): 517.


The Long Run Consequences of Disease

‘Dance of Death’. Illustrations from the Nuremberg Chronicle, by Hartmann Schedel (1440-1514). Available at Wikipedia.

The way epidemics affects families is complex. John Parman wrestles wit h one of the most difficult issues – how parents respond to the harms caused by exposure to an epidemic. Parman  shows that parents chose to concentrate resources on the children who were not affected by exposure to influenza in 1918, which reinforced the differences between their children: ‘Childhood Health and Sibling Outcomes: Nurture Reinforcing Nature during the 1918 Influenza Pandemic’, Explorations in Economic History 58 (2015): 22-43.  Martin Saavedra addresses a related question: how did exposure to disease in early childhood affect life in the long run? Using late 19th century census data from the US, Saavedra  shows that children of immigrants who were exposed to yellow fever in the womb or early infancy, did less well in later life than their peers,  because they were only able to secure lower-paid  employment: ‘Early-life Disease Exposure and Occupational Status: The Impact of Yellow Fever during the 19th Century’.  Explorations in Economic History 64, no. C (2017): 62-81.  One of the great advantages of historical research is its  ability to reveal how the experiences of disease over a lifetime generates cumulative harms. Javier Birchenall’s extraordinary paper shows how soldiers’ exposure to disease during the American Civil War increased the probability  they would  contract tuberculosis later in life: ‘Airborne Diseases: Tuberculosis in the Union Army’. Explorations in Economic History 48, no. 2 (2011): 325-42.


V0010604 A street during the plague in London with a death cart and m
“Bring Out Your Dead” A street during the Great Plague in London, 1665. Available at Wellcome Collection.


Patrick Wallis, Giovanni Federico & John Turner, for the Economic History Review;

Dan Bogart, Karen Clay, William Collins, for the Journal of Economic History;

Kris James Mitchener, Carola Frydman, and Marianne Wanamaker, for Explorations in Economic History;

Joan Roses, Kerstin Enflo, Christopher Meissner, for the European Review of Economic History.


If you wish to read further, other papers on this topic are available on the journal websites:


* Thanks to Leigh Shaw-Taylor, Cambridge University Press, Elsevier, Oxford University Press, and Wiley, for their advice and support.

Military casualties and exchange rates during the First World War: did the Eastern Front matter?

by Pablo Duarte and Andreas Hoffmann (Leipzig University)

An article expanding on this blog has been published in the Economic History Review.


Russion troops going to the front. Available at Wikimedia Commons.

In 1918 the Entente forces defeated the Central Powers on the Western Front. The First World War, with countless brutal battles and over 40 million casualties, had finally ended.

During the war, all governments substantially increased their national debt and promised to hand the bill to the losers. They also promised to return to the pre-war gold parity rather than inflating and devaluing their currency. Since the outcome of the war was expected to severely affect currency values, particularly for the losers,  foreign exchange traders had an incentive to closely follow war events to update their beliefs on who was more likely to win.

According to Ferguson’s (1998) The Pity of War, the lost morale of the German troops — reflected in higher numbers of prisoners of war and of soldiers surrendering on the Western Front — was the ultimate reason for their defeat. Complementing this argument, Hall (2004) provided evidence that military casualties on the Western Front — the key front to finally winning the war — can help explain contemporary fluctuations in the exchange rates between belligerents’ currencies.

Although finally decided in the West, historians have emphasized the relevance of the global dimension of the First World War and the importance of the Eastern Front in understanding its complex evolution. Imagine it is 1914. Russia has just entered the war (earlier than expected), upsetting the plans of the Central Powers to circumvent a two-front war. Events on one front affected those on the other. But did contemporary traders, like historians today, consider the Eastern Front to be of relevance?

In our forthcoming article, we provide the first empirical insights into the relative importance of the Eastern Front during the First World War from the perspective of contemporary foreign exchange traders. Building on Hall’s study, the article indicates when and to what extent military casualties from both the Western and  Eastern Fronts were linked to exchange rate fluctuations during the First World War, and suggest that traders used this information as an indicator as to  which side was more likely to win.

