All efforts Montana’s health officials, physicians, nurses, and private citizens made were simply not enough to curb the state’s mortality rate. Through October, November, and December 1918 alone, the state Board of Health received reports of 37,567 cases of influenza, a number nearly equal to the population of the city of Butte. For weeks, life in Montana paused. The University of Montana in Missoula and Montana State College in Bozeman both closed their doors shortly after the fall session of 1918 began, and classes did not resume for months. The only students left on campus were members of the Student Army Training Corps, a program designed to keep young men in college while simultaneously preparing them for the front lines. Illness and official orders changed how Montanans did business and interacted with one another. Officials postponed teacher evaluations, businesses failed to open, churches kept their doors closed, and prevention measures like wearing gauze masks changed social norms. Once influenza passed, many Montanans found their world altered forever.
The pandemic brought a number of lasting changes to public health policy in Montana. Influenza was not new to Montana, but prior to the pandemic officials did not require physicians to report cases of the disease. After the pandemic, state health officials not only required the reporting of influenza, but also created a position for an epidemiologist to study “the incidence of communicable diseases” and work cooperatively “with local and county health departments in the suppression of the same.” The State Board of Health also called for more funding for public health efforts; officials argued that funding shortages made it impossible to give aid to several afflicted communities during the pandemic. The pandemic’s morbidity and mortality rates made disease control and monitoring a top priority for state and local public health officials.
In the years immediately following the pandemic, many communities around the nation reported lasting economic effects; there is no documentation of this in Montana, but the loss of so many of the state’s workers certainly effected individual families and communities. Many families lost the young men who were their primary breadwinners, and closures stole days and weeks of income from business owners. Lillian Jarussi, a child in Red Lodge during the pandemic, recalled, “one day you’d see these young men going by with their loads of grain, and then two or three days later you would hear that they were gone.” A number of these young men left families behind, and, unfortunately, the fate of their widows and children is largely unknown. Beginning in 1917, drought began to spread over Montana’s northern plains. By 1919, nearly two-thirds of the state was in drought condition. Insect invasions and debt added to the crop failures, and thousands of Montana’s homesteaders left the state. The exodus peaked in the summer of 1919. Though crop failure was certainly the main reason, but it is acceptable to include influenza as well. Many families, struggling to make ends meet during the dry years of 1917 to 1919, came upon harder times following the loss of one or more family members, especially if there was no one left alive to run the homestead. These desperate families had few choices, and leaving Montana to return to family or former homes in the east was likely one of the only options for several. Hundreds of children all over Montana became wards of the state. By November 1918, the Board of Health in Butte took over the care of fifty children whose parents were influenza victims. It is uncertain how many children became dependents of other organizations or families and the economic toll their care took on the state.
Some communities experienced positive change in economic circumstances following the pandemic. In cities with predominantly manufacturing-based economies, labor shortages led to a rise in wages. Influenza and World War I predominantly killed the demographic group employed most in manufacturing. Wage increases were especially prevalent in cities with high influenza mortality rates. However, though Butte had an extremely high mortality rate and young miners accounted for half of the city’s influenza deaths, the mining industry did not experience the labor shortage and subsequent wage increase that manufacturing-based cities did. John Gillie, manager of one of the city’s largest copper mines, the Anaconda, noted that workforce numbers did not change throughout the course of the pandemic. Industry issues like mine failures and labor disputes meant that there were always men looking for work in the mines. The transient nature of mining ensured that workers were always available to take the place of an ill, injured, or deceased miner. The city’s primary industry was responsible for many of its influenza deaths, but its transitory nature also ensured that the economic status quo remained unchanged during and after the social upheaval of the pandemic.
 Cogswell, Ninth Biennial Report, 10, Spanish Influenza Vertical File, MHSRC, Helena; U.S. Census Bureau, 1910 Census, Montana; Mullen and Nelson, “’The Most Peculiar Disease,’” 57; River Press (Fort Benton, MT), October 23, 30, 1918. On October 24, Secretary Dr. Cogswell of the State Board of Health asked all of Montana’s residents to wear gauze masks to avoid spreading influenza. This mandate was never required statewide, and researchers now know that the masks actually did little to stop the spread of disease.
 Cogswell, Ninth Biennial Report, 1, Spanish Influenza Vertical File, MHSRC, Helena. The State Board of Health filled the discussed epidemiologist position in April 1919. Through the spring of 1919, the number of disease reported increased over previous years, but deaths did not. It is likely that new disease surveillance methods, including the work of the epidemiologist and local physicians’ increased reporting, worked as the Board of Health hoped.
 Ibid., 11.
 Lillian Jarussi and Loretta Jarussi, interview by Laurie Mercier, September 24, 1982, OH 363, MHSRC, Helena.
 Thomas A. Garrett, “War and Pestilence as Labor Market Shocks: U.S. Manufacturing Wage Growth, 1919-1919,” Economic Inquiry 47, no. 4 (October 2009), 724; Toole, Twentieth-Century Montana, 70-1, 76-80; “Health Board Provides Care for Children Left Destitute by Epidemic,” Anaconda (MT) Standard, November 2, 1918.
 Garrett, “Labor Market Shocks,” 711-25; “Methods to Combat the Raging Epidemic are Being Defined,” Anaconda (MT) Standard, October 22, 1918; Emmons, The Butte Irish, 135.