This paper examines the health tradeoffs associated with the historical expansion in coal-fired electricity generation in the United States. We combine newly digitized data on all major coal-fired power plants for the period 1938–1962 with two complementary difference-in-differences strategies. Coal-fired plants imposed large negative health externalities that were partially offset by the benefits of local electricity generation. The health impacts varied widely according to initial electricity access and evolved as the stock of generating capacity expanded over the sample period. These findings highlight the importance of accounting for both current and future payoffs when designing environmental regulation.

This paper studies how better access to public health insurance affects infant mortality during pandemics. The analysis combines cross-state variation in mandated eligibility for Medicaid with two influenza pandemics that arrived shortly before and after the program’s introduction in 1965. We find that better access to public health insurance in high-eligibility states substantially reduced pandemic infant mortality. The reductions in pandemic infant mortality are too large to be attributable solely to new Medicaid recipients, suggesting that expanded access to public health insurance helped mitigate disease transmission among the broader population.