To analyze the link between exchange rates and casualties we have introduced a novel dataset:  the German Reichsarchiv and the Austrian War Office. Merging our dataset with that for the Western Front employed by Hall (2004), we have been able to construct a rich dataset on war casualties for France, Britain, and Russia as well as Germany and Austria-Hungary, for  both Fronts.


Figure 1. 15,000 Russian Prisoners of war in Germany.

Duarte & Hoffmann
Russian prisoners in Germany. Available at Wikimedia Commons.


Using the digital archives of the Neue Zürcher Zeitung (a Swiss newspaper),  we have further documented information on casualties, specifically  the number of prisoners of war (Figure 1).  The following quote from December 1914 makes this finding explicit:

Berlin, Dec. 31 [1914] (Wolff. Authorized) The overall number of prisoners of war (no civilian prisoners) in Germany at the end of the year is 8,138 officers and 577,875 men. This number does not include a portion of those captured on the run in Russian Poland nor any of those still in transit. The overall number is comprised of the following: French 3,159 officers and 215,905 men, including 7 generals; Russians 3,575 officers and 306,294 men, including 3 generals; British 492 officers and 18,824 men (Neue Zürcher Zeitung, 1 Jan. 1915, p. A1.).


In summary, our forthcoming article provides evidence that foreign exchange traders recognized the global dimension of the war, especially the Eastern and Western Fronts.  Casualties on both Fronts were associated with exchange rate fluctuations. The number of soldiers captured on the Eastern Front affected exchange rates in the early war years. Foreign exchange traders gave additional weight to the Eastern Front during the first year of the war because Russia’s attack came as a surprise and the number of casualties was substantially higher than on the Western Front.

From autumn 1916 onwards, even though Russia had not yet left the war, our findings indicate that traders believed that the key to winning the war was in the west.  The Brusilov offensive, a massive Russian attack (from June to September 1916), had proven that the Central Powers would face substantial opposition in the East. Moreover, the Allied forces on the Western Front had started to coordinate joint offenses.


To contact the authors: Twitter: @economusiker Twitter: @Andhoflei



Ferguson, N. (1998). The Pity of War. Basic Books.

Hall, G. J., ‘Exchange rates and casualties during the First World War’, Journal of Monetary Economics, 51 (2004), pp. 1711–42.




People, Places and Business Cultures: Essays in Honour of Francesca Carnevali

review by Jim Tomlinson (University of Glasgow)

book edited by Paolo Di Martino, Andrew Popp and Peter Scott.

People, Places and Business Cultures: Essays in Honour of Francesca Carnevali’ is published by Boydell and Brewer. SAVE  25% when you order direct from the publisher – offer ends on the 2nd April 2019. See below for details.




Festschriften are usually produced at or around retirement, and to celebrate long academic careers. This collection, tragically, marks the end of a foreshortened career, that of Francesca Carnevali, who died in 2013 at the age of 48.

The chapters of the book have all been written by historian colleagues and friends of Francesca. The authors come from a diverse set of academic backgrounds, including the prominent medievalist Chris Wickham and the social and cultural historian Matthew Hilton. But most of the contributors come, as did Francesca, from the broadly-defined subject of business history.

Francesca’s own work provided a broad and variegated set of concerns and approaches that enables the contributors to link her work to their own diverse areas of expertise. Thus, for example, Leslie Hannah (who supervised Francesca’s PhD, and co-authored an article on banking with her), provides a new approach to the old question of the comparative performance of British banking before 1914. He stresses the paradox (at least for those who think competition is always the key to efficiency), that by any standards Britain at that time had a highly competitive banking system, yet suffered a growth ‘climacteric’. More broadly, Hannah, like Francesca herself, adheres to a broadly declinist view of British economic history, whilst clearly identifying the unsatisfactory nature of many declinist stories.

Francesca’s own work on banking contrasted Italy and Britain, and the financing of Italian small business is the concern of Alberto Rinaldi and Anna Spadavecchia’s chapter. The conclusion of this analysis emphasizes the embeddedness of financial institutions in legal, social and political conditions as well as economic circumstances, a conclusion that links to Francesca’s broadening concerns after her early work on banking. Key to this broadening was an examination of social capital and trust, as key, if problematic, concepts for understanding business behaviour.

