Centre for Economic Demography (CED) and Department of Economic History, Lund University, Box 7083, 220 07, Lund, Sweden.
Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 19th Avenue South, Minneapolis, MN, 55455, USA.
Demography. 2019 Aug;56(4):1389-1425. doi: 10.1007/s13524-019-00799-x.
The 1918 influenza pandemic had not only a massive instant death toll but also lasting effects on its survivors. Several studies have shown that children born in 1919, and thus exposed to the H1N1 virus in utero, experienced worse health and socioeconomic outcomes in older ages than surrounding birth cohorts. This study combines several sources of contemporary statistics with full-population individual-level data for Sweden during 1968-2012 to examine the influence of fetal exposure to the Spanish flu on health, adulthood income, and occupational attainment. For both men and women, fetal exposure resulted in higher morbidity in ages 54-87, as measured by hospitalization. For males, exposure during the second trimester also affected mortality in cancer and heart disease. Overall, the effects on all-cause mortality were modest, with about three months shorter remaining life expectancy for the cohorts exposed during the second trimester. For socioeconomic outcomes, results fail to provide consistent evidence supporting any long-term consequences of fetal exposure. We conclude that although the immediate health effects of exposure to the 1918 pandemic were huge, the long-term effects were modest in size.
1918 年流感大流行不仅造成了大量的即时死亡人数，而且对幸存者也产生了持久的影响。多项研究表明，1919 年出生的儿童（因此在子宫内接触到 H1N1 病毒），在老年时的健康和社会经济状况比周围的出生队列更差。本研究结合了瑞典 1968-2012 年期间的几个当代统计数据来源和全人群个人层面数据，研究了胎儿暴露于西班牙流感对健康、成年期收入和职业成就的影响。对于男性和女性，胎儿暴露导致 54-87 岁时的发病率更高，这一结果通过住院治疗来衡量。对于男性，暴露于妊娠中期也会影响癌症和心脏病的死亡率。总体而言，对所有原因死亡率的影响较小，暴露于妊娠中期的队列预期寿命减少了约三个月。对于社会经济结果，研究结果未能提供一致的证据来支持胎儿暴露的任何长期后果。我们的结论是，尽管暴露于 1918 年大流行的即时健康影响巨大，但长期影响的规模较小。
