Public Health and Culture in Butte – Pt. 2

Many of Butte’s citizens refused to obey authorities’ orders, and much of that attitude stemmed from the city’s unique history and settlement. Most of Butte’s residents depended upon the mining industry, which followed cyclical “boom and bust” periods and was semi-permanent. Mine shutdowns, work accidents, and labor union disputes made miners an incredibly transient population made creating a citywide sense of community difficult. Butte became a city overnight, and its swift development and transitory state ensured that the progressive reforms that took place in similar-sized cities did not happen in Butte. Butte had a reputation as one of the roughest and most dangerous towns in the west. Drinking, gambling, and prostitution were common, and officials were often lax in enforcing laws that regulated such vices. Therefore, regulations aimed at limiting citizens’ access to regular businesses were not popular with the people of Butte.[1]

            Saloons and pool halls were responsible for most public health violations during the pandemic. The Board of Health waged a constant battle with saloon proprietors to keep the facilities closed or limit patrons’ access. On October 17, 1918, Butte police arrested 23 men for congregating in pool hall the Board’s orders had closed. In order to help saloons stay in business, but limit contact between patrons, the Board ruled on October 22, “no drinks be sold over the Bar. Package goods may be sold and carried away, no liquor consumed on the premises.”[2] The violations continued, though. Police arrested saloon proprietor Thomas Connolly on October 25 for “selling beer in glasses.”[3] On November 4 and 5, the Board ordered two saloons closed for multiple violations of the order.[4]

            Officials had such trouble with Butte’s saloons and pool halls because they were vital components of the city’s ethnic communities. Nearly one-quarter of Butte’s population Irish-born or the children of Irish immigrants, and Irish keepers ran almost 30 percent of the city’s saloons. The saloons served as the unofficial community halls of the male-dominated population. The Irish gathered in saloons not just to drink, but also to meet after their shifts in the mines, sing their nationalist songs, and commiserate on their rough treatment at the hands of the English. Other ethnic groups used their saloons in much the same way. The city’s German, Slavic, Italian, English, and Finnish communities all had their own saloons, each with a defining ethnic culture. Saloons often served as the unofficial banks and news outlets of their communities, and many even allowed patrons in at all hours to use the toilet and other facilities. One particular Butte saloon served as the contemporary equivalent of a soup kitchen and shelter. The “hobo house” offered beds, food, and even laundry facilities to homeless patrons. A 1919 County Board of Health study found that many of Butte’s saloons were cleaner and healthier than boarding houses. A number of Butte’s citizens depended upon their community’s saloon, and closure orders disrupted far more than their drinking activities. Due to language and cultural differences, many immigrants felt more comfortable visiting neighborhood saloons than official agencies for news, resources, and assistance. The Board struggled to enforce orders on saloons because they played such a vital role within Butte’s many ethnic communities.[5]

            The city’s religious leaders hotly protested the decision to allow saloons to remain open. Butte’s priests and reverends argued that if churches could not hold services, saloons should close. “Not only are all men equal before the law, but…all public dangers are equal before the law,” the Silver Bow Ministerial Administration protested. “Our institutions and national declarations stand for vital facts in the life of the people,” they declared.[6] Many of Butte’s residents found the prohibition of church functions nearly as grievous as saloon closure. By 1918, Butte had forty-seven churches, missions, and synagogues.  For many, churches were the center of the community. The churches baptized babies, educated children, performed marriages, and provided other social services and assistance to their members. The Catholic Church, especially, provided a sense of stability in their transitory mining world. Almost half of Butte’s citizens belonged to a Catholic parish, illustrating the influence the Church had within the city. Parish members and priests resented having their churches closed. It is unknown how many unlawful services took place and rites performed while bans were in place, but it is unlikely that these close-knit religious communities ceased meeting altogether to obey public health orders. Even small meetings allowed for the spread of influenza throughout the community.[7]

