Unequal Mortality During the Spanish Flu

Basco, Sergi; Domènech, Jordi; Rosés, Joan R.

doi:10.1007/978-3-031-05668-0_3

Cited by 5 publications

(3 citation statements)

References 64 publications

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“…The education results are in line with those of Chul Hong and Yun, who used data from the 1960 Korean Census to find that foetal exposure to the pandemic (the 1910–20 birth cohort) resulted in lower educational attainment as measured by years of schooling and literacy, especially in provinces that suffered intensively. Basco et al. note the heterogeneous impacts of the pandemic in Spain where low‐income workers experienced the highest mortality, and hypothesise that climatic differences may have influenced regional patterns in contagion.…”

Section: Literaturementioning

confidence: 99%

Short‐ and medium‐run health and literacy impacts of the 1918 Spanish Flu pandemic in Brazil

Guimbeau

Menon

Musacchio

2022

The Economic History Review

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We study the lasting repercussions of the 1918 influenza (‘Spanish Flu’) pandemic on health measures and literacy rates in São Paulo, Brazil, the most populous city in South America today, but significantly poorer a century ago. Leveraging temporal and spatial variation in district‐level estimates of influenza‐related deaths for the 1917–20 time period, combined with a unique database on demographic and literacy outcomes as well as a detailed set of socio‐economic, infrastructure, and regional determinants newly constructed from historical data, we find that the pandemic had significant impacts. In particular, infant mortality and stillbirths rose, sex ratios at birth fell, and there was a marked improvement in male literacy rates for those 15 years and above in 1920. Further analyses reveal that these impacts are most pronounced in districts with older populations, less literate districts, and districts where access to doctors was relatively limited. We find evidence that the male literacy effects persist in 1940. These results highlight that ramifications of the 1918 Spanish Flu pandemic were experienced for at least two decades after the event in a context where institutions were relatively weak and resources for mitigation were limited.

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Section: Literaturementioning

confidence: 99%

Short‐ and medium‐run health and literacy impacts of the 1918 Spanish Flu pandemic in Brazil

Guimbeau

Menon

Musacchio

2022

The Economic History Review

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“…Island populations, even small ones, experienced influenza death rates that were not homogenous across the island; on the Pacific islands, Indigenous populations experienced higher mortality rates relative to the smaller non-Indigenous residents [29,30]. There was also variation in spatial/geographical expression of mortality, and in particular with regards to rurality as a protective factor (for rurality having lower rates than urban areas, in other words, 'the urban penalty,' see: [26,31], and for rurality as not offering protection, 'the rural penalty,' see [32,33]), as well as heterogeneity in wave patterns, and in timing of the pandemic [29]. Explanations for regional heterogeneity of 1918/19 influenza patterns have focused on socio-geographic factors such as population size, population density, malnutrition, poverty, and overcrowded living environments, as well as sociopolitical factors [26,[34][35][36].…”

Section: Introductionmentioning

confidence: 99%

The emergence of a suburban penalty during the 1918/19 influenza pandemic in Malta: The role of a marketplace, railway, and measles

Tripp,

Sawchuk

2023

PLOS Glob Public Health

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The Malta 1918/19 influenza experience adds to our understanding of the pandemic by illustrating the importance of suburban populations, their vulnerabilities, and elevated mortality rates. Studies on the socio-geographical variation in the 1918/19 influenza mortality has largely overlooked the suburban experience, and thus the often-hidden heterogeneity of the disease experience is missing. A comparison of mortality rates across the three settlement types (urban, suburban, and rural) for the second wave of the pandemic revealed that there were significant differences across the settlement types (x2 = 22.67, 2df, p <0.0001). There was a statistically significant divide between suburban settlement type versus urban and rural communities. Further, the geographical division of the central suburban region had the highest mortality rate at 4.28 per 1000 living of all suburban regions. A closer examination of the central suburban communities revealed that the town of Birchicara was the driving force behind the elevated influenza mortality, with a rate of 5.28 per 1000 living. The exceedingly high rate of influenza mortality in Birchicara was significantly different from the other suburban communities (Z = 2.915, p = 0.004). Birchicara was notable as both a transmission and burden hotspot for influenza infection because of a unique conflation of factors not observed elsewhere on the island. Foremost, was the pitkali market, which was a produce wholesale distributing centre; second, was the fact that the train station was a central hub especially for Maltese labourers; third, was that the measles epidemic in 1916/17 contributed to elevated childhood influenza deaths because the presence of military personnel and their families. We argue that the interaction of the three factors, and in particular, the measles epidemic with childhood influenza, amounted to a syndemic. Factors associated with urbanization and high rates of infectious diseases, such as overcrowding and infant mortality, did not play a primary role in the syndemic.

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“…6 Basco et al (2021) use Spanish occupation level data and associated income to show a negative association between income and pandemic mortality rates. Furthermore, Clay et al (2018) control for the manufacturing payroll per worker in 1900, but the results for this estimator are not reported.…”

Section: Introductionmentioning

confidence: 99%

Poverty, pollution, and mortality: The 1918 influenza pandemic in a developing German economy

Franke

2022

The Economic History Review

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The paper provides a detailed analysis of excess mortality during the "Spanish Flu" in a developing German economy and the effect of poverty and air pollution on pandemic mortality. The empirical analysis is based on a difference-in-differences approach using annual all-cause mortality statistics at the parish level in the Kingdom of Württemberg. The paper complements the existing literature on urban pandemic severity with comprehensive evidence from mostly rural parishes. The results show that middle and high-income parishes had a significantly lower increase in mortality rates than low-income parishes. Moreover, the mortality rate during the 1918 influenza pandemic was significantly higher in highly polluted parishes compared to least polluted parishes.

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Unequal Mortality During the Spanish Flu

Cited by 5 publications

References 64 publications

Short‐ and medium‐run health and literacy impacts of the 1918 Spanish Flu pandemic in Brazil

Short‐ and medium‐run health and literacy impacts of the 1918 Spanish Flu pandemic in Brazil

The emergence of a suburban penalty during the 1918/19 influenza pandemic in Malta: The role of a marketplace, railway, and measles

Poverty, pollution, and mortality: The 1918 influenza pandemic in a developing German economy

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