Mortality From the Influenza Pandemic of 1918–1919: The Case of India
ABSTRACT Estimates of worldwide mortality from the influenza pandemic of 1918-1919 vary widely, from 15 million to 100 million. In terms of loss of life, India was the focal point of this profound demographic event. In this article, we calculate mortality from the influenza pandemic in India using panel data models and data from the Census of India. The new estimates suggest that for the districts included in the sample, mortality was at most 13.88 million, compared with 17.21 million when calculated using the assumptions of Davis (1951). We conclude that Davis' influential estimate of mortality from influenza in British India is overstated by at least 24%. Future analyses of the effects of the pandemic on demographic change in India and worldwide will need to account for this significant downward revision.
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ABSTRACT: The influenza pandemic of 1918-19 was the single most lethal short-term epidemic of the twentieth century. For Indonesia, the world's fourth most populous country, the most widely used estimate of mortality from that pandemic is 1.5 million. We estimated mortality from the influenza pandemic in Java and Madura, home to the majority of Indonesia's population, using panel data methods and data from multiple quinquennial population counts and two decennial censuses. The new estimates suggest that, for Java alone, population loss was in the range of 4.26-4.37 million, or more than twice the established estimate for mortality for all of Indonesia. We conclude that the standing estimates of mortality from influenza in Java and Indonesia need to be revised upward significantly. We also present new findings on geographic patterns of population loss across Java, and pre-pandemic and post-pandemic population growth rates.Population Studies 01/2013; 67(2). DOI:10.1080/00324728.2012.754486 · 1.08 Impact Factor
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ABSTRACT: Background Geographic variables play an important role in the study of epidemics. The role of one such variable, population density, in the spread of influenza is controversial. Prior studies have tested for such a role using arbitrary thresholds for population density above or below which places are hypothesized to have higher or lower mortality. The results of such studies are mixed. The objective of this study is to estimate, rather than assume, a threshold level of population density that separates low-density regions from high-density regions on the basis of population loss during an influenza pandemic. We study the case of the influenza pandemic of 1918–19 in India, where over 15 million people died in the short span of less than one year. Methods Using data from six censuses for 199 districts of India (n=1194), the country with the largest number of deaths from the influenza of 1918–19, we use a sample-splitting method embedded within a population growth model that explicitly quantifies population loss from the pandemic to estimate a threshold level of population density that separates low-density districts from high-density districts. Results The results demonstrate a threshold level of population density of 175 people per square mile. A concurrent finding is that districts on the low side of the threshold experienced rates of population loss (3.72%) that were lower than districts on the high side of the threshold (4.69%). Conclusions This paper introduces a useful analytic tool to the health geographic literature. It illustrates an application of the tool to demonstrate that it can be useful for pandemic awareness and preparedness efforts. Specifically, it estimates a level of population density above which policies to socially distance, redistribute or quarantine populations are likely to be more effective than they are for areas with population densities that lie below the threshold.International Journal of Health Geographics 02/2013; 12(1):9. DOI:10.1186/1476-072X-12-9 · 2.62 Impact Factor
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ABSTRACT: Current estimates of deaths from the influenza pandemic of 1918-19 in Japan are based on vital records and range from 257,000 to 481,000. The resulting crude death rate range of 0.47%-0.88% is considerably lower than parallel and conservative worldwide estimates of 1.66%-2.77%. Because the accuracy of vital registration records for early 20th century Asia is questionable, to calculate the percentage of the population who died from the pandemic, we used alternative prefecture-level population count data for Japan in combination with estimation methods for panel data that were not available to earlier demographers. Our population loss estimates of 1.97-2.02 million are appreciably higher than the standing estimates, and they yield a crude rate of population loss of 3.62%-3.71%. This rate resolves a major puzzle about the pandemic by indicating that the experience of Japan was similar to that of other parts of Asia.Emerging Infectious Diseases 04/2013; 19(4):616-22. DOI:10.3201/eid1904.120103 · 7.33 Impact Factor