Exposure to the 1918 Pandemic and Later Mortality by Cause: Evidence from the NHIS Data

Mikko Myrskylä, Max Planck Institute for Demographic Research
Neil Mehta, University of Michigan
Virginia W. Chang, University of Pennsylvania

Accumulating evidence suggests that exposure to disease in utero is associated with negative adult outcomes, such as decreased educational attainment and higher disability rates, and potentially also with excess mortality. However, existing research looking at the long-term effects of the 1918 Influenza Pandemic has failed to find any mortality effects. We use a large sample from the National Health Interview Surveys to study whether mortality of cohorts exposed in utero to the 1918 Influenza Pandemic is elevated. We find that cohorts born right after the peak of the epidemic have excess all-cause and cardiovascular disease mortality when compared to the neighboring birth cohorts. The results suggest that late in utero exposure to disease may have increase mortality decades later. These findings are especially important in the light of contemporary disease epidemics, suggesting that an epidemic is not necessarily over once the incidence rates decline.