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Spanish Influenza in the City of Vancouver, British Columbia, 1918-1919

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Spanish Influenza in the City of Vancouver, British Columbia, 1918-1919 Spanish Influenza in the City of Vancouver, British Columbia, 1918-1919 by Sarah Buchanan B.Sc., Queen‟s University, 2007 A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCE in the Department of Geography Sarah Buchanan, 2012 University of Victoria All rights reserved. This thesis may not be reproduced in whole or in part, by photocopy or other means, without the permission of the author. ii Supervisory Committee Spanish Influenza in the City of Vancouver, British Columbia, 1918-1919 by Sarah Buchanan B.Sc., Queen‟s University, 2007 Supervisory Committee Dr. Aleck Ostry, (Department of Geography, University of Victoria) Supervisor Dr. Denise Cloutier, (Department of Geography, University of Victoria) Departmental Member Dr. Mary-Ellen Kelm, (Department of History, Simon Fraser University) Additional Member iii Abstract Supervisory Committee Supervisor Dr. Aleck Ostry, Department of Geography, University of Victoria Departmental Member Dr. Denise Cloutier, Department of Geography, University of Victoria Additional Member Dr. Mary-Ellen Kelm, Department of History, Simon Fraser University During the last year of World War I (1918), a second deadly foe was causing mortality around the world. Spanish Influenza killed an estimated 50-100 million people worldwide, including 50,000 people in Canada during the 1918-1919 pandemic. This thesis examines the impact of Spanish Influenza on people living in Vancouver, British Columbia, Canada between June of 1918 and June of 1919. Statistical analysis with SPSS was used to determine the association between influenza-caused deaths and socio- demographic characteristics such as age, gender, immigration status, and employment. In Vancouver, those who were between the ages of 19 to 39, and those who were employed, showed higher odds of dying from influenza during the epidemic. iv Table of Contents Supervisory Committee .........................................................................................................ii Abstract.................................................................................................................................. iii Table of Contents .................................................................................................................. iv List of Tables .......................................................................................................................... vi List of Figures .......................................................................................................................vii Acknowledgments .............................................................................................................. viii Dedication ............................................................................................................................... ix Chapter 1: Introduction ........................................................................................................ 1 1.1 Purpose/Objectives .................................................................................................. 1 Chapter 2: Literature Review .............................................................................................. 4 2.1 Understanding Spanish Influenza through the Lens of Medical Geography ............. 4 2.2 Spanish Influenza around the World ............................................................................ 5 2.3 Public Health and the Response to Spanish Influenza ................................................ 7 2.4 Origins, Timing, and Mortality from the Epidemic ................................................... 10 2.5 Groups Most Vulnerable to the Epidemic .................................................................. 20 2.6 Spanish Influenza in British Columbia and Vancouver ............................................ 21 2.7 Summary ...................................................................................................................... 23 Chapter 3: Methods ............................................................................................................. 25 3.1 Data Collection and Determining Population Size .................................................... 25 3.2 Boundary of Analysis .................................................................................................. 26 3.3 Calculating Mortality Rates ........................................................................................ 27 3.4 Managing the Association between Pneumonia and Influenza ................................ 28 3.5 Analysis using the Statistics Package for Social Sciences (SPSS) ........................... 28 3.6 Visual Representation .................................................................................................. 30 3.7 Limitations ................................................................................................................... 31 Chapter 4: Results ................................................................................................................ 34 4.1 Boundaries .................................................................................................................... 34 4.2 Case Definition of Influenza Deaths........................................................................... 35 4.3 Socio-demographic description of influenza versus non-influenza deaths in both time periods ........................................................................................................................ 38 4.4 Temporality of Influenza Deaths within Vancouver ................................................. 46 4.5 Distribution of Influenza Deaths in Vancouver ......................................................... 47 4.6 Mortality Rates in the City of Vancouver .................................................................. 49 4.7 Statistical Analysis of Links between social and geographic characteristics of residents and influenza deaths in Vancouver ................................................................... 51 4.7.1. Univariate analyses.............................................................................................. 51 4.7.2 Multivariate Analysis ........................................................................................... 58 Chapter 5: Discussion .......................................................................................................... 61 5.1 Timing and Intensity .................................................................................................... 62 5.2 Spatial Distribution of Influenza Deaths in Vancouver ............................................ 63 5.3 Socio-Demographic Characteristics of Influenza in Vancouver .............................. 64 5.4 Mortality Rates for Spanish Influenza in Vancouver ................................................ 65 5.5 Contributions to Medical Geography ......................................................................... 66 5.6 Future Research Opportunities.................................................................................... 67 v Chapter 6: Conclusion ......................................................................................................... 69 Bibliography .......................................................................................................................... 71 Appendix A: Codebook ....................................................................................................... 78 A.1 Coding for Cause of Death and Secondary Cause of Death .................................... 78 A.2 Coding for Occupation ............................................................................................. 115 A.3 Coding for Birthplace ............................................................................................... 131 A.4 Coding for Place of Death ........................................................................................ 135 A.5 Coding for Residence ............................................................................................... 135 A.6 Coding for Immigrant Status .................................................................................... 135 A.7 Coding for Race ........................................................................................................ 136 Appendix B: Immigrant Proportions .............................................................................. 137 Appendix C: Socio-Demographic Characteristics ........................................................ 138 vi List of Tables Table 1. Overview of Canadian provincial and city mortality rates from the literature. ... 15 Table 2. Primary cause of death in 1918-19 and 1921-22. .................................................. 36 Table 3. Secondary cause of death for 1918-19 and 1921-22. ............................................ 37 Table 4. Influenza versus non influenza deaths by time period. ......................................... 38 Table 5. Influenza versus non influenza deaths by residence and time period. ................. 38 Table 6. Influenza versus non influenza deaths by gender and time period. ...................... 39 Table 7. Influenza versus non influenza deaths by age category and time period. ............ 40 Table 8. Influenza versus non influenza deaths by place of death and time period........... 41 Table 9. Influenza versus non influenza deaths by birthplace and time period. ................ 42 Table 10. Influenza versus non influenza
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