The Influenza Epidemic of 1918–1920 among the Navajos: Marginality, Mortality, and the Implications of Some Neglected Eyewitness Accounts

The influenza pandemic of 1918–19 was “the most widespread disease event in human history.” It “killed more people in a year than the Black Death of the Middle Ages killed in a century.”¹ “Nothing else—no infection, no war, no famine—has ever killed so many in as short a period.” Perhaps one-fourth of the earth’s 1.8 billion people were infected, and over 50 million (2.8 percent) died from the disease and its complications.²

Some populations suffered higher mortality than others. Across the globe, indigenous peoples were much at risk; remote indigenous populations were especially vulnerable. Many Native Americans, Pacific Islanders, and Africans—tribal peoples having more or less “naive” immune systems—“were not just decimated but sometimes annihilated” by the influenza. Native Americans “suffered hideously,” with mortality rates four times higher than in the wider population.³

Studies on mortality differentials in the 1918 pandemic have identified several “associated factors” or “risk factors.”⁴ Taken together, these characteristics comprise a framework within which the experience of particular populations may be interpreted. In this article, the experience of the 1918 influenza among the Navajos is organized according to these factors gleaned from studies of the pandemic among other indigenous populations. We proceed from a review of these risk factors to a description of the 1918 influenza on the Navajo reservation, drawing on both Navajo and non-Navajo sources. We conclude with a reassessment of influenza-related mortality on the reservation, adjusting early-published official figures to reflect later data, some of it previously unpublished primary observation.

Method

Our method may be summarized in four stages. First, we conducted a review of relevant historical and analytical literature on the 1918 influenza pandemic, combining works identified in contemporary databases (notably Social Sciences Citation Index / Web of Science) and library catalogs with an exhaustive “snowball” bibliographic search, tracking down items cited in works already identified, then following up relevant items cited in those works, and so on. We paid special attention to reports of unusually high influenza mortality and morbidity, noting population characteristics associated with high mortality. Second, we made a focused search for influenza-related materials in the Navajo literature, using the Internet and bibliographies specific to the Navajos and searches within the relevant time span of published and archival materials at the National Archives and in several southwestern university collections, including the libraries of the University of Arizona, Northern Arizona University, and the University of New Mexico.⁵ Third, drawing on materials identified in stage 1, we established a set of “risk factors” associated with high mortality during the 1918 influenza; these characteristics then served as an organizing framework for a summary description of the Navajo experience of the influenza epidemic, as revealed in stage 2. Finally, our consideration of primary and secondary accounts of the epidemic on the Navajo reservation makes possible a reevaluation of official reports on influenza mortality on the reservation, supporting the conclusion that official Bureau of Indian Affairs figures on influenza mortality among the Navajos in the epidemic are substantial underestimates.⁶

Indigenous populations and the 1918 influenza

Relevant to interpreting the influenza’s impact on the Navajos is the experience of other populations experiencing high mortality. The 1918 influenza was a new disease for which neither scientists nor medical personnel had a cure. Many of the responses recommended by physicians and other modernist experts at the time were no more effective than traditional remedies or techniques formulated in desperation by tribal peoples.

Early commentary on the 1918 influenza distinguished it from other diseases in that it seemed “socially neutral,” infecting people across nationalities, ethnic groups, and social strata. It later emerged that while the virulence of the disease was such that “everyone” caught it (much of the population was susceptible to this powerful pathogen), there were substantial social differentials in its lethality.⁷ In Britain, for example, 2.5 percent of the total population died, although almost 30 percent was infected. The same ratio...