            Illness rendered hundreds of Butte’s citizens unable to work, which meant their families ran short of money for food, clothing, and other necessities. The prohibition on church activities mean to provide support, be it physical, emotional, or spiritual, meant that many Butte residents needed to find resources and assistance elsewhere. Some may have turned to saloons, as official orders closed them later than churches. Once saloons closed, however, many families and individuals, especially linguistically and culturally isolated immigrants, had few options. Their close neighbors shared the same challenges and could offer little assistance. Orders to close churches and saloons certainly helped to limit the spread of the virus, but they also isolated a large number of Butte’s residents and prevented some from obtaining much needed assistance during a time of need.

            The Butte Board of Health was one of the most proactive and best organized in the state. However, even their greatest efforts could not stop or even slow the spread of influenza throughout the city. Mining had made Butte an incredibly diverse city, and a unified culture and sense of community did not exist. Butte’s citizens resented the Board’s interference with their daily lives, and chose not to follow many of the imposed regulations, which pushed the city’s mortality rate as high as anywhere else in the continental United States. Further, orders limiting residents’ access to usual sources of support and resources had a negative effect on how well Butte’s citizens were able to respond to and recover from influenza.

 

[1] Murphy, Mining Cultures, xiv, xvi; Emmons, The Butte Irish, 22, 71, 135.

[2] River Press (Fort Benton, MT), October 23, 1918, 8; Butte Health Officer, Department of Health Minute Book, 1903-1923, October 22, 1918, Silver Bow Country Board of Health Collection, BSBPA, Butte, MT.

[3] “Saloonman Held for Selling Over a Bar,” Anaconda (MT) Standard, October 26, 1918.

[4] Department of Health Minute Book, 1903-1923, November 4, 5, 1918, Silver Bow County Board of Health Collection.

[5] Emmons, The Butte Irish, 42-3; Murphy, Mining Cultures, 45, 48, 50.

[6] “Ministers Protest,” Anaconda (MT) Standard, October 11, 1918.

[7] Department of Health Minute Book, 1903-1923, October 11, 1918, Silver Bow Country Board of Health Collection; Murphy, Mining Cultures, 82; Emmons, The Butte Irish, 97.

Public Health and Culture in Butte – Pt. 1

Butte had an especially proactive Board of Health that met almost daily throughout the course of the pandemic. They instituted many prevention measures and passed regulations to combat the spread of influenza. These efforts, though, were only effective as long as the public complied, which it often did not. Copper mining created an incredibly diverse population, demographically, culturally, and socially. Approximately 30 percent of the city’s population was foreign-born, and countless others were the children of immigrants. These cultural differences, coupled with the transient and often lawless nature of mining communities, created an environment where laws and ordinances were exceedingly difficult to enforce.[1]

             Beginning October 9, 1918, the Butte Board of Health received word of the stringent prevention measures the State Board of Health enacted to combat the spread of influenza and began to meet almost daily. The disease was present within the city by this time, and to prevent “widespread devastation by this contagious and deadly plague” the Board ordered all “churches, theatres, moving picture shows, dance halls, parades, cabarets, and public dances” closed and “bargain sales in stores and all public gatherings prohibited.”[2] By the end of the month, the Board also prohibited large funerals and ruled that all businesses that can be open must “fumigate” their facilities daily and require staff to wear masks.[3] Streetcar windows must be left open and cars fumigated each day, and even all old telephone directories must be destroyed, all in an effort to prevent the spread of disease. Officials believed that disinfecting surfaces and destroying possibly contaminated materials could reduce the number of disease-causing pathogens people contacted. They also felt reducing crowd size limited the opportunities to spread disease. The Board asked the National Guard for assistance in ensuring that crowds did not congregate on the city’s streets, and the police stood guard at funerals to ensure that mourners followed crowd control regulations. The reasoning behind these control measures was sound, but only a total restriction on public gatherings and personal contact could completely stop the spread of disease. The measures the Board took did help to slow influenza’s progression, but none could effectively curb the epidemic entirely.[4]

