Investigating the Relationship between Immigration Status and Mortality during the 1918 Influenza Pandemic in Cleveland, Ohio

Abstract

The 1918 Influenza Pandemic stands as one of the most notable pandemics to date. Not only for its global death toll, but for its unique age-mortality curve, showing unusually high mortality among young adults (approximately ages 20 to 40). While current literature explores various characteristics of this Pandemic, it is limited on the impact immigration status may have had during this time. As such, the objective of this study was to assess how death counts differed across immigration statuses during the 1918 Influenza Pandemic when compared to the year prior. Using the genealogy website, Family Search, 2% of death certificates, per month, from Cuyahoga County in Cleveland, Ohio, were collected. This information was utilized to categorize individuals into the Control or Flu timelines (i.e., September 1917 to April 1918, and September 1918 to April 1919, respectively), immigration status (i.e., domestic, first-generation, or second-generation), age of death, and cause of death. A saturated generalized linear model assessed status and age combinations between the Control and Flu timelines using an analysis of deviance and chi-squared analyses. Results suggest that no specific immigration status group was associated with disproportionate mortality. However, when specifically assessing individuals ages 20 to 39, analyses suggest that first-generation individuals had a higher mortality relative to domestic-status individuals. This may illuminate additional characteristics from the Pandemic, suggest an additional avenue for research when assessing its unique age-mortality curve, and create an area of consideration for future pandemic research. Future studies may continue studying this relationship on larger spatial, temporal, and data scales.