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