Volume 47 - Article 32 | Pages 1009–1018
The Spanish flu and the health system: Considerations from the city of Parma, 1918
23 Jun 2022
16 Dec 2022
Background: The gravity of the Spanish flu has been often associated with inadequate health systems. However, few studies have used health data effectively in their analysis of epidemics.
Objective: To analyze the role of hospitals in an Italian town during the Spanish flu and its effect on the risk of dying at home.
Methods: Individual-level information from the Permission of Burials was used to evaluate the impact of the epidemic on city hospitals. A logistic model was used to estimate the odds of a home death in order to elucidate possible sociodemographic mechanisms linked to hospital saturation issues.
Results: During the epidemic the odds of dying at home increased by 29% overall, driven especially by an increase in home deaths among the poorest social groups. However, the well-off maintained the highest odds of dying at home throughout 1918.
Conclusions: Hospitals facilitated the spread of the epidemic in the city and contributed to its high mortality level. The increase in the odds of dying at home for the poorest was likely associated with hospital saturation, which conversely does not appear to have affected the well-off. In fact, this social group already had very high levels of home deaths in the pre-epidemic period.
Contribution: Evaluating the role of hospitals during the Spanish flu allows better comprehension of the spread and evolution of the epidemic, especially regarding possible saturation issues and differential access to health resources.
- Matteo Manfredini - Università degli Studi di Parma (UNIPR), Italy EMAIL
Other articles by the same author/authors in Demographic Research
Deaths and survivors in war: The Italian soldiers in WWI
Volume 40 - Article 22
Patterns of reproductive behavior in transitional Italy: The rediscovery of the Italian fertility survey of 1961
Volume 29 - Article 44
Demographic responses to short-term stress in a 19th century Tuscan population: The case of household out-migration
Volume 25 - Article 15
Health and socio-demographic conditions as determinants of marriage and social mobility: Male partner choice in Sardinia, late 19th-early 20th century
Volume 22 - Article 33
Most recent similar articles in Demographic Research
Measuring short-term mobility patterns in North America using Facebook advertising data, with an application to adjusting COVID-19 mortality rates
Volume 50 - Article 10
Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic
Volume 50 - Article 7
Frailty at death: An examination of multiple causes of death in four low mortality countries in 2017
Volume 49 - Article 2
causes of mortality,
multiple causes of death
Ethnic and regional inequalities in Russian military fatalities in Ukraine: Preliminary findings from crowdsourced data
Volume 48 - Article 31
The question of the human mortality plateau: Contrasting insights by longevity pioneers
Volume 48 - Article 11