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1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations

Identifieur interne : 000644 ( Pmc/Corpus ); précédent : 000643; suivant : 000645

1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations

Auteurs : Joseph Kofi Acquah ; Roshani Dahal ; Frank A. Sloan

Source :

RBID : PMC:5551642

Abstract

Objectives. To explore associations between in utero exposure to the 1918 influenza pandemic and hospitalization rates in old age (≥ 70 years) in the United States.

Methods. We identified individuals exposed (mild and deadly waves) and unexposed in utero to the 1918 influenza pandemic (a natural experiment) by using birth dates from the Asset and Health Dynamics Among the Oldest Old survey. We analyzed differences in hospitalization rates by exposure status with multivariate linear regression.

Results. In utero exposure to the deadly wave of the 1918 influenza pandemic increased the number of hospital visits by 10.0 per 100 persons. For those exposed in utero to the deadliest wave of the influenza pandemic, high rates of functional limitations are shown to drive the higher rates of hospitalizations in old age.

Conclusions. In utero exposure to the influenza pandemic increased functional limitations and hospitalization rates in old age.

Public Health Implications. To determine investments in influenza pandemic prevention programs that protect fetal health, policymakers should include long-term reductions in hospitalizations in their cost–benefit evaluations.


Url:
DOI: 10.2105/AJPH.2017.303887
PubMed: 28727536
PubMed Central: 5551642

Links to Exploration step

PMC:5551642

Le document en format XML

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<title xml:lang="en">1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations</title>
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<name sortKey="Dahal, Roshani" sort="Dahal, Roshani" uniqKey="Dahal R" first="Roshani" last="Dahal">Roshani Dahal</name>
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<name sortKey="Sloan, Frank A" sort="Sloan, Frank A" uniqKey="Sloan F" first="Frank A." last="Sloan">Frank A. Sloan</name>
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<name sortKey="Sloan, Frank A" sort="Sloan, Frank A" uniqKey="Sloan F" first="Frank A." last="Sloan">Frank A. Sloan</name>
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<title level="j">American Journal of Public Health</title>
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<div type="abstract" xml:lang="en">
<p>
<italic>Objectives.</italic>
To explore associations between in utero exposure to the 1918 influenza pandemic and hospitalization rates in old age (≥ 70 years) in the United States.</p>
<p>
<italic>Methods.</italic>
We identified individuals exposed (mild and deadly waves) and unexposed in utero to the 1918 influenza pandemic (a natural experiment) by using birth dates from the Asset and Health Dynamics Among the Oldest Old survey. We analyzed differences in hospitalization rates by exposure status with multivariate linear regression.</p>
<p>
<italic>Results.</italic>
In utero exposure to the deadly wave of the 1918 influenza pandemic increased the number of hospital visits by 10.0 per 100 persons. For those exposed in utero to the deadliest wave of the influenza pandemic, high rates of functional limitations are shown to drive the higher rates of hospitalizations in old age.</p>
<p>
<italic>Conclusions.</italic>
In utero exposure to the influenza pandemic increased functional limitations and hospitalization rates in old age.</p>
<p>
<italic>Public Health Implications.</italic>
To determine investments in influenza pandemic prevention programs that protect fetal health, policymakers should include long-term reductions in hospitalizations in their cost–benefit evaluations.</p>
</div>
</front>
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<journal-id journal-id-type="nlm-ta">Am J Public Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Am J Public Health</journal-id>
<journal-id journal-id-type="publisher-id">ajph</journal-id>
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<journal-title>American Journal of Public Health</journal-title>
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<issn pub-type="ppub">0090-0036</issn>
<issn pub-type="epub">1541-0048</issn>
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<publisher-name>American Public Health Association</publisher-name>
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<subj-group subj-group-type="hwp-journal-coll">
<subject>Aging</subject>
<subject>Disability</subject>
<subject>Global Health</subject>
<subject>Health Care Facilities/Services</subject>
<subject>Maternal and Infant Health</subject>
<subject>Public Health Practice</subject>
</subj-group>
<subj-group subj-group-type="heading">
<subject>AJPH Research</subject>
<subj-group>
<subject>Influenza</subject>
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<article-title>1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations</article-title>
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<name>
<surname>Acquah</surname>
<given-names>Joseph Kofi</given-names>
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<degrees>PhD</degrees>
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<contrib contrib-type="author">
<name>
<surname>Dahal</surname>
<given-names>Roshani</given-names>
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<degrees>MPH</degrees>
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<contrib contrib-type="author">
<name>
<surname>Sloan</surname>
<given-names>Frank A.</given-names>
</name>
<degrees>PhD</degrees>
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<aff>Joseph Kofi Acquah is with RTI International, Research Triangle Park, NC. Roshani Dahal is with the School of Public Health, Brown University, Providence, RI. Frank A. Sloan is with the Department of Economics, Duke University, Durham, NC.</aff>
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<author-notes>
<corresp>Correspondence should be sent to Joseph Kofi Acquah, PhD, RTI International, 3040 East Cornwallis Rd, Research Triangle Park, NC 27709 (e-mail:
<email>jacquah@rti.org</email>
). Reprints can be ordered at
<ext-link ext-link-type="uri" xlink:href="http://www.ajph.org">http://www.ajph.org</ext-link>
by clicking the “Reprints” link.</corresp>
<fn>
<p>
<bold>CONTRIBUTORS</bold>
</p>
<p>J. K. Acquah conceptualized and designed the study and drafted the article. All authors participated in analysis and interpretation of data, revision of the article, and approval of the final version.</p>
</fn>
<fn>
<p>Peer Reviewed</p>
</fn>
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<pub-date pub-type="ppub">
<month>9</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<month>9</month>
<year>2017</year>
</pub-date>
<volume>107</volume>
<issue>9</issue>
<fpage>1477</fpage>
<lpage>1483</lpage>
<history>
<date date-type="accepted">
<day>30</day>
<month>4</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© American Public Health Association 2017</copyright-statement>
<copyright-year>2017</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="AJPH.2017.303887.pdf"></self-uri>
<abstract>
<p>
<italic>Objectives.</italic>
To explore associations between in utero exposure to the 1918 influenza pandemic and hospitalization rates in old age (≥ 70 years) in the United States.</p>
<p>
<italic>Methods.</italic>
We identified individuals exposed (mild and deadly waves) and unexposed in utero to the 1918 influenza pandemic (a natural experiment) by using birth dates from the Asset and Health Dynamics Among the Oldest Old survey. We analyzed differences in hospitalization rates by exposure status with multivariate linear regression.</p>
<p>
<italic>Results.</italic>
In utero exposure to the deadly wave of the 1918 influenza pandemic increased the number of hospital visits by 10.0 per 100 persons. For those exposed in utero to the deadliest wave of the influenza pandemic, high rates of functional limitations are shown to drive the higher rates of hospitalizations in old age.</p>
<p>
<italic>Conclusions.</italic>
In utero exposure to the influenza pandemic increased functional limitations and hospitalization rates in old age.</p>
<p>
<italic>Public Health Implications.</italic>
To determine investments in influenza pandemic prevention programs that protect fetal health, policymakers should include long-term reductions in hospitalizations in their cost–benefit evaluations.</p>
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