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This study explores the validity of chain effects of clean water, which areknown as the "Mills-Reincke phenomenon," in early twentieth-century Japan.Recent studies have reported that water purifications systems are responsiblefor huge contributions to human capital. Although some studies haveinvestigated the instantaneous effects of water-supply systems in pre-warJapan, little is known about the chain effects of these systems. By analyzingcity-level cause-specific mortality data from 1922-1940, we find that a declinein typhoid deaths by one per 1,000 people decreased the risk of death due tonon-waterborne diseases such as tuberculosis and pneumonia by 0.742-2.942 per1,000 people. Our finding suggests that the observed Mills-Reincke phenomenoncould have resulted in the relatively rapid decline in the mortality rate inearly twentieth-century Japan.

Chain effects of clean water: The Mills-Reincke phenomenon in early twentieth-century Japan