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特定年龄段的死亡率与居住偏远的关系:挪威卡累利阿的 1918-20 年流感大流行。

Age-specific mortality and the role of living remotely: The 1918-20 influenza pandemic in Kautokeino and Karasjok, Norway.

机构信息

Department of Archaeology, History, Religious Studies and Theology, University of Tromsø - the Arctic University of Norway, Norway.

School of Public Health, Georgia State University, Atlanta, GA, USA.

出版信息

Int J Circumpolar Health. 2023 Dec;82(1):2179452. doi: 10.1080/22423982.2023.2179452.

Abstract

The 1918-20 pandemic influenza killed 50-100 million people worldwide, but mortality varied by ethnicity and geography. In Norway, areas dominated by Sámi experienced 3-5 times higher mortality than the country's average. We here use data from burial registers and censuses to calculate all-cause excess mortality by age and wave in two remote Sámi areas of Norway 1918-20. We hypothesise that geographic isolation, less prior exposure to seasonal influenza, and thus less immunity led to higher Indigenous mortality and a different age distribution of mortality (higher mortality for all) than was typical for this pandemic in non-isolated majority populations (higher young adult mortality & sparing of the elderly). Our results show that in the fall of 1918 (Karasjok), winter of 1919 (Kautokeino), and winter of 1920 (Karasjok), young adults had the highest excess mortality, followed by also high excess mortality among the elderly and children. Children did not exhibit excess mortality in the second wave in Karasjok in 1920. It was not the young adults alone who produced the excess mortality in Kautokeino and Karasjok. We conclude that geographic isolation caused higher mortality among the elderly in the first and second waves, and among children in the first wave.

摘要

1918-1920 年大流感在全球范围内造成 5000 万至 1 亿人死亡,但死亡率因种族和地理位置而异。在挪威,以萨米人为主的地区的死亡率比全国平均水平高出 3-5 倍。我们在这里使用来自埋葬登记册和人口普查的数据,计算了挪威两个偏远的萨米地区在 1918-20 年期间按年龄和波次计算的全因超额死亡率。我们假设地理隔离、较少接触季节性流感,从而导致免疫力较低,导致土著死亡率更高,死亡率的年龄分布(所有人的死亡率更高)与非隔离的大多数人群中这种大流行的典型情况不同(年轻成年人死亡率更高,老年人死亡率较低)。我们的结果表明,在 1918 年秋季(卡拉绍克)、1919 年冬季(克托凯诺)和 1920 年冬季(卡拉绍克),年轻人的超额死亡率最高,其次是老年人和儿童的超额死亡率也很高。在 1920 年卡拉绍克的第二波中,儿童没有表现出超额死亡率。在克托凯诺和卡拉绍克,超额死亡率不仅仅是年轻人造成的。我们的结论是,地理隔离导致第一波和第二波中老年人死亡率更高,第一波中儿童死亡率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1383/9970246/07841ead8561/ZICH_A_2179452_F0001_OC.jpg

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