title: Population decline induced by gonorrhoea and tuberculosis transmission: Micronesia during the Japanese occupation, 1919-45.
abstract: The islands of Yap in Micronesia survived a period of severe depopulation during the Japanese occupation from 1919 to 1945. Using data from historical documents, supplemented by ethnographic evidence, we calibrate a simulation model that accounts for this phenomenon. Our model tracks the reproduction histories of a synthetic cohort of women in Yap, including effects of infertility due to gonorrhoea as well as tuberculosis mortality, and predicts the net reproduction rate (NRR). In this particular case and throughout history, human migrations and associated social and cultural interactions have frequently been accompanied by dramatic changes in patterns of disease transmission and substantial demographic consequences. Despite the broad emphasis on mortality as a measure of demographic consequences in the historical and contemporary literature, there are important instances where life expectancy at birth, fertility rates, and total population size are important demographic consequences. We find that gonorrhoea may have significantly contributed to depopulation during the Japanese occupation of Micronesia, due to repeated infections and high risk of sterility. Results of our model suggest that gonorrhoea alone could have reduced the net reproduction rate by 82%, whereas deaths from tuberculosis may have contributed to a 17% decline.
authors.affiliation: Departments of Epidemiology & Global Health, University of Washington, 325, 9th Ave, Box 359931, Seattle, WA 98104, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cassels
authors.forename: Burton H
authors.initials: BH
authors.lastname: Singer