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We analyze the repercussions of the 1918 Influenza Pandemic on demographic measures, human capital formation, and productivity markers in the state of Sao Paulo, Brazil&apos;s financial center and the most populous city in South America today. Leveraging temporal and spatial variation in district-level estimates of influenza-related deaths for the period 1917-1920 combined with a unique database on socio-economic, health and productivity outcomes constructed from historical and contemporary documents for all districts in Sao Paulo, we find that the 1918 Influenza pandemic had significant negative impacts on infant mortality and sex ratios at birth in 1920 (the short-run). We find robust evidence of persistent effects on health, educational attainment and productivity more than twenty years later. Our study highlights the importance of documenting the legacy of historical shocks in understanding the development trajectories of countries over time.

The Brazilian Bombshell? The Long-Term Impact of the 1918 Influenza Pandemic the South American Way