The Effect of in Utero Exposure to the 1918 Influenza Pandemic on Life Expectancy in the United States

Jonas Helgertz, University of Minnesota/Lund University
Elaine M. Hernandez, Indiana University
John Robert Warren, University of Minnesota

In utero exposure to insults during the prenatal period may not only have an effect on infant health, it may have lasting effects on health over the life course. Recent evidence lends weight to this theory, with in utero exposure to the 1918 pandemic linked to increased rates of physical disability, cardiovascular problems, cancer, and metabolic disorders (Almond 2006; Almond and Mazumder 2005; Bengtsson and Helgertz 2015; Mazumder et al. 2010). In spite of the growing evidence that in utero exposure to nutritional deprivation and maternal infection impact adult morbidity, we know less about the effects on life expectancy, particularly by timing of exposure (i.e., pregnancy trimester). We address this gap by using newly available data linking (1) monthly data on city level influenza mortality with (2) U.S. census (1910, 1920, and 1940) and (3) mortality records to assess the effect of in utero exposure to the 1918 influenza pandemic on life expectancy in the United States. Our approach will enable increased specificity with regard to the trimester specific effects of in utero exposure to infection/stress on life expectancy, and will allow us to compare exposure in the periods just prior to and after pregnancy. Aside from this novel contribution, by linking to the 1940s Census we are able to obtain information about adult socioeconomic attainment, which allows us to examine whether the relationship between fetal exposure and timing of death operates through socioeconomic pathways. Importantly, our linked data will allow us to examine whether these effects differ by maternal socioeconomic status, race, and geographic location.

No extended abstract or paper available

 Presented in Session 35. Effects of Environmental Conditions on Urban Mortality