The 1918 influenza pandemic highlighted significant health and socioeconomic disparities within the US. But how do you go about researching these disparities when primary sources on them often do not exist? While gaps in primary source material are telling, and can be used to great effect in research papers, such gaps leave research groups like ourselves struggling for concrete information. With more resources or time at our disposal, the topic of how various demographic groups in Florida were impacted by the influenza pandemic could have proven to be a rich and interesting avenue to travel. While we unfortunately had to exclude demographics and disparities from our research question, the fact remains that demographic factors had significant and tangible, if not widely reported at the time, effects on how people experienced the 1918 influenza pandemic. Black Americans had up to this point suffered higher morbidity and mortality rates across the board in the early 20th century [1]. However, that did not stop eugenicists from claiming that black Americans must have more immunity to certain diseases, and influenza proved no different. Studies have found that the black population had a higher case fatality rate, despite also having a lower incidence rate, a conclusion that agrees with reports from black physicians at the time [1,2]. This lower incidence rate encouraged eugenicists’ claims, with the Chicago Commissioner of Public Health himself claiming that black people must have more immunity to the flu than white people1. Of course, there are many reasons why black Americans may have had lower incidence rates. One theory is that because of the environment many black communities lived in, they may have had greater exposure to the flu in the spring and summer, when cases were less likely to be attributed to the pandemic, and thus conferring immunity against the fall wave and beyond, leading to lower incidence rates during these times [1]. Another possibility is that segregation created a kind of natural cordon sanitaire [1,3]. This restricted contact outside of their own communities meant that black people may have been less likely to catch the virus, especially from white people. Of course, when they did become infected, the environment would have made it more difficult for them to fight the infection, explaining the higher case fatality rate as well1. Regardless of the practical explanations, these racist claims were not anything new, as similar claims about the immunity of black people, based in eugenics and biological determinism, had been repeated for over a century. While mainstream newspapers generally did nothing to push back against these ideas, black newspapers like The Chicago Defender documented the illness amongst black communities [1,3]. Figure 1:Headline from the Chicago Defender, Oct 19 1918 [4] Black Americans were also forced to protect their own communities in other ways. Very few black women were able to enter nursing school, and were entirely barred from serving with the Red Cross during World War I [5]. Black communities instead had to build their own schools and hospitals, providing not only care for people likely to be turned away from white hospitals, but a place to work for the black doctors and nurses turned away from working at those white hospitals [3,5]. These communities, already severely disadvantaged due to rampant poverty, segregation, and discrimination, had to support themselves through this crisis. Even when black nurses and doctors were allowed to enter white spaces, it was hard fought and on an extremely limited basis. In 1917, the Red Cross had reversed its policy barring black nurses, but by November 1918 had still failed to assign any of the black nurses who had enrolled to military duty [5]. In December of 1918, after the war was over, 18 black nurses were finally assigned to Army Camps Grant and Sherman, in Ohio, where they treated both black and white patients, but lived in segregated quarters [3,5]. Figure 2: Black women would have been excluded from nursing schools such as the Chicago School of Nursing, despite the urgent need for more nurses [6]. Black Americans were not the only racial minority to suffer disparately from the 1918 influenza pandemic. Native Americans were another group that suffered significantly higher excess death rates as a result of the 1918 pandemic [7], with some indigenous communities in Alaska and Canada reporting mortality rates of up to 90% [8]. One significant example of how the treatment of Native Americans impacted how they experienced the pandemic was the influenza outbreak at the Haskell Institute in early 1918, which demonstrated how the poor conditions faced by many young Native Americans had a clear effect on their health [9]. The Haskell Institute was one of many boarding schools that operated throughout much of the late 19th and 20th centuries with the purpose of stripping Native American children of their culture [10]. The abuse at these facilities is well documented, and it is unsurprising Haskell was hit so hard and so early by the pandemic. However, this case study is still telling of how particular demographics were affected differently by the pandemic. Native Americans in these boarding schools at the time were facing stressors due to being separated from their families and cultures, while also facing physical stressors in the form of abuse and malnourishment [10]. All of these stressors would have weakened the children’s immune systems, and so with the Haskell Institute being overcrowded and immunocompromised, 60% of the 750 students were infected with influenza, and 5 died [9]. Figure 3: A telegram from Haskell Superintendent Peairs to the Indian Office in Washington DC. Dated March 21, 1918 [9]. This only scratches the surface of the impact racial disparities had during the 1918 influenza pandemic. Racial minorities had to develop their own systems to respond to this crisis, or rely on racist systems for help when unable to develop their own systems. While the incremental advancement of black nurses being allowed to serve in the Red Cross was made, the continued empowerment of the American eugenics movement made what little progress this was feel empty. It is unfortunate that such an important and relevant topic was ultimately excluded from the purview of our research. Many black newspapers did not survive, while many white newspapers had no such reporting on the impact the pandemic had on racial minorities, limiting the primary sources that would be easily available to us. Given more time, and perhaps more resources, we would have been able to delve into this topic, and give it the time and care it deserves. References
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