Heterogeneity in Disease Resistance and the Impact of Antibiotics in the U.S.
Presented by:
Justin Cook
Department of Economics
University of California, Merced
Monday, January 7, 2019
12:00 pm-1:30 pm
(different day)
Taylor-Hibbard Seminar Room (Rm103)
The discovery of antibiotics—beginning in 1937 with the widespread usage of sulfa drugs—led to rapid declines in mortality rates from bacterial infectious diseases; however, there is limited understanding of the potential heterogeneity in these mortality impacts. Our primary hypothesis is that the impact of antibiotics is moderated by a population’s inherent resistance mechanisms, from which more resistant populations benefited less than more susceptible populations. To measure this heterogeneity, we use a yearly panel of bacterial infectious disease deaths that covers most of the 20th century for the 48 contiguous US states. We find that states with higher levels of innate resistance, measured by population-level genetic diversity within the human leukocyte antigen (HLA) system, have smaller mortality responses from the discovery of antibiotics, suggesting area-level genetic endowments of disease resistance and the discovery of medical technologies have acted as substitutes in determining levels of health across the US. We then use this measure of resistance as an instrument for levels of pre-1937 bacterial disease mortality to estimate the impacts of infectious disease reductions on a variety of socioeconomic outcomes, showing previous results were understated.