This behaviour is examined in a variety of contexts in this book, ranging from Andrew Popp’s study of Liverpool cotton brokers and their ‘public staging of business life’ to Lucy Newton’s study(jointly authored with Francesca) of making and selling pianos in Victorian and Edwardian England. This concern with consumer goods is linked by Peter Scott and James Walker to an innovative study of how mass consumption and mass marketing, to some degree at least, blurred class demarcations on interwar Britain.

These empirical studies are complemented by more conceptually focussed chapter, by Chris Wickham on the genealogy of ‘micro-history’, by Kenneth Lipartito on the concept of social capital and its limits, and by Andrea Colli on the problems of doing comparative European history.  Last, but very far from least, there is a characteristically wide-ranging and insightful chapter by Mathew Hilton on the problems of writing the economic and social history of twentieth-century Britain in the light of the recent ‘turns’ in how that history is being written.

The diversity of this book’s contents is a strength not a weakness. Business historians of almost any bent will find something interesting and important to engage with. The breadth of analytical and empirical concerns, allied with the close attention to important conceptual puzzles, makes this book a fitting reflection of, and tribute to, Francesca’s productive and well-lived life.


SAVE 25% when you order direct from the publisher using the offer code BB500 online hereOffer ends 2nd April 2019. Discount applies to print and eBook editions. Alternatively call Boydell’s distributor, Wiley, on 01243 843 291, and quote the same code. Any queries please email


To contact Jim Tomlinson:


Note: this review was originally published on-line in Business History, 2019.  It is reproduced by kind permission of  Lee-Ann Anderson (Permissions and Licensing, Taylor and Francis).

The gender division of labour in early modern England: why study women’s work?

by Jane Whittle (University of Exeter) and Mark Hailwood (University of Bristol)

This article is published by The Economic History Review, and it is available on the EHS website.


Interior with an Old Woman at the Spinning Wheel. Available at Wikimedia Commons.

Here are ten reasons to know more about women’s work and read our article on ‘The gender division of labour in early modern England’. We have collected evidence about work tasks in order to quantify the differences between women’s and men’s work in the period from 1500-1700. This research allows us to dispel some common misconceptions.


  1. Men did most of the work didn’t they? This is unlikely, when both paid and unpaid work are counted, modern time-use studies show that women do the majority of work – 55% of rural areas of developing countries and 51% in modern industrial countries (UN Human Development report 1995). There is no reason why the pattern would have been markedly different in preindustrial England.
  2. But we know about occupational structure in the past don’t we? Documents from the medieval period onwards describe men by their occupations, but women by their marital status. As a result we know quite a lot about male occupations but very little about women’s.
  3. But women worked in households headed by their father, husband or employer. Surely, if we know what these men did, then we know what women were doing too? Recent research undertaken by Amy Erickson, Alex Shepard and Jane Whittle shows that married women often had different occupations from their husbands. If we do not know what women did, we are missing an important part of the economy.
  4. But we have evidence of women working for wages. It shows that around 20% of agricultural workers were women, surely this demonstrates that women’s work wasn’t as important as men’s in the wider economy? This evidence only relates to labourers paid by the day, and before 1700 most agricultural labour was not carried out by day labourers, so this isn’t a very good measure. Our article shows that women carried out a third of agricultural work tasks, not 20%.
  5. But women mostly did domestic stuff – cooking, housework and childcare – didn’t they, and that type of work doesn’t change much across history? Women did do most cooking, housework and childcare, but our research suggests it did not take up the majority of their working time. These forms of work did change markedly over time. A third of early modern housework took place outside, and our data suggests the majority was done for other households, not as unpaid work for one’s own family.
  6. But women only worked in a narrow range occupations, didn’t they? Our research shows that women worked in all the major sectors of the economy, but often doing slightly different tasks from men. They undertook a third of work tasks in agriculture, around half of the work in everyday commerce and almost two thirds of work tasks in textile production. But women also did forms of work we might not expect, such as shearing sheep, dealing in second-hand iron, and droving cattle.
  7. Women’s work was all low skilled wasn’t it? Women very rarely benefitted from formal apprenticeship in the way that men did, but that does not mean the tasks they undertook were unskilled. Women undertook many tasks, such as making lace and providing medical care, which required a great deal of skill.
  8. But this was all in the past, what relevance does it have now? Many gendered patterns of work are remarkably persistent over time. Analysis by the Office of National Statistics states that one third of the gender pay gap in modern Britain can be explained by men and women working in different occupations, and by the lower rates of pay for part-time work, which is more commonly undertaken by women than men.
  9. So nothing ever changes …? Well, not necessarily. In fact looking carefully at patterns of women’s work in the past shows some noticeably shifts over time. For instance, women worked as tailors and weavers in the medieval period and in the eighteenth century, but not in the sixteenth century.
  10. But we know why women work differently from men, particularly in preindustrial societies – isn’t it because they are less physically strong and all the child-bearing stuff? Physical strength does not explain why women did some physically taxing forms of work and not others (why they walked for miles carrying heavy loads on their heads rather than driving carts). And not all women were married or had children. Neither physical strength nor child-bearing can explain why women were excluded from tailoring between 1500 and 1650, but worked successfully and skilfully in this and other closely related crafts in other periods.

