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Jonas Helgertz

Vice Dean Research, Associate Professor

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Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities

Author

  • Martin Eiermann
  • Elizabeth Wrigley-Field
  • James J Feigenbaum
  • Jonas Helgertz
  • Elaine Hernandez
  • Courtney E Boen

Summary, in English

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.

Department/s

  • Economic demography
  • Centre for Economic Demography
  • Department of Economic History

Publishing year

2022-09-20

Language

English

Pages

1953-1979

Publication/Series

Demography

Volume

59

Issue

5

Document type

Journal article

Publisher

Population Assn Amer

Topic

  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • 1918 influenza pandemic
  • Racial disparaties
  • Immunological imprinting
  • nonpharmaceutical intervention
  • residential segregation

Status

Published

ISBN/ISSN/Other

  • ISSN: 0070-3370