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MODELING the SPREAD of the 1918 INFLUENZA PANDEMIC in a NEWFOUNDLAND COMMUNITY a Dissertation Presented to the Faculty of the Gr MODELING THE SPREAD OF THE 1918 INFLUENZA PANDEMIC IN A NEWFOUNDLAND COMMUNITY A Dissertation presented to the Faculty of the Graduate School at the University of Missouri In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy By JESSICA LEA DIMKA Dr. Lisa Sattenspiel, Dissertation Supervisor MAY 2015 The undersigned, appointed by the dean of the Graduate School, have examined the dissertation entitled MODELING THE SPREAD OF THE 1918 INFLUENZA PANDEMIC IN A NEWFOUNDLAND COMMUNITY Presented by Jessica Lea Dimka A candidate for the degree of Doctor of Philosophy And hereby certify that, in their opinion, it is worthy of acceptance. Professor Lisa Sattenspiel Professor Gregory Blomquist Professor Mary Shenk Professor Enid Schatz ACKNOWLEDGEMENTS This research could not have been completed without the support and guidance of many people who deserve recognition. Dr. Lisa Sattenspiel provided the largest amount of assistance and insight into this project, from initial development through model creation and data analysis to the composition of this manuscript. She has been an excellent mentor over the last seven years. I would also like to extend my gratitude to my committee members – Dr. Greg Blomquist, Dr. Mary Shenk, and Dr. Enid Schatz – for their advice, comments, patience and time. I also would like to thank Dr. Craig Palmer for his insight and support on this project. Additionally, I am grateful to Dr. Allison Kabel, who has provided me with valuable experience, advice and support in my research and education activities while at MU. Many thanks go to the librarians and staff of the Provincial Archives of Newfoundland and Labrador and the Centre for Newfoundland Studies at Memorial University of Newfoundland. In particular, I would like to thank Linda White for her support of this research (as well as her continued, dedicated efforts in curating the history of Greenspond). I also appreciate the hospitality of the people of Greenspond, especially Gail Crocker, Ivy Tong and Lesley Davis. ii I also would like to express my appreciation to Carolyn Orbann, Erin Miller, Amy Warren, Dana Schmidt, and Rebecca Lander for their insights and assistance in writing the models used in this research, particularly in the early stages of model development. Last but certainly not least, I am deeply grateful for the support of my family, especially my parents who provided financial assistance for fieldwork and data collection activities. iii TABLE OF CONTENTS Acknowledgements ..............................................................................................................ii List of Figures ..................................................................................................................... vii List of Tables ....................................................................................................................... ix Chapter 1 – Introduction .................................................................................................... 1 Statement of Problem .................................................................................................... 2 Organization ................................................................................................................... 4 Chapter 2 – Theoretical Approaches to the Study of Population Health ........................... 6 Social/Cultural Approaches ............................................................................................ 8 Social determinants of health ................................................................................... 9 Syndemics ................................................................................................................ 11 Physical/Biological Approaches ................................................................................... 13 Transition theories ................................................................................................... 14 The demographic transition. ........................................................................................................... 15 The epidemiological transition........................................................................................................ 17 Chapter 3 – Influenza and the 1918 Pandemic ................................................................. 22 The Influenza Virus ....................................................................................................... 22 Influenza in Humans ..................................................................................................... 24 Pandemic Influenza ...................................................................................................... 26 The 1918 Pandemic ...................................................................................................... 28 Chapter 4 – Historical and Ethnographic Background of Newfoundland ......................... 38 History and Settlement of Newfoundland ................................................................... 38 Household and Social Organization ............................................................................. 42 Men’s activities ........................................................................................................ 44 Women’s activities .................................................................................................. 47 iv Children’s activities .................................................................................................. 49 The Study Community: Newell’s Island, Greenspond .................................................. 51 Health and Medicine in Newfoundland ....................................................................... 56 The 1918 Influenza Pandemic in Newfoundland and Greenspond ............................. 59 Chapter 5 – Modeling in Anthropology and Epidemiology .............................................. 62 The SIR Model .............................................................................................................. 63 Simulation Models ....................................................................................................... 66 Agent-Based Models .................................................................................................... 67 Social Network Models ................................................................................................ 71 Comparisons of Modeling Strategies ........................................................................... 78 Chapter 6 – Methods ........................................................................................................ 83 Data Collection and Evaluation .................................................................................... 84 Description of Models .................................................................................................. 87 Family reconstitution and construction of model population ................................. 88 Structure of the agent-based (dynamic network) model ........................................ 95 Structure of the (static) social network model ...................................................... 100 Mortality and adoption processes ......................................................................... 104 Data output ........................................................................................................... 110 Validation and Verification of the Models ................................................................. 110 Methods for Addressing Research Questions ............................................................ 113 Chapter 7 – Sensitivity Analyses Results and Discussion ................................................ 116 Transmission Probability ............................................................................................ 118 Latent Period .............................................................................................................. 122 Infectious Period ........................................................................................................ 126 Mortality Probability .................................................................................................. 130 Estimated Influenza Epidemic Parameters ................................................................ 133 Broad Comparisons and Implications for Model Design ........................................... 135 v Chapter 8 – The Impact of Demographic Structures and Associated Social Behaviors on Epidemic Outcomes ........................................................................................................ 140 Epidemic Outcomes ................................................................................................... 142 Outcomes for Different Groups ................................................................................. 146 Outcomes across groups holding the group of the first case constant ................. 148 Outcomes within specific groups varying the group of the first case ................... 151 Model Comparisons and Implications ....................................................................... 157 Chapter 9 – Conclusions ................................................................................................. 162 Construction of the Model Population ...................................................................... 162 Development of the Epidemic Simulation Models ...................................................
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