We now have data which allows us to look more carefully at these issues, but there is still much more to uncover.


To contact Jane Whittle:, Twitter: @jcwhittle1

To contact Mark Hailwood:, Twitter: @mark_hailwood

A New Take on Sovereign Debt and Gunboat Diplomacy

Going multilateral? Financial Markets’ Access and the League of Nations Loans, 1923-8


Juan Flores (The Paul Bairoch Institute of Economic History, University of Geneva) and
Yann Decorzant (Centre Régional d’Etudes des Populations Alpines)

Abstract: Why are international financial institutions important? This article reassesses the role of the loans issued with the support of the League of Nations. These long-term loans constituted the financial basis of the League’s strategy to restore the productive basis of countries in central and eastern Europe in the aftermath of the First World War. In this article, it is argued that the League’s loans accomplished the task for which they were conceived because they allowed countries in financial distress to access capital markets. The League adopted an innovative system of funds management and monitoring that ensured the compliance of borrowing countries with its programmes. Empirical evidence is provided to show that financial markets had a positive view of the League’s role as an external, multilateral agent, solving the credibility problem of borrowing countries and allowing them to engage in economic and institutional reforms. This success was achieved despite the League’s own lack of lending resources. It is also demonstrated that this multilateral solution performed better than the bilateral arrangements adopted by other governments in eastern Europe because of its lower borrowing and transaction costs.

Source: The Economic History Review (2016), 69:2, pp. 653–678

Review by Vincent Bignon (Banque de France, France)

Flores and Decorzant’s paper deals with the achievements of the League of Nations in helping some central and Eastern European sovereign states to secure market access during in the Interwar years. Its success is assessed by measuring the financial performance of the loans of those countries and is compared with the performance of the loans issued by a control group made of countries of the same region that did not received the League’s support. The comparison of the yield at issue and fees paid to issuing banks allows the authors to conclude that the League of Nations did a very good job in helping those countries, hence the suggestion in the title to go multilateral.

The authors argue that the loans sponsored by the League of Nation – League’s loan thereafter – solved a commitment issue for borrowing governments, which consisted in the non-credibility when trying to signal their willingness to repay. The authors mention that the League brought financial expertise related to the planning of the loan issuance and in the negotiations of the clauses of contracts, suggesting that those countries lacked the human capital in their Treasuries and central banks. They also describe that the League support went with a monitoring of the stabilization program by a special League envoy.


Empirical results show that League loans led to a reduction of countries’ risk premium, thus allowing relaxing the borrowing constraint, and sometimes reduced quantity rationing for countries that were unable to issue directly through prestigious private bankers. Yet the interests rates of League loans were much higher than those of comparable US bond of the same rating, suggesting that the League did not create a free lunch.

