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. 2023 Dec;82(1):2179452.
doi: 10.1080/22423982.2023.2179452.

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

Ingrid Hellem Nygaard  1 , Sushma Dahal  2 , Gerardo Chowell  2 , Lisa Sattenspiel  3 , Hilde Leikny Sommerseth  1 , Svenn-Erik Mamelund  4
Affiliations

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

Ingrid Hellem Nygaard et al. Int J Circumpolar Health. 2023 Dec.

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.

Keywords: 1918-20 influenza; Norway; Spanish flu; indigenous people; pandemic influenza; sámi; sápmi.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Time series of monthly mortality rates per 10,000 population (Y-axis), Karasjok, 1910–1921 (X-axis).
Figure 2.
Figure 2.
Timeseries of monthly mortality rates per 10,000 population (Y-axis), Kautokeino 1910–1921 (X-axis).
Figure 3.
Figure 3.
Excess mortality per 10,000 population (Y-axis) by age in Karasjok for wave 1 (August 1918-January 1919) and wave 2 (October 1919-April 1920) and Kautokeino for wave 1 (August 1918-March 1919).
See this image and copyright information in PMC

References

    1. Johnson NP, Mueller J.. Updating the accounts: global mortality of the 1918-1920 ”Spanish” influenza pandemic. Bull Hist Med. 2002;76(1):105–10. - PubMed
    1. Mamelund S-E. Geography may explain adult mortality from the 1918-20 influenza pandemic. Epidemics. 2011;3(1):46–60. - PubMed
    1. Mamelund S-E, Sattenspiel L, Influenza-Associated DJ. Mortality during the 1918-1919 Influenza Pandemic in Alaska and Labrador: a Comparison. Social Sci Hist. 2013;37(2):177–229.
    1. Mamelund S-E. Spanish Influenza Mortality of Ethnic Minorities in Norway 1918–1919. Eur J Population/Revue européenne de Démographie. 2003;19(1):83–102.
    1. Dahal S, Mamelund S-E, Luo R, et al. COVID-19 transmission and mortality differences between indigenous and non-indigenous populations in Mexico. Inter J Infect Dis. 2022;122:910–920. - PMC - PubMed

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