Of the great transformations that have reshaped human society in the modern era, one of the most important is the increase in the average length of time that a newly born human can expect to live. The pattern of increasing longevity raises an important and as-yet unresolved question - did political institutions play any role in the great transformation of the human lifespan? My dissertation aims to contribute to the literature on political institutions and public health by focusing on the efforts to reduce malaria in the United States and Mexico. Malaria was a major source of disease and premature death in both countries. The central question that occupies the analysis in the subsequent empirical chapters is whether malaria control was shaped by political competition and ethnic or racial diversity. I develop a simple model of disease control in a political system which demonstrates two important facts. First, the impact of political competition on disease control efforts is, theoretically speaking, ambiguous. Competition might increase effort, but might also decrease it. Second, I show that there are two channels through which diversity might impact disease control, one direct, and the other contingent on the level of political competition. The first test of this theory I provide appears in Chapter 3, which focuses on competition, race and malaria in U.S. counties. I find that the effect of race on malaria outcomes is contingent on political disenfranchisement, with more densely black counties suffering from greater levels of malaria only where historical disenfranchisement was low. In Chapter 4, I perform a similar analysis of Mexican municipalities, in which I find that both being located in a competitive state and having a higher level of ethnic diversity lead to worse malaria outcomes, controlling for other factors. Chapter 5 uses another novel data set to explore long term trends in malaria in the Mexican states.
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