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This paper investigates the impact of railway expansion on mortality across British India. The paper compiles a new dataset of annual mortality at the town level and constructs a spatially weighted railway density measure for each town and year. We demonstrate two key findings. First, increased connectivity had a significant impact on deaths from cholera and smallpox. Second, the areas that were exposed to seasonal malaria reported higher deaths as railway lines multiplied. The paper suggests that increased mobility fuelled communicable disease transmission rates while waterlogging in railway construction sites affected vector-borne infections.

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