Women's choices appear to emphasize child welfare more than those of men. This paper presents new evidence on how suffrage rights for American women helped children to benefit from the scientific breakthroughs of the bacteriological revolution. Consistent with standard models of electoral competition, suffrage laws were followed by immediate shifts in legislative behavior and large, sudden increases in local public health spending. This growth in public health spending fueled large-scale door-to-door hygiene campaigns, and child mortality declined by 8-15% (or 20,000 annual child deaths nationwide) as cause-specific reductions occurred exclusively among infectious childhood killers sensitive to hygienic conditions.
I. IntroductionWomen's choices appear to systematically differ from those of men (Byrnes, Miller, and Schafer 1999;Niederle and Vesterlund 2007). The underlying causes of these differences remain unclear, but a growing body of evidence suggests that women place relatively greater weight on child welfare and the provision of public goods (Thomas 1990(Thomas , 1994Duflo 2003). Such sex differences are now leading many to view the promotion of gender equality as a potent means of human development in poor countries (not simply an important end) (United Nations 2005). In particular, 'empowering' women is believed to increase investments in children (World Bank 2001).Despite recent interest, this issue is not new; a long history links the status of women with child well-being. For example, the nineteenth century bacteriological discoveries of Ignaz Semmelweis, Louis Pasteur, Joseph Lister, Robert Koch, and others revolutionized scientific knowledge about disease, but it was decades before the public at large (and children in particular) enjoyed their most immediate benefits. Principal among them were the basics of good household hygiene: hand and food washing, water and milk boiling, meat refrigeration, and breastfeeding (Duffy 1990;Meckel 1990). In the United States, good household hygiene was promoted through large-scale door-to-door hygiene campaigns -and through charitable organizations and then government, women were their leading advocates (Meckel 1990;Skocpol 1992;Tomes 1998 This paper investigates how a historical milestone in the advancement of American women -their enfranchisement -influenced child survival, drawing out new quantitative lessons where there is rich qualitative history. Specifically, it relates the sharp timing of state-level women's suffrage laws enacted between 1869 and 1920 to state-level trend breaks in the voting behavior of legislators, state and local public spending, and age-and cause-specific mortality. This approach has a number of attractive features. First, America's system of federalism created considerable variation across states and over time in laws governing women's suffrage. Second, although many related studies have focused on lump-sum transfers to women, many policies and programs that 'empower' women have nuanced incentives with theoretically ambiguous...