双脚被过去束缚前行：童年期暴露于1918年流感大流行与晚年男性死亡率
Walking with Feet Tied to the Past: Childhood Exposure to the 1918 Influenza Pandemic and Later-Life Male Mortality
NBER Working Papers · 2026 · [{"name": "Hamid Noghanibehambari", "affiliation": []}, {"name": "Jason Fletcher", "affiliation": []}]
中文摘要
以往许多研究通过跨队列比较、聚焦子宫内暴露，记录了1918年流感大流行对幸存者晚年结果的持续影响。其中一部分研究考察了其对老年健康和死亡率的影响，发现结果不一。本文通过将分析拓展至评估生命早期和童年期暴露于此次大流行对老年长寿的影响，并检验一系列候选机制，为相关文献做出贡献。我们使用与1940年全量人口普查相关联的社会保障管理局死亡记录，采用事件研究和双重差分回归，基于1918年流感相关死亡率将出生城市划分为高暴露与低暴露组，比较不同暴露年龄队列的长寿状况。我们的处理组平均处理效应（ATT）估算表明，暴露年龄为3-8岁和9-11岁的队列，其老年长寿分别减少6.4个月和11.2个月；值得注意的是，这些队列在更广泛的文献中常被用作“对照组”。由于数据限制，我们的主要分析集中于男性，但补充结果显示女性所受影响更小、估计也更不精确。对普查数据的分析表明，健康、教育和社会经济评分的下降可能是潜在的作用机制。
Abstract
Many previous studies have used cross-cohort comparisons and a focus on in utero exposure to document the lingering effects of the 1918 influenza pandemic on survivors’ outcomes later in life. A subset has examined impacts on old-age health and mortality, finding mixed results. This paper contributes to the literature by extending the analysis to evaluate early-life and childhood exposure to the pandemic on old-age longevity along with a set of candidate mechanisms. We employ Social Security Administration death records linked to the full-count 1940 census and employ event-study and difference-in-difference regressions to compare longevity of cohorts with different age-at-exposure who were born in cities with high versus low exposure based on 1918 influenza-related mortality. Our treatment-on-treated calculations suggest that cohorts with age-at-exposure of 3-8 and 9-11 experience 6.4 and 11.2 months reductions in old age longevity; importantly, we note that these cohorts are often used as “controls” in the broader literature. While our main analysis focuses on males due to data constraints, supplementary results suggest smaller and less precise effects for females. An analysis of census data suggests reductions in health, education and socioeconomic scores as potential mechanisms.