Influenza in India 1918: excess mortality reassessed

Kenneth Hill



Routine demographic data for India for the period 1901 to 1921 are evaluated and adjusted to assess the size and regional distribution by province of the impact of the 1918 influenza epidemic. Further analysis focuses on the districts of Central Provinces and Berar (CP-B). Previous estimates of “excess” deaths in the range of 17.5 to 22.5 million were probably too high, having not taken account of the effect of the epidemic on births; I estimate a range of 11.0 to 13.5 million. Even so, the “excess” crude death rate between August 1918 and January 1919 is estimated to have averaged over 30 per 1,000, and in CP-B to have exceeded 60 per 1,000. For the districts of CP-B, associations between excess death rates and other characteristics are explored; severity is found to be positively associated with rainfall, and negatively associated with the sex ratio of the population and emigration rates.

Kenneth HILL, Professor of Public Health, Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge MA 02130, USA. E-mail:


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ISSN: 2035-5556

Reg. Tribunale di Roma n. 3321/54