Periodic Reporting for period 1 - DIS2 (Disability and Disease during the 1918 Influenza Pandemic: Implications for Preparedness Policies)
Okres sprawozdawczy: 2019-06-03 do 2021-06-02
The aim of this project was to examine historical, epidemiological and anthropological data to enhance understanding of disability as a risk factor for infectious disease and improve pandemic preparedness, reducing vulnerability of people with disabilities in the future. Specific objectives were:
1. To identify social factors that contribute to inequalities in morbidity (illness) and mortality (death) among people with disabilities during influenza pandemics.
2. To develop a simulation tool for evaluation of interventions to reduce the spread of epidemics among institutionalised populations of people with disabilities, with which to inform public health policy.
3. To establish a foundation for future research on disability and infectious disease within the theoretical framework of syndemics, and enhance my professional capacity to be a leader in this field.
Second, I worked with colleagues at Umeå University, Sweden, to extract records from the Demographic Data Base for individuals living in nine parishes from 1918-1920. Among other variables, these records noted disability and institutionalisation statuses, as well as causes of death. More than 22,000 records were complete enough for further analysis. Statistical comparisons suggest that mortality from influenza and related causes during the pandemic was significantly higher, relative to the non-disabled population, for people with disabilities who were also institutionalised, people with psychiatric or psychological but not other types of disabilities, and people with only one disability but not those with multiple recorded disabilities. This last finding may be due to small sample sizes and/or different rates of institutionalisation and needs further investigation.
Third, quantitative and qualitative data were used to construct a simulation model of a school for children with disabilities, based on annual reports for the Holmestrand School for the Deaf and other schools in early 20th century Norway. This model consists of a population of students and staff who engage in daily activities in social spaces such as bedrooms, classrooms and a dining hall. Simulations of the model show that, on average, epidemics have different sizes, timing and patterns of spread depending on whether a teacher or student is the first case and on how many students share each bedroom.
Dissemination of project results include a peer-reviewed paper based on the first phase of research and published in the Scandinavian Journal of Disability Research. A paper reporting model results is currently under review. Results from both the first and second phases have been presented at conferences, including the American Anthropological Association and the European Social Science History Conference. A final talk was given online, posted to the project website and shared via social media. I also recorded two podcasts with Oslo Metropolitan University and was interviewed about my project for an article in Horizon magazine discussing its relevance for disabled people during COVID-19.
Further, previous models have focused on day schools within communities, nursing homes and hospital wards. The simulation model I built links several important risk factors: disability, school environments, and institutionalisation. Model results therefore provide new insights into populations with these intersecting risk factors. The effectiveness of different potential interventions can also be tested, in order to develop strategies for responding to outbreaks within such institutions.
To my knowledge, this project is also among the first to look at disability and influenza pandemics using a syndemics perspective. Both pandemics and disability are strongly shaped by interacting biological and social factors at multiple scales. This project, therefore, advances disciplines such as anthropology, epidemiology, disability studies and history. Results also can be used to inform COVID-19 recovery and the development of inclusive and equitable preparedness plans for future pandemics.