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SSM Popul Health
. 2021 Oct 14;16:100944.
doi: 10.1016/j.ssmph.2021.100944. eCollection 2021 Dec.
Social distancing and influenza mortality in 1918 did not increase suicide rates in the United States
Hampton Gray Gaddy 1
Affiliations
- PMID: 34746358
- PMCID: PMC8551840
- DOI: 10.1016/j.ssmph.2021.100944
Abstract
Recent research has suggested that the social distancing mandates introduced in the United States during the main waves of the 1918-20 influenza pandemic caused an increase in suicide rates. However, that finding relies on poor-quality, temporally mismatched data and has signs of omitted variable bias. Similarly, a long-standing finding that American suicide rates in 1918-20 were also boosted by the influenza mortality of the time has gone unquestioned in the literature, despite the original research admitting its risk of ecological fallacy. Using higher-powered mortality data, I cast doubt on both findings by analyzing the experiences of the pandemic in 43 of the largest American cities of the time. In line with some populations' experiences of COVID-19, I report tentative evidence that social distancing mandates during the 1918-20 pandemic may have been associated with decreased suicide rates. Larger, cross-national investigations of the effects of historical pandemics and social distancing mandates on mental health and suicide are needed.
Keywords: 1918 influenza pandemic; Mental health; Social distancing; Social epidemiology; Suicide; United States.
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