Malaria: An Early Indicator of Later Disease and Work Level

The effect of early-life exposure to malaria on disability and work level in old age has been rarely studied. This study investigates this less explored question over the past one and a half century. First, using longitudinal lifetime records of Union Army veterans, I estimate that exposure to a malarial environment in early life (c.1840) substantially increased the likelihood of having various chronic diseases and not working in old age (c.1900). Second, from data on US cohorts born between 1891 and 1965, I find that those exposed to a higher level of the antimalaria campaign, which began in 1920, suffered less from work disability in old age than otherwise. This effect was substantial among cohorts born in high-risk malaria counties. Third, I seek the same implications for the modern period by linking World Health Organization¡¯s country statistics on disability-adjusted life years (DALYs) among older populations in 2004 to country-level malaria risk in 1946. In the paper, I discuss possible mechanisms and propose the significance of malaria eradication and early-life conditions from a longer-term perspective.