This article uses the Standard Cross-Cultural Samples to test the relationship between disease and economic growth among sub-Saharan African societies. The authors suggest that a higher disease prevalence limits social integration and economic development since pre-colonial times. The variable measuring economic growth is the complexity of large or impressive structures. The hypotheses are that 1) pathogen stress is negatively correlated to the presence of complex buildings, and 2) pathogen stress is positively correlated to increased ethnic diversity. The results support both hypotheses, and there are additional results, like 1) the negative correlation between pathogen stress and current income per capita and 2) the negative correlation between the increased ethnic diversity and current income per capita. Overall, this article shows the robust relationship between disease and economic development.