            By the first days of November, the Board felt that the pace of infection had slowed enough to lift restrictions. On November 11, 1918, the Board believed that “if the public used precausion [sic]” they did not “anticipate any further spread of the Epidemic.”[5] The number of reported cases had decreased, but the Board’s actions were premature. As long as the disease was still present, continued infection was possible, and lifting prevention measures allowed the virus to circulate within a larger and unrestricted population. Butte’s Armistice Day celebrations illustrated this point. On the afternoon and evening of November 11, 1918, just hours after the Board decided to ease prevention measures, Butte’s citizens crowded the streets to celebrate the end of World War I. The Armistice Day festivities caused an explosion in the number of cases not only within Butte, but in the entire state. Within three days, the number of cases in the city more than doubled, and the death toll rose. The effects of the Armistice Day celebration illustrated that the decision to ease public restrictions and prevention measures was premature. The Board determined that the city might need to “adopt drastic measures to exterminate the disease.”[6] Reenacting the measures was necessary to remedy the upsurge in cases that redacting them had caused.[7]

            Within one month, the Board reinstituted all previous restrictions, introduced new ones, and strengthened their enforcement methods. All individuals with influenza had to follow quarantine regulations and placard their homes to announce the presence of the disease. Undertakers had to place those killed by influenza or pneumonia in a closed casket, with the face and head wrapped within 24 hours of death; the casket had to remain closed. Any infractions resulted in misdemeanor charges. Barbershops, saloons, and pools halls remained open, but the Board regulated crowd size and again employed National Guard troops to ensure crowd control.[8]

            Most of the measures met with at least some resistance, and offenders met swift and strict judgment. The police made a number of arrests for violations that included spitting on the sidewalk and sweeping dust into the street, and authorities closed a number of saloons for violating closure and crowd size orders. Despite authorities’ best efforts at enforcement, the public regularly broke regulations and orders, and the city suffered an appalling death toll. In the months of October, November, and December 1918, Butte health officials recorded 5,721 cases and 641 deaths from influenza, numbers that are certainly low as overworked physicians often failed to report all of their cases.[9]

 

[1] U.S. Census Bureau, 1910 United States Census, Silver Bow County, MT.

[2] Butte Health Officer, Department of Health Minute Book, 1903-1923, October 9, 1918, Silver Bow County Board of Health Collection, GR.HL.SB.002, Box 1, Volume 1, BSBPA, Butte, MT.

[3] Ibid., October 15, 1918.

[4] Butte Health Officer, Department of Health Minute Book, 1903-1923, October 12, 15, 18, 21, 31, 1918, Silver Bow County Board of Health Collection, BSBPA, Butte, MT; “Sixteen Deaths from Pneumonia,” Anaconda (MT) Standard, October 23, 1918.

[5] Butte Health Officer, Department of Health Minute Book, 1903-1923, November 11, 1918, Silver Bow County Board of Health Collection, BSBPA, Butte, MT.

[6] Ibid., November 14, 15, 1918.

[7] Ibid., November 15, 1918.

[8] Ibid., November 16, 21, 29, 1918, December 7, 1918,.

[9] Daniel Milton, “Population Control: Butte, Silver County Board of Health, and Spanish Influenza of 1918” (master’s thesis, University of Montana, 1991), 19, 23, AW HO42, BSBPA, Butte, MT; W.F. Cogswell, Tenth Biennial Report of the Montana State Board of Health for the Years 1919-1920, 3, Spanish Influenza Vertical File, MHSRC, Helena.  

Public Health and Health Care Resources in Rural Montana

The circumstances that rural and urban Montanans lived in not only created different sets of risk factors for influenza, but also allowed different access to public health and health care resources. Agricultural pursuits required a large amount of land and meant that great distances separated rural Montanans from their neighbors. Visits to neighboring homesteads and communities and transient farm, ranch, and railroad workers allowed the spread of influenza in these sparsely populated areas, but once the virus weakened rural residents the distance to travel for health care proved too much. Rural Montanans depended upon one another for care, support, and cooperation in order to keep influenza at bay, especially when official intervention failed.

