The 1918 Influenza Epidemic's Effects on Sex Differentials in Mortality in the United States

Abstract

The 1918 influenza epidemic had a marked and fairly long-lasting effect on the sex differential in mortality in the United States. After 1918 women lost most of their mortality advantage over men and the female/male gap did not regain its pre-epidemic level until the 1930s. An analysis of causes of deaths shows a link with tuberculosis. We conjecture the existence of a selection effect, whereby many 1918 influenza deaths were among tuberculous persons, so that tuberculosis death rates dropped in later years, disproportionately among males. Age- and sex-specific data by cause of death corroborate this hypothesis. Copyright 2000 by The Population Council, Inc..

The 1918 influenza pandemic and subsequent birth deficit in Japan

“…The significant and negative cross-correlation between deaths and births two months later may have been the result of stillbirths in the seventh month of gestation at the height of the pandemic. It is also possible that many women in the third trimester of pregnancy died during the pandemic, including (and perhaps especially) women who were in the seventh month of pregnancy, thus contributing to the birth trough observed two months after the mortality peak − a well-known fact about the age distribution of deaths during the 1918 pandemic period is the unusually high mortality rate among adults in the prime of life, including women of peak childbearing age (15−44 years old), forming a W-shaped age-specific death rate in contrast to the Ushaped distribution commonly observed in influenza epidemics (Noymer and Garenne 2000;Taubenberger and Morens 2006). In sum, the results suggest that, in addition to the two above observations, the mechanisms of reduced conceptions and embryonic losses in the first month of the first trimester of the pregnancy, rather than elevated embryonic losses in the late stage of the first-trimester, are the dominant ones linking mortality and fertility.…”

Economic Implications of Epidemics Old and New

“…6 The inner 'spike' was especially sharp among adult men, a fact that has been attributed to higher rates of latent tuberculosis among males. The aggregate result was an abrupt decline in life expectancy at birth of about 12 years for both sexes, followed by a rapid recovery, especially among males (Noymer and Garenne, 2000).…”

Gender Roles and Medical Progress

“…The White House followed with a similar national report and this precicipated the efforts to standardize obstetric practices and train physicians. 8 Noymer and Garenne (2000) show that the drop in the female-male differential in life expectancy between 1915 and 1920 is a consequence of the influenza epidemic of 1918 on female-male mortality differentials for tuberculosis. Influenza increased mortality associated with tuberculosis.…”