Testing the influenza-tuberculosis selective mortality hypothesis with Union Army data.
Using Cox regression, this paper shows a weak association between having tuberculosis and dying from influenza among Union Army veterans in late nineteenth-century America. It has been suggested elsewhere [Noymer, A. and M. Garenne (2000). The 1918 influenza epidemic's effects on sex differentials in mortality in the United States. Population and Development Review 26(3), 565-581.] that the 1918 influenza pandemic accelerated the decline of tuberculosis, by killing many people with tuberculosis. The question remains whether individuals with tuberculosis were at greater risk of influenza death, or if the 1918/post-1918 phenomenon arose from the sheer number of deaths in the influenza pandemic. The present findings, from microdata, cautiously point toward an explanation of Noymer and Garenne's selection effect in terms of age-overlap of the 1918 pandemic mortality and tuberculosis morbidity, a phenomenon I term "passive selection". Another way to think of this is selection at the cohort, as opposed to individual, level.
Noymer
Andrew
A
Department of Sociology, University of California, 3151 Social Sciences Plaza, Irvine, CA 92697-5100, USA. noymer@uci.edu
D017677:Age Distribution; D002423:Cause of Death; D015331:Cohort Studies; D004196:Disease Outbreaks / Q000266:history*; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000266:history* / Q000401:mortality; D008297:Male; D008889:Military Personnel / Q000266:history / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012307:Risk Factors; D014376:Tuberculosis / Q000266:history* / Q000401:mortality; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000266:history* / Q000706:statistics & numerical data