Pandemics’ backlash: The effects of the 1918 influenza on health attitudes and behavior

We examine how, when, and for how long adverse health shocks shape health-related attitudes and behaviors, and perceptions of future-oriented policies. We utilize self-digitized, individual-level death and vaccination records, and policy voting data around the 1918 influenza pandemic. Exposure to influenza causes opposing effects: places with predominantly indirectly-affected families reduce support for public health measures, while direct family exposure increases it. This suggests a U-shaped relationship between suffering and support for health policies. Our findings reveal divergent public responses to health crises and explain recent post-pandemic declines in vaccination rates and trust in health authorities in the U.S. and worldwide.