Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1389-1425 |
| Number of pages | 37 |
| Journal | Demography |
| Volume | 56 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 15 2019 |
Bibliographical note
Funding Information:We are thankful for the assistance of Petter Lundborg and Dan-Olof Rooth throughout the process. We are also grateful to anonymous referees for invaluable comments and suggestions on the manuscript. An earlier version of the manuscript was presented at seminars at the Institute for Social Research, Oslo; the Warsaw School of Economics; and the IUSSP seminar on “Pandemics: Reflections on the Centennial of the 1918 Spanish Influenza Virus” in Madrid, Spain. We acknowledge the Centre for Economic Demography at Lund University for access to data as well as financial support, as well as financial support from the project The Rise and Fall of the Industrial City: The Landskrona Population Study (M15-0173:1), financed by Riksbankens Jubileumsfond. Support also came from the Minnesota Population Center, which receives core funding (P2C HD041023) from the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD).
Funding Information:
We are thankful for the assistance of Petter Lundborg and Dan-Olof Rooth throughout the process. We are also grateful to anonymous referees for invaluable comments and suggestions on the manuscript. An earlier version of the manuscript was presented at seminars at the Institute for Social Research, Oslo; the Warsaw School of Economics; and the IUSSP seminar on “Pandemics: Reflections on the Centennial of the 1918 Spanish Influenza Virus” in Madrid, Spain. We acknowledge the Centre for Economic Demography at Lund University for access to data as well as financial support, as well as financial support from the project The Rise and Fall of the Industrial City: The Landskrona Population Study (M15-0173:1), financed by Riksbankens Jubileumsfond. Support also came from the Minnesota Population Center, which receives core funding (P2C HD041023) from the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD).
Publisher Copyright:
© 2019, The Author(s).
Keywords
- Fetal origins
- Health and socioeconomic outcomes
- Longitudinal data
- Spanish influenza pandemic
- Sweden
