Development and Underdevelopment in the History of Economic Thought

Edgar Sydenstricker: The first health economist?

Erreygers Guido, University of Antwerp
Philip Clarke, University of Oxford

The economist Edgar Sydenstricker, who spent most of his working life at the United States Public Health Service and at the Milbank Memorial Fund, examined a wide range of health economics issues. He was appointed as the first statistician of the United States Public Health Service in 1915 and immediately contributed to debates around the cause of the disease pellagra. Sydenstricker used a range of statistics including time series on food prices and household incomes to correctly argue that it was due to a dietary deficiency. This research was followed by many studies quantifying income-related health inequalities including the mortality associated with the influenza pandemic of 1919 and the health of workers in the garment industry. Sydenstricker’s contribution was not just confined to analysis: he was heavily involved in the use of surveys to collect information and he was instrumental in the development of the first US National Health Survey. Other contributions include extending health insurance in the United States and methods of evaluating public health programs that involve assessment of costs and outcomes. His activities were cut short by his death in 1936. While recognised for his contributions to epidemiology, his contribution to health economics has largely been forgotten.


Keywords: socioeconomic inequality of health; history of economic thought in the USA; early 20th century

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