A Comparison of White and Colored Troops in Respect to Incidence of Disease

Abstract

Army, 1918. Some comparative data have occasionally been included derived from the nine preceding annual reports.In many cases the morbidity rate is almost the same for the white and colored troops. In this paper particular attention is paid to those diseases that have a strikingly different rate in the two races. It is to be kept in mind that all troops had been subjected to the same examination at induction, in order to exclude chronic diseases; and that they lived under equally good sanitary conditions. First, may be considered the diseases that are commoner in colored than in white troops. These fall into four groups (a), those in which the excess is due to the fact that fewer of the colored men had become artificially immunized by inoculation before, or at, mobilization. They probably brought their disease to camp; or failed to get a reaction there; (b) those in which there is a lower natural immunity in the negro; (c) venereal disease and its complications, (d) other diseases.(a) Of the diseases that are due to lack of acquired immunity, smallpox is the most striking. The morbidity rate for this disease is for colored troops 9 times that for white troops (there being 146 admissions altogether). Chickenpox was relatively 8 times as common in colored as in white troops.(b) Of the diseases for which negroes lack relative natural resistance tuberculosis of the lungs and pneumonia take first places. There were over 24 times the admission rate for tuberculosis of the lungs in colored as in white troops in 1917. This is a little greater difference than the average of the past 58

Race and 1918 Influenza Pandemic in the United States: A Review of the Literature

“…Placing these results for insurance holders in the context of the above research for Bergen and Maryland, it is likely that (1) a previously unrecognized pandemic summer wave may have hit the two regions of Maryland in 1918 but also other areas of the USA than New York and Kansas, and (2) that males of both races and black people were more exposed in the spring/summer of 1918, while females and white people with less exposure and acquired immunity during the spring/summer had higher morbidity and mortality in the fall of 1918. This would also be consistent with the assumption of a higher pre-pandemic exposure among black people, which would be one explanation for why white soldiers had higher influenza morbidity than black soldiers [7]. That positive excess mortality was mainly visible for those aged 20–40 of both races, that it peaked in those around the age of 30, and that excess mortality was negative for those 70+, is generally consistent with prior research [42].…”

“…We found one report documenting the baseline morbidity from influenza among 558,668 soldiers for the calendar year of 1917, including 545,518 white (97.6%) and 13,150 black (2.4%) soldiers. The hospital admission rate for influenza was 2.1 and 4.0 times higher for the white than for the black soldiers in 1917 and 1910–1917, respectively [7] (for 1917: 5.84% vs. 2.78%, a rate difference at 3.06, 95% CI 1.33–4.79, z = 3.47). On the other hand, hospitalization rates for lobar pneumonia in 1917, which could be due to influenza, measles, or other underlying diseases, was 4.68 times more frequent for black than for white soldiers (5.37% vs. 1.15%, a rate difference of 4.22, 95% CI 2.49–5.95, z = 4.78).…”

“…The black troops were, on the other hand, more susceptible to pneumonia than white troops, and a higher share of black influenza cases developed pneumonia. They had often, but not always, higher pneumonia morbidity, mortality, and case fatality both before and during the pandemic [7,8,9,10,11,12,13]. Humphreys [27] discussed whether the black population in the Southern states had more often been exposed to malaria, hookworm, and pellagra compared to the white population.…”

“…A contemporary theory as to why the black population seemed to be less susceptible to upper respiratory tract diseases such as influenza and polio was that the lining of their noses (nasopharynx) was more resistant to microorganisms [7]. A more scientific and credible hypothesis, consistent with Crosby’s hypothesis, is that the black population on a general basis were exposed to flu viruses due to their social conditions and therefore had lower susceptibility during both the autumn and the spring/summer waves [46].…”

“…Further, although black people more often were placed in noncombatant battalions and more often lived in tent colonies fully segregated from white barracks, both black and white soldiers were at the time assumed to live under relatively controlled conditions and under the same military nutrition, clothing, training, and discipline [7]. One major weakness of military data is that they only include males 18–45 years, while other male age groups and females are not considered [7,8,9,10,11,12,13]. Military data also include the physically and mentally fittest of males 18–45 years [8,10,14,15].…”