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

1
Department of Business, History and Social Sciences, University of South-Eastern Norway, Raveien 215, 3184 Borre, Norway
2
Work Research Institute, OsloMet—Oslo Metropolitan University, PO. Box 4, St. Olavs Plass, 0130 Oslo, Norway
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(14), 2487; https://doi.org/10.3390/ijerph16142487
Received: 25 June 2019 / Revised: 8 July 2019 / Accepted: 9 July 2019 / Published: 12 July 2019
(This article belongs to the Special Issue Health of Marginalized People)
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Abstract

During epidemics, the poorest part of the population usually suffers the most. Alfred Crosby noted that the norm changed during the 1918 influenza pandemic in the US: The black population (which were expected to have higher influenza morbidity and mortality) had lower morbidity and mortality than the white population during the autumn of 1918. Crosby’s explanation for this was that black people were more exposed to a mild spring/summer wave of influenza earlier that same year. In this paper, we review the literature from the pandemic of 1918 to better understand the crossover in the role of race on mortality. The literature has used insurance, military, survey, and routine notification data. Results show that the black population had lower morbidity, and during September, October, and November, lower mortality but higher case fatality than the white population. The results also show that the black population had lower influenza morbidity prior to 1918. The reasons for lower morbidity among the black population both at baseline and during the herald and later waves in 1918 remain unclear. Results may imply that black people had a lower risk of developing the disease given exposure, but when they did get sick, they had a higher risk of dying. View Full-Text
Keywords: influenza; pneumonia; pandemic; inequality; race; morbidity; mortality; case fatality; 1918; USA influenza; pneumonia; pandemic; inequality; race; morbidity; mortality; case fatality; 1918; USA
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Økland, H.; Mamelund, S.-E. Race and 1918 Influenza Pandemic in the United States: A Review of the Literature. Int. J. Environ. Res. Public Health 2019, 16, 2487.

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