Pandemics, Public Health Interventions and Fertility: Evidence from the 1918 Influenza

Abstract

Understanding how pandemics — and the policy interventions to counter them — interact with demographic processes is of urgent scientific importance. Leveraging vital records from 26 major cities in the United States, we assess how variation in non-pharmaceutical interventions (NPIs), during the 1918 influenza pandemic influenced fertility. We find a strong reduction in fertility 9 months after pandemic peaks, with fertility dropping 20% in cities with short NPIs. Fertility a year later returns to pre-pandemic levels only in the cities with longer implementation of NPIs. The interplay between longer NPIs and reduced virus transmission appears to be the main mechanism increasing fertility 9 months after implementation.