Svenn-Erik Mamelund
Spanish Influenza and beyond: the case of Norway

Aims and objectives

The aim of the project is to analyse both the immediate and the long-term demographic impact of Spanish Influenza in Norway, which struck the country during the years 1918-1920. More specifically, the objectives are: I ) to analyse socio-economic correlates of mortality at the individual level for the inhabitants of selected parishes in Kristiania; 2) to estimate socio-economic and climatic correlates of morbidity and mortality after infection with influenza in Norwegian medical districts; 3) to estimate the immediate and long-term impact of Spanish Influenza on national and regional fertility; and 4) to study the effect of Spanish Influenza on national long-term mortality. None of these problems have been studied adequately in the international literature, and hardly at all in a Norwegian context. Moreover, most of the studies relevant to this project were carried out in the years immediately after 1918, long before modem demographic methods were developed. Norwegian historical demographic data are unique in an international context. Therefore the project will contribute significantly to the existing knowledge regarding the flu of 1918.

Outline

In the following, I will outline the planned papers in the project, including each paper's sub-goal.

1.Spanish Influenza in Kristiania - a study of social and geographical differentials inmortality

Objective.- Estimate correlates of mortality by age, sex, and occupation in the parishes of Grønland, Wexels and Frogner in the years 1918-1919 at the individual level using logistic regression.

2.Regional morbidity and mortality - a study of the 1918-1919 flu in Norway

Objective: Use ecological regression to analyse the relationship between socio-economic, regional, and

climatic factors in Norway's 321 medical districts on the one hand, and influenza morbidity and mortality at

the other.

3.The demographic response to Spanish Influenza in Norway with emphasis on regional fertility

Objective: Use ecological regression to study the effect on fertility in medical districts of morbidity and mortality after infection with influenza, and of socio-economic, regional, and climatic factors.

4.Long term effects of the Spanish flu on mortality among Norwegian cohorts

Objective: Analyse long term effects on mortality among cohorts that experienced Spanish Influenza using Age-Period-Cohort-analysis. A special emphasis will be put on sex differentials and possible selection effects.

Background

Spanish Influenza swept the entire globe in the years 1918-1920, leaving a billion people sick, more than half of the worid's population at that time. It killed at least 30 million people, threc times the death toll of World War l (Wilton 1993). A study for Norway has recently resulted in an upward revision of the death toll. The suggested estimate is 14 676, twice as high as the most frequently cited figure (Mamelund 199Sa). The socio-economic impact of the flu was also considerable. One reason for this is that the flu took its greatest toll among people in their most productive ages (20-40 years, especially men), i.e. that part of life when people tend to marry and have children (Mamelund 1998a). This led to high rates of maniage dissolution through the death of one or both spouses, and as a result children were also orphaned (Rice 1988). Another consequence was fewer conceptions than expected in 1918 and 1919 (Höijer 1959, Pool 1973, Rice 1983, Underwood 1983, Mills 1986).

Despite immense demographic and socio-economic turmoil, Spanish Influenza has largely been forgotten in the writing of world history (Crosby 1989). Recently, however, there is a revived interest in the flu. There are three reasons for this. First, the virus hunters at Svalbard (Spitsbergen) in August 1998, put the epidemic on the international news agenda when thev excavated the graves of flu victims in search of the virus of 1918. Secondly, an International Medico-Historical Conference concerning the Spanish Flu was held in Cape Town, South Africa, September 1998. This was the very first international conference where the flu was the only topic discussed. Thirdly, the possibility of a new pandemic in the near future has given Spanish Influeriza attention as a worst case scenario, especially among health authorities and planners. For instance, based on findings of Mamelund (1998a), Folkehelsa and Helsetilsynet ( 1999) have estimated that 2 million persons would be infected and that 28 600 would die if a pandemie similar to the Spanish Influenza reappeared in Norway.

The proposed project is a logical follow-up of my Master Thesis (Mamelund 1998a), which received support from The Norwegian Rescarch Council in 1997. In the Thesis, which has resulted in several articles (Mamelund 1998b-d. 1999) as well as a television documentary, (Schrødingers Katt, NRK. 3 February 1999), I analysed the diffusion of Spanish Influenza and its level of excess national mortality and regional mortality in 1918 and 1919. I did not, however, analyse the effect of Spanish Influenza on post-crisis mortality, or the effect of the flu on any other demographic variable than mortality. That means that I studied the direct loss of population due to mortality, not its consequences for fertility, or its long-terim effects on demographic behaviour.