Department of Business, History and Social Sciences, University of South-Eastern Norway, Raveien 215, 3184 Borre, Norway.
Work Research Institute, OsloMet-Oslo Metropolitan University, PO. Box 4, St. Olavs Plass, 0130 Oslo, Norway.
Int J Environ Res Public Health. 2019 Jul 12;16(14):2487. doi: 10.3390/ijerph16142487.
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.
在疫情期间，通常是最贫困的人群受到的影响最大。阿尔弗雷德·克罗斯比（Alfred Crosby）注意到，在 1918 年美国流感大流行期间，这种常态发生了变化：黑人（预期流感发病率和死亡率更高）在 1918 年秋季的发病率和死亡率低于白人。克罗斯比对此的解释是，黑人在同年早些时候更易受到春季/夏季流感轻度浪潮的影响。在本文中，我们回顾了 1918 年大流行期间的文献，以更好地了解种族在死亡率方面的作用转变。文献使用了保险、军事、调查和常规通知数据。结果表明，黑人的发病率较低，在 9 月、10 月和 11 月，死亡率较低，但病死率高于白人。结果还表明，黑人在 1918 年之前的流感发病率较低。黑人在基线和 1918 年的先兆和后期浪潮中发病率较低的原因仍不清楚。结果可能意味着黑人在接触疾病时风险较低，但一旦患病，死亡风险较高。
