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Reevaluating the Long-Term Impact of In Utero Exposure to the 1918 Influenza Pandemic.

ABSTRACT: Almond (2006) argues that in utero exposure to the 1918 influenza pandemic reduced the 1919 birth cohort's adult socioeconomic status (SES). We show that this cohort came from lower-SES families, which is incompatible with Almond's cohort-comparison identification strategy. The adult SES deficit is reduced after background characteristics are controlled for; it is small and statistically insignificant in models that include household fixed effects. Replicating Almond's state-level dose-response analysis, we find no evidence in census data that influenza exposure reduced adult SES. Evidence from a city-level dose-response analysis on educational attainment using WWII enlistees from 287 cities is mixed.

SUBMITTER: Beach B

PROVIDER: S-EPMC10578057 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Reevaluating the Long-Term Impact of In Utero Exposure to the 1918 Influenza Pandemic.

Beach Brian B Brown Ryan R Ferrie Joseph J Saavedra Martin M Thomas Duncan D

The journal of political economy 20220701 7

Almond (2006) argues that in utero exposure to the 1918 influenza pandemic reduced the 1919 birth cohort's adult socioeconomic status (SES). We show that this cohort came from lower-SES families, which is incompatible with Almond's cohort-comparison identification strategy. The adult SES deficit is reduced after background characteristics are controlled for; it is small and statistically insignificant in models that include household fixed effects. Replicating Almond's state-level dose-response ...[more]

PMID: 37846350

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Project description:BACKGROUND:Increasing our knowledge of past influenza pandemic patterns in different regions of the world is crucial to guide preparedness plans against future influenza pandemics. Here, we undertook extensive archival collection efforts from three representative cities of Peru-Lima in the central coast, Iquitos in the northeastern Amazon region, Ica in the southern coast-to characterize the temporal, age and geographic patterns of the 1918-1920 influenza pandemic in this country. MATERIALS AND METHODS:We analyzed historical documents describing the 1918-1920 influenza pandemic in Peru and retrieved individual mortality records from local provincial archives for quantitative analysis. We applied seasonal excess mortality models to daily and monthly respiratory mortality rates for 1917-1920 and quantified transmissibility estimates based on the daily growth rate in respiratory deaths. RESULTS:A total of 52,739 individual mortality records were inspected from local provincial archives. We found evidence for an initial mild pandemic wave during July-September 1918 in Lima, identified a synchronized severe pandemic wave of respiratory mortality in all three locations during November 1918-February 1919, and a severe pandemic wave during January 1920-March 1920 in Lima and July-October 1920 in Ica. There was no recrudescent pandemic wave in 1920 in Iquitos. Remarkably, Lima experienced the brunt of the 1918-1920 excess mortality impact during the 1920 recrudescent wave, with all age groups experiencing an increase in all cause excess mortality from 1918-1919 to 1920. Middle age groups experienced the highest excess mortality impact, relative to baseline levels, in the 1918-1919 and 1920 pandemic waves. Cumulative excess mortality rates for the 1918-1920 pandemic period were higher in Iquitos (2.9%) than Lima (1.6%). The mean reproduction number for Lima was estimated in the range 1.3-1.5. CONCLUSIONS:We identified synchronized pandemic waves of intense excess respiratory mortality during November 1918-February 1919 in Lima, Iquitos, Ica, followed by asynchronous recrudescent waves in 1920. Cumulative data from quantitative studies of the 1918 influenza pandemic in Latin American settings have confirmed the high mortality impact associated with this pandemic. Further historical studies in lesser studied regions of Latin America, Africa, and Asia are warranted for a full understanding of the global impact of the 1918 pandemic virus.

Dataset Information

Reevaluating the Long-Term Impact of In Utero Exposure to the 1918 Influenza Pandemic.

Publications

Reevaluating the Long-Term Impact of In Utero Exposure to the 1918 Influenza Pandemic.

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