Unequal Outcomes Tie Two Pandemics

Responses to 1918, COVID Crises Eerily Similar, Public Health Researcher Finds
By Chris Carroll | Illustration by Keith Negley

Authorities shrugging off risk—or ordering everyone to mask up. The virus surging in locales that dropped their guards too soon. Death rates that cut along racial lines, battering African Americans with particular ferocity.

What might sound like recent news stories from the COVID-19 pandemic describe the 1918 influenza pandemic just as well, according to a School of Public Health researcher’s study published this summer in the International Journal of Environmental Research and Public Health.

Jennifer D. Roberts, assistant professor of kinesiology, found that despite leaps in science, technology and civil rights, the United States didn’t appear to learn much from the earlier pandemic.

“Even though it’s been more than 100 years, what we found is that the response to these two pandemics was very similar, in terms of public health being the first line of defense—you saw the orders to separate and create social distance, orders to wear face coverings; schools, churches and theaters were shutting down,” says Roberts, who wrote the paper with Shahdi O. Tehrani, a student of architecture and environmental design at the Iran University of Science and Technology, Tehran.

Their sobering conclusion is that the broad effects of racism a century ago through today have led to unequal access to health care, housing, wealth, education and employment. All are social determinants that impact health and longevity, says Roberts, who specializes in studying the interplay between the built environment and transit systems, racial and socioeconomic disparities, and health.

One consequence during the flu pandemic was a significantly higher fatality rate for African Americans; during the coronavirus crisis, the rate is more than double that of white Americans.

“The strongest thread we found between both pandemics was inequality,” Roberts says. “Because of this inequality, there is a big difference in how well people can protect themselves from the virus, and a big difference in what happens to you if you contract it.”


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