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dc.contributor.authorMamelund, Svenn-Erik
dc.date.accessioned2018-01-22T13:50:49Z
dc.date.accessioned2018-03-23T09:09:30Z
dc.date.available2018-01-22T13:50:49Z
dc.date.available2018-03-23T09:09:30Z
dc.date.issued2018
dc.identifier.citationMamelund S. 1918 pandemic morbidity: the first wave hits the poor, the second wave hits the rich. Influenza and Other Respiratory Viruses. 2018en
dc.identifier.issn1750-2640
dc.identifier.issn1750-2659
dc.identifier.urihttps://hdl.handle.net/10642/5808
dc.description.abstractBackground Whether morbidity from the 1918‐19 influenza pandemic discriminated by socioeconomic status has remained a subject of debate for 100 years. In lack of data to study this issue, the recent literature has hypothesized that morbidity was “socially neutral.” Objectives To study the associations between influenza‐like illness (ILI) and socioeconomic status (SES), gender, and wave during the 1918‐19 influenza pandemic. Methods Availability of incidence data on the 1918‐19 pandemic is scarce, in particular for waves other than the “fall wave” October‐December 1918. Here, an overlooked survey from Bergen, Norway (n = 10 633), is used to study differences in probabilities of ILI and ILI probability ratios by apartment size as a measure of SES and gender for 3 waves including the waves prior to and after the “fall wave.” Results Socioeconomic status was negatively associated with ILI in the first wave, but positively associated in the second wave. At all SES levels, men had the highest ILI in the summer, while women had the highest ILI in the fall. There were no SES or gender differences in ILI in the winter of 1919. Conclusions For the first time, it is documented a crossover in the role of socioeconomic status in 1918 pandemic morbidity. The poor came down with influenza first, while the rich with less exposure in the first wave had the highest morbidity in the second wave. The study suggests that the socioeconomically disadvantaged should be prioritized if vaccines are of limited availability in a future pandemic.en
dc.language.isoenen
dc.publisherWiley Open Accessen
dc.rightsThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject1918‐19 influenza pandemicen
dc.subjectApartment sizeen
dc.subjectCross‐protectionen
dc.subjectGenderen
dc.subjectInfluenza‐like illnessen
dc.subjectMorbidity crossoveren
dc.subjectSocioeconomic statusen
dc.title1918 pandemic morbidity: the first wave hits the poor, the second wave hits the richen
dc.typeJournal articleen
dc.typePeer revieweden
dc.date.updated2018-01-22T13:50:49Z
dc.description.versionpublishedVersionen
dc.identifier.doihttp://doi.org/10.1111/irv.12541
dc.identifier.cristin1539876
dc.source.journalInfluenza and Other Respiratory Viruses


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This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, 
provided the original work is properly cited.
© 2018 The Authors. 
Influenza and Other Respiratory Viruses
 Published by John Wiley & Sons Ltd.
Med mindre annet er angitt, så er denne innførselen lisensiert som This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.