Sex- and age-based differences in mortality during the 1918 influenza pandemic on the island of Newfoundland
Sex- and age-based differences in mortality during the 1918 influenza pandemic on the island of Newfoundland
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DOI：
10.1002/ajhb.23198
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发表时间：
2019-01-01
影响因子：
2.9
通讯作者：
Sattenspiel, Lisa
中科院分区：
文献类型：
--
作者：
Paskoff, Taylor;Sattenspiel, Lisa
目的我们的目的是了解1918年纽芬兰岛流感大流行期间死亡率的性别和年龄差异。大流行病对不同年龄组的影响一直是其他研究的重点，但很少考虑基于性别的死亡率差异。社会组织，劳动模式和社会行为，有助于男性和女性之间的死亡率在所有年龄的方面被用来解释观察到的死亡率模式。方法使用岛上记录的肺炎和流感死亡人数（n = 1871）计算死因特异性死亡率，并评估基于性别的死亡率差异。使用标准化死亡率（SMR）比较了17个地区和4个地区（阿瓦隆、北部、南部和西部）的死亡率水平。一个逻辑回归模型，以确定在哪些地区基于性别的死亡率可以预测使用年龄和地区作为交互式预测。结果不同地区的性别死亡率差异不同，但对总人口来说并不显著。SMR也是可变的，没有显著的性别差异。基于性别的差异在区域内差异很大。逻辑回归分析的结果表明，南部地区的女性可能比其他岛屿居民经历了更高的死亡概率。结论聚集人群的死亡率分析同质化了重要的流行病学模式。1918年的流感大流行，男性和女性的经历并不相同，通过分析区域和地区地理层面的数据，可以用生活在那里的人们的经济和社会组织来解释模式。
Objectives Our aim was to understand sex- and age-based differences in mortality during the 1918 influenza pandemic on the island of Newfoundland. The pandemic's impact on different age groups has been the focus of other research, but sex-based differences in mortality are rarely considered. Aspects of social organization, labor patterns, and social behaviors that contribute to mortality between males and females at all ages are used to explain observed mortality patterns. Methods Recorded pneumonia and influenza deaths on the island (n = 1871) were used to calculate cause-specific death rates and to evaluate differences in sex-based mortality. Mortality levels in 17 districts and four regions (Avalon, North, South, and West) were compared using standardized mortality ratios (SMRs). A logistic regression model was fit to determine in which regions sex-based mortality could be predicted using age and region as interactive predictors. Results Differences in sex-based mortality varied across regions; they were not significant for the aggregate population. SMRs were also variable, with no significant sex-based differences. Sex-based differences were highly variable within regions. Results from a logistic regression analysis suggest that females in the South region may have experienced a higher probability of death than other island residents. Conclusions Mortality analysis for aggregate populations homogenizes important epidemiologic patterns. Men and women did not experience the 1918 influenza pandemic in the same way, and by analyzing data at the regional and district geographic levels, patterns emerge that can be explained by the economies and social organization of the people who lived there.