Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities
(2022) In Demography 59(5). p.1953-1979- Abstract
- Against a backdrop of extreme racial health inequality, the 1918 influenza pandemic resulted in a striking reduction of non-White to White influenza and pneumonia mortality disparities in United States cities. We provide the most complete account to date of these reduced racial disparities, showing that they were unexpectedly uniform across cities. Linking data from multiple sources, we then examine potential explanations for this finding, including city-level sociodemographic factors such as segregation, implementation of nonpharmaceutical interventions, racial differences in exposure to the milder spring 1918 “herald wave,” and racial differences in early-life influenza exposures, resulting in differential immunological vulnerability to... (More)
- Against a backdrop of extreme racial health inequality, the 1918 influenza pandemic resulted in a striking reduction of non-White to White influenza and pneumonia mortality disparities in United States cities. We provide the most complete account to date of these reduced racial disparities, showing that they were unexpectedly uniform across cities. Linking data from multiple sources, we then examine potential explanations for this finding, including city-level sociodemographic factors such as segregation, implementation of nonpharmaceutical interventions, racial differences in exposure to the milder spring 1918 “herald wave,” and racial differences in early-life influenza exposures, resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for the first three explanations, we offer suggestive evidence that racial variation in childhood exposure to the 1889–1892 influenza pandemic may have shrunk racial disparities in 1918. We also highlight the possibility that differential behavioral responses to the herald wave may have protected non-White urban populations. By providing a comprehensive description and examination of racial inequality in mortality during the 1918 pandemic, we offer a framework for understanding disparities in infectious disease mortality that considers interactions between the natural histories of particular microbial agents and the social histories of those they infect. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/6e4969f5-a169-4531-9321-01b85698f977
- author
- Eiermann, Martin ; Wrigley-Field, Elizabeth ; Feigenbaum, James J ; Helgertz, Jonas LU ; Hernandez, Elaine and Boen, Courtney E
- organization
- publishing date
- 2022-09-20
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- 1918 influenza pandemic, Racial disparaties, Immunological imprinting, nonpharmaceutical intervention, residential segregation
- in
- Demography
- volume
- 59
- issue
- 5
- pages
- 1953 - 1979
- publisher
- Population Assn Amer
- external identifiers
-
- pmid:36124998
- scopus:85139442647
- ISSN
- 0070-3370
- DOI
- 10.1215/00703370-10235825
- language
- English
- LU publication?
- yes
- id
- 6e4969f5-a169-4531-9321-01b85698f977
- date added to LUP
- 2022-09-22 16:31:39
- date last changed
- 2022-11-08 04:08:41
@article{6e4969f5-a169-4531-9321-01b85698f977,
abstract = {{Against a backdrop of extreme racial health inequality, the 1918 influenza pandemic resulted in a striking reduction of non-White to White influenza and pneumonia mortality disparities in United States cities. We provide the most complete account to date of these reduced racial disparities, showing that they were unexpectedly uniform across cities. Linking data from multiple sources, we then examine potential explanations for this finding, including city-level sociodemographic factors such as segregation, implementation of nonpharmaceutical interventions, racial differences in exposure to the milder spring 1918 “herald wave,” and racial differences in early-life influenza exposures, resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for the first three explanations, we offer suggestive evidence that racial variation in childhood exposure to the 1889–1892 influenza pandemic may have shrunk racial disparities in 1918. We also highlight the possibility that differential behavioral responses to the herald wave may have protected non-White urban populations. By providing a comprehensive description and examination of racial inequality in mortality during the 1918 pandemic, we offer a framework for understanding disparities in infectious disease mortality that considers interactions between the natural histories of particular microbial agents and the social histories of those they infect.}},
author = {{Eiermann, Martin and Wrigley-Field, Elizabeth and Feigenbaum, James J and Helgertz, Jonas and Hernandez, Elaine and Boen, Courtney E}},
issn = {{0070-3370}},
keywords = {{1918 influenza pandemic; Racial disparaties; Immunological imprinting; nonpharmaceutical intervention; residential segregation}},
language = {{eng}},
month = {{09}},
number = {{5}},
pages = {{1953--1979}},
publisher = {{Population Assn Amer}},
series = {{Demography}},
title = {{Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities}},
url = {{http://dx.doi.org/10.1215/00703370-10235825}},
doi = {{10.1215/00703370-10235825}},
volume = {{59}},
year = {{2022}},
}