Demographic and socioeconomic effects of disease control: The case of malaria eradication in Sardinia

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Abstract
The eradication of endemic malaria in Sardinia is evaluated for its demographic and socioeconomic impact in an examination of the relationship between disease control, population growth, and economic development. Pre‐eradication public health literature had argued that malaria was a sufficient cause of underdevelopment, Unking disease, labor shortages, and agricultural inefficiency in a pattern of involution. In Sardinia, population growth was a desired effect of disease control. A cultural ecological model labeled the “Malaria Blocks Development” hypothesis is used to generate specific questions about the effects of malaria eradication. Demographic analysis reveals that malaria control causes a substantial decrease in overall mortality rates, much greater than the simple elimination of malaria‐specific deaths. The geographical distribution of population growth does not follow the predicted pattern. Historical analysis of economic change in a particular ex‐malarial community and of regional economic data demonstrate that the expected intensification of agriculture fails to occur. Sardinian economic change, described as modernization without development, is best understood in terms of the impact of policies of the European Common Market. It is concluded that political economic shifts are more influential to economic development than health improvements made by disease control programs. This paper explores the relationship between health improvements, economic development, and population growth through a study of the demographic and socioeconomic effects of malaria eradication in Sardinia, Italy. It is an anthropological study of a disease control program as an agent of medical, economic, and demographic change. Historically, international public health programs have often been conceived and financed as a form of international foreign aid.