Leviathan's health: state capacity and pestilence from the Black Death to Covid

Journal article

This article examines how state capacity influenced epidemic control from the Black Death to Covid-19. Contrary to conventional theories linking fiscal capacity, centralization, and parliamentary governance to beneficial deployment of state capacity, historical evidence reveals that these features were neither necessary nor sufficient for successful contagion control. Fiscal resources were largely diverted to warfare; centralization often stifled local policy innovation; and parliaments frequently served elite interests. The analysis also reveals the «dark side» of state capacity, showing how governments used their powers to conceal outbreaks, block disease control, and suppress dissent, exacerbating contagion. Effective epidemic control emerged not from Leviathan alone, but from a heterogeneous institutional framework in which the state was supplemented and curbed by non-state institutions – market, community, religion, medical profession, and family.

Authors: Ogilvie, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Società Editrice Il Mulino
• Journal: Rivista di Storia Economica / Italian Review of Economic History
• Publication date: 2026-03-17
• Acceptance date: 2026-02-24
• DOI: 10.1410/120051
• EISSN: 2612-1026
• ISSN: 0393-3415
• Language: English
• Keywords: institutions; state capacity; epidemics; public health; economic history