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Empirical research has shown that climate-related variables, the decline in economic well-being, and the mutual reinforcement of positive checks are the primary drivers of epidemic outbreaks in recent human history. However, their relative importance in causing the outbreak of epidemics is rarely examined quantitatively in a single study. I sought to address this issue by analyzing the 1402 epidemic incidents in China between 1841 and 1911, which partially overlaps partly with the Third Pandemic period. Fine-grained historical big data, multiple regression, and wavelet coherence analysis were employed. Statistical results show that economic fluctuations drove the country-wide epidemics outbreaks in China in inter-annual and decadal time scales. Economic fluctuations could cause short-term hardship and long-term impoverishment to the underprivileged social groups since a large portion of the Chinese population lived at the subsistence level in the past. The fluctuations might have sustained the repeated waves of epidemic outbreaks during the Third Pandemic period.

Did Hydro-climatic Extremes, Positive Checks, and Economic Fluctuations Modulate the Epidemics Outbreaks in Late Imperial China?