Same place, different stories: The mortality burden of the 1918-1920 influenza pandemic in Denmark

Ingholt, Mathias Mølbak; Simonsen, Lone; Wijhe, Maarten van

doi:10.33231/j.ihe.2020.10.005

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…These factors could also explain the lower excess mortality in urban areas in our study. In 1890 and 1918 the number of hospitals did not seem to be associated with excess mortality, which lines up with a study from Denmark showing that access to medical care were not associated with increased mortality 42 . In our study, however, we could not investigate access to medical doctors or the effective distance to medical care.…”

Section: Discussionsupporting

confidence: 65%

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Spatial pattern of all cause excess mortality in Swiss districts during the pandemic years 1890, 1918 and 2020

Matthes,

Floris,

Merzouki

et al. 2024

Preprint

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Background: Every pandemic is embedded in specific spatial and temporal context. However, spatial patterns have almost always only been considered in the context of one individual pandemic. Until now, there has been limited consideration of spatial similarities or differences between pandemics. Objective: The aim of this study was to examine spatial pattern of excess mortality in Swiss districts during the pandemic years 1890, 1918 and 2020. In addition, determinants that could explain the difference between districts were analyzed. Methods: Excess mortality rate was estimated using a Bayesian spatial model for disease mapping. A robust linear regression was used to assess the association between ecological determinants and excess mortality. Results: The highest excess mortality rate in all districts occurred during the 1918 pandemic, the lowest excess mortality rate was seen for the 1890 pandemic. Moreover, this analysis revealed heterogeneous spatial patterns of excess mortality in each pandemic year. Different socio-demographic determinants, in each pandemic, might have favored excess mortality. While the age composition, cultural and area-based socio-economic position differences and the proximity to France and Italy were the main determinants of excess mortality during the Covid-19 pandemic, the mobility, preexisting health issues (i.e. TB) or the remoteness location in the mountains played crucial roles during the historical pandemics. Contribution: The analysis of spatial patterns in pandemics is important for public health interventions in future pandemics or outbreaks since it helps to identifying patterns of transmission. Identifying and understanding geographic hotspots informs precise interventions, aids in public health implementation, and contributes to tailored health policies for the region.

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Section: Discussionsupporting

confidence: 65%

“…In addition, the proportion of men living in a district was used as a determinant of excess mortality. Furthermore, each district was defined as an urban or rural district, assuming that urban areas are more affected 42 . The socio-economic position (SEP) is known to be correlated to health and mortality 21,[43][44][45] .…”

Section: Determinantsmentioning

confidence: 99%

Spatial pattern of all cause excess mortality in Swiss districts during the pandemic years 1890, 1918 and 2020

Matthes,

Floris,

Merzouki

et al. 2024

Preprint

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“…Although a mortality of around 3% in these areas is the highest recorded in any area of Norway, this mortality is on par with the global mortality of 2.5–5% and mortality in the Sámi dominated area of Arjeplog, Sweden. It is also higher than the mortality observed among Inuits in Greenland [ 23 ], where 1.6% of the population died of influenza related deaths in 1919, similar to the pre-pandemic year of 1916 (1.4%). The Indigenous Sámi mortality toll was much lower than among Indigenous people elsewhere in the Arctic, however [ 2 ].…”

Section: Discussionmentioning

confidence: 87%

Age-specific mortality and the role of living remotely: The 1918-20 influenza pandemic in Kautokeino and Karasjok, Norway

Nygaard

Dahal

Chowell

et al. 2023

International Journal of Circumpolar Health

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The 1918–20 pandemic influenza killed 50–100 million people worldwide, but mortality varied by ethnicity and geography. In Norway, areas dominated by Sámi experienced 3–5 times higher mortality than the country’s average. We here use data from burial registers and censuses to calculate all-cause excess mortality by age and wave in two remote Sámi areas of Norway 1918–20. We hypothesise that geographic isolation, less prior exposure to seasonal influenza, and thus less immunity led to higher Indigenous mortality and a different age distribution of mortality (higher mortality for all) than was typical for this pandemic in non-isolated majority populations (higher young adult mortality & sparing of the elderly). Our results show that in the fall of 1918 (Karasjok), winter of 1919 (Kautokeino), and winter of 1920 (Karasjok), young adults had the highest excess mortality, followed by also high excess mortality among the elderly and children. Children did not exhibit excess mortality in the second wave in Karasjok in 1920. It was not the young adults alone who produced the excess mortality in Kautokeino and Karasjok. We conclude that geographic isolation caused higher mortality among the elderly in the first and second waves, and among children in the first wave.

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“…The pattern of spread of the global 1918-20 influenza pandemic has been characterized as a series of three waves occurring during an approximate one-year period in 1918 and 1919 [62,63]. A growing body of recent research suggests that many regions, including the State of Missouri, experienced a substantial fourth wave of the pandemic in 1920 [58,[64][65][66][67][68][69][70][71].…”

Section: General Pattern Of the 1918-20 Influenza Pandemic In The Sta...mentioning

confidence: 99%

Associations between rurality and regional differences in sociodemographic factors and the 1918–20 influenza and 2020–21 COVID-19 pandemics in Missouri counties: An ecological study

Sattenspiel,

Orbann,

Bogan

et al. 2023

PLoS ONE

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This study compares pandemic experiences of Missouri’s 115 counties based on rurality and sociodemographic characteristics during the 1918–20 influenza and 2020–21 COVID-19 pandemics. The state’s counties and overall population distribution have remained relatively stable over the last century, which enables identification of long-lasting pandemic attributes. Sociodemographic data available at the county level for both time periods were taken from U.S. census data and used to create clusters of similar counties. Counties were also grouped by rural status (RSU), including fully (100%) rural, semirural (1–49% living in urban areas), and urban (>50% of the population living in urban areas). Deaths from 1918 through 1920 were collated from the Missouri Digital Heritage database and COVID-19 cases and deaths were downloaded from the Missouri COVID-19 dashboard. Results from sociodemographic analyses indicate that, during both time periods, average farm value, proportion White, and literacy were the most important determinants of sociodemographic clusters. Furthermore, the Urban/Central and Southeastern regions experienced higher mortality during both pandemics than did the North and South. Analyses comparing county groups by rurality indicated that throughout the 1918–20 influenza pandemic, urban counties had the highest and rural had the lowest mortality rates. Early in the 2020–21 COVID-19 pandemic, urban counties saw the most extensive epidemic spread and highest mortality, but as the epidemic progressed, cumulative mortality became highest in semirural counties. Additional results highlight the greater effects both pandemics had on county groups with lower rates of education and a lower proportion of Whites in the population. This was especially true for the far southeastern counties of Missouri (“the Bootheel”) during the COVID-19 pandemic. These results indicate that rural-urban and socioeconomic differences in health outcomes are long-standing problems that continue to be of significant importance, even though the overall quality of health care is substantially better in the 21st century.

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Same place, different stories: The mortality burden of the 1918-1920 influenza pandemic in Denmark

Cited by 5 publications

References 17 publications

Spatial pattern of all cause excess mortality in Swiss districts during the pandemic years 1890, 1918 and 2020

Spatial pattern of all cause excess mortality in Swiss districts during the pandemic years 1890, 1918 and 2020

Age-specific mortality and the role of living remotely: The 1918-20 influenza pandemic in Kautokeino and Karasjok, Norway

Associations between rurality and regional differences in sociodemographic factors and the 1918–20 influenza and 2020–21 COVID-19 pandemics in Missouri counties: An ecological study

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