Besides those important points, the paper is important by dealing with a major post war macro financial management issue: the organization of sovereign loans issuance to failed states since their technical administrative apparatus were too impoverished by the war to be able to provide basic peacetime functions such as a stable exchange rate, a fiscal policy with able tax collection. Comparison is made of the League’s loans with those of the IMF, but the situation also echoes the unilateral post WW 2 US Marshall plan. The paper does not study whether the League succeeded in channeling some other private funds to those countries on top of the proceeds of the League loans and does not study how the funds were used to stabilize the situation.


The paper belongs to the recent economic history tradition that aims at deciphering the explanations for sovereign debt repayment away from the gunboat diplomacy explanation, to which Juan Flores had previously contributed together with Marc Flandreau. It is also inspired by the issue of institutional fixes used to signal and enforce credible commitment, suggesting that multilateral foreign fixes solved this problem. This detailed study of financial conditions of League loans adds stimulating knowledge to our knowledge of post WW1 stabilization plans, adding on Sargent (1984) and Santaella (1993). It’s also a very nice complement to the couple of papers on multilateral lending to sovereign states by Tunker and Esteves (2016a, 2016b) that deal with 19th century style multilateralism, when the main European powers guaranteed loans to help a few states secured market access, but without any founding of an international organization.

But the main contribution of the paper, somewhat clouded by the comparison with the IMF, is to lead to a questioning of the functions fulfilled by the League of Nations in the Interwar political system. This bigger issue surfaced at two critical moments. First in the choice of the control group that focus on the sole Central and Eastern European countries, but does not include Germany and France despite that they both received external funding to stabilize their financial situation at the exact moment of the League’s loans. This brings a second issue, one of self-selection of countries into the League’s loans program. Indeed, Germany and France chose to not participate to the League’s scheme despite the fact that they both needed a similar type of funding to stabilize their macro situation. The fact that they did not apply for financial assistance means either that they have the qualified staff and the state apparatus to signal their commitment to repay, or that the League’s loan came with too harsh a monitoring and external constraint on financial policy. It is as if the conditions attached with League’ loans self-selected the good-enough failed states (new states created out of the demise of the Austro-Hungarian Empire) but discouraged more powerful states to apply to the League’ assistance.


Now if one reminds that the promise of the League of Nations was the preservation of peace, the success of the League loans issuance was meager compared to the failure in preserving Europe from a second major war. This of course echoes the previous research of Juan Flores with Marc Flandreau on the role of financial market microstructure in keeping the world in peace during the 19th century. By comparison, the League of Nations failed. Yet a successful League, which would have emulated Rothschild’s 19th century role in peace-keeping would have designed a scheme in which all states in need -France and Germany included – would have borrowed through it.

This leads to wonder the function assigned by their political brokers to the program of financial assistance of the League. As the IMF, the League was only able to design a scheme attractive to the sole countries that had no allies ready or strong-enough to help them secure market access. Also why did the UK and the US chose to channel funds through the League rather than directly? Clearly they needed the League as a delegated agent. Does that means that the League was another form of money doctors or that it acts as a coalition of powerful countries made of those too weak to lend and those rich but without enforcement power? This interpretation is consistent with the authors’ view “the League (…) provided arbitration functions in case of disputes.”

In sum the paper opens new connections with the political science literature on important historical issues dealing with the design of international organization able to provide public goods such as peace and not just helping the (strategic) failed states.


Esteves, R. and Tuner, C. (2016a) “Feeling the blues. Moral hazard and debt dilution in eurobonds before 1914”, Journal of International Money and Finance 65, pp. 46-68.

Esteves, R. and Tuner, C. (2016b) “Eurobonds past and present: A comparative review on debt mutualization in Europe”, Review of Law & Economics (forthcoming).

Flandreau, M. and Flores, J. (2012) “The peaceful conspiracy: Bond markets and international relations during the Pax Britannica”, International Organization, 66, pp. 211-41.

Santaella, J. A (1993) ‘Stabilization programs and external enforcement: experience from the 1920s’, Staff Papers—International Monetary Fund (J. IMF Econ Rev), 40, pp. 584–621

Sargent, T. J., (1983) ‘The ends of four big inflations’, in R. E. Hall, ed., Inflation: Causes and Effects (Chicago, Ill.: University of Chicago Press, pp. 41–97