Influence of Influenza in Lincoln County (1918-1919)

So, what does a history teacher do with so much time on his hands and a ton of records readily available to the public through the Missouri Secretary of State’s Archives? Get more data.

I can’t take credit for all of the data collected. This project started as part of my Applied History course. I originally had my students locate all of the death certificates for Lincoln County, MO in 1918 in an effort to evaluate the impact of the initial stages of the pandemic in Lincoln County. Their initial task was more about learning transcription and the importance of paying attention to detail. Afterward, we analyzed some of the data to see if the trends in Lincoln County matched those of the nation.

In light of the recent pandemic, and canceled plans, I used some of my time to transcribe Lincoln County death certificates from 1919. Over the course of the project, we collected a lot of information (place of death, date of death, race, age, occupation, cause of death, contributing cause of death). Often, doctors would label the cause of death as Influenza/Grip/Flu. Those were easy. I coded them as “yes.” The “no” labels were easy as well. Some, however, were a little more ambiguous. If pneumonia/tuberculosis/lungs were listed, but influenza was not mentioned, we coded them as “maybe.” The only exception was if tuberculosis was listed and they had suffered with it for a considerable time. Those cases were labeled “no.”.

There are a few things that stood out to me. First, the number of deaths in Lincoln County as a result of influenza was roughly equal in both 1918 and 1919, but that does not tell the entire story. I think the real story here is in the number of cases that fall under the “maybe” category. Although I would need to explore the data and documentary sources, it seems logical that by 1919 they were more conscientious about coding it as influenza if that was, indeed, the cause.

I wasn’t ready to stop here. I knew the data could tell us a little more. Because I was concerned that a relatively small sample size would not tell us much if we look at the date of death, I grouped all of the deaths by month and year. The result can be viewed in the following chart. Notice the humps in early 1918. The flu has always been a cause of death, but you should notice that the strand that arrived in September 1918 and lasted through early 1919 was unlike previous or future iterations.

As has been reported, COVID-19 has been especially devastating to the elderly and immunocompromised. The Influenza epidemic in 1918 was different, The young seemed to be more vulnerable. The data in Lincoln County seems to bear that out. In Lincoln County, the average age of those who died as a result of influenza was roughly 18 years younger than those who died as a result of other causes. I’m not sure that I have read the reason that younger people were more susceptible (if I did I have forgotten), but the trend is also evident in the numbers in Lincoln County.

I was able to group the deaths by township, which is how the county is subdivided. The death certificates sometimes listed towns, while listing townships at others. Since a death in a town was also a death in that township, I decided to code the township rather than the town. For instance, instead of coding a death as Elsberry, I coded it as Hurricane. I have two tables. One is a summary by year. The other is by month and year. When looking at that, I would like you to notice the concentrations in Dec. 1918 and Jan 1919. Twenty-six deaths from influenza in Lincoln County in two months. In order to visualize the cases, I created an animated map across time. Each dot represents a death as a result of influenza. They do not, however represent the actual location of the deceased - just the town / township.

Animated Map