São Paulo, the major sugarcane-producing state in Brazil, commands over a fifth of the world's sugarcane production.
Between the late 2000s and the mid-2010s, the state replaced manual pre-harvest burning with mechanical harvesting across nearly its entire sugarcane area — a shift we use to study its consequences for public health in São Paulo's municipalities.
Using a difference-in-differences design that exploits variation in municipal sugarcane land share, we find that greater exposure to the technical change reduced respiratory hospitalizations. Circulatory hospitalizations also decline, but this decline cannot be separated from a convergence already under way before the transition.
We further document reductions in pollution-linked congenital anomalies. Mortality from respiratory and circulatory causes shows no detectable effect, among adults or among children under five.
The pattern of the effect points to the smoke channel: fire incidence and particulate matter fall only during the harvest season, respiratory hospitalization reductions are larger during those same months, and municipalities downwind of sugarcane areas benefit more.
Keywords: Sugarcane Burning; Technical Change; Health Outcomes; Air Pollution. · JEL Codes: Q52, Q55, I18.