In rural Montana, the great distances between settlements meant that very few residents had ready access to health care. Often, a single physician served an area of hundreds of square miles. Dr. Harry B. Tice served as the county health officer and sole physician of the Upper Musselshell drainage; his death from pneumonia in January 1919 left an area over one hundred miles across without a healthcare provider. The south central Montana community of Rapelje had no facilities for its three hundred cases, so Dr. Alfred C. Dogge converted schools and churches into emergency hospitals and used wagons to transport the ill. The centralized treatment locations allowed Dr. Dogge to provide care for individuals that, had they remained spread out, may not have received adequate attention. The efforts Dr. Dogge and his volunteers took to improve efficiency of care in this rural area kept the death toll at five. Orlean Daems Bassett accompanied her father, one of the Madison Valley’s only physicians, on house calls. Dr. Bassett, she recalled, possessed the only “fever thermometer” in the area.

Many retired physicians returned to service for the duration of the pandemic to assist communities without a provider. Dr. O.M. Lanstrum, a retired physician campaigning for the United States Senate, postponed all speaking dates and campaign engagements when the Rocky Mountain Front community of Choteau lost their physician to influenza. Dr. Lanstrum reported to Choteau immediately to give aid. Dr. J.J. Leiser of East Helena traveled seventy miles to Cascade, a community with no physician, when thirteen residents presented with influenza in one day.

Some communities were unable to obtain a medical provider, and heroic civilians often stepped up to help their neighbors. A Mr. Christler of Havre drove into surrounding rural communities to check on isolated families. It is unknown how many his efforts saved, but among them was a family of eleven; all suffered from influenza, and no one was available to prepare food, obtain clean water, or heat the house. Mr. Christler accomplished these tasks, allowing the family members to not only recover from influenza, but avoid starvation or freezing. Untrained volunteers in Harlowton set up an emergency hospital. They buried several individuals, but just as many recovered. The number of cases, however, was often too much for the few rural providers and kindhearted residents, and many individuals died before they had an opportunity to receive assistance. For example, a family of five in Miles City died before anyone discovered they were ill.

Other rural communities around the state petitioned the governor for assistance. An urgent telegram from tiny Ringling reported that it was “impossible for the one and only doctor” in the county to “even attempt to reach all those afflicted.” The people of the central Montana community of Suffolk were without a physician and could persuade no providers from neighboring municipalities to help them; they pleaded with the governor for aid. Governor Stewart found there was little he could do and replied that he consulted the State Board of Health on the matter. It is unknown if Ringling and Suffolk received the medical aid they desperately needed.

The Red Cross provided resources and personnel for communities in need. In cities and rural communities around the state, Red Cross chapters supplied gauze masks for residents to wear to avoid spreading germs and provided afflicted families with meals and assistance. Their most important effort was providing nursing care. Treatments doctors prescribed were ineffective against influenza; patients benefitted most from bed rest and the care nurses provided, which consisted of providing basic comfort like feeding, changing bed linens, and ensuring fluid intake. However, the war effort occupied many of Montana’s nurses, and few were available to treat the state’s influenza patients. To help increase nursing provider numbers, the Red Cross set hourly wages for its nurses. They also provided voluntary service for families unable to pay and asked private citizens to volunteer as “visiting nurses.” “There are not sufficient nurses in Butte to meet this emergency,” the city’s Red Cross Chapter advertised: “Offer your services as a visiting nurse (experience not necessary).”

The State Board of Health worked tirelessly in the autumn of 1918 mandating prevention measures, filling calls for medical providers, and providing mitigation guidance, all in an effort to slow the spread of influenza and provide relief to desperate communities. Secretary W.F. Cogswell and fellow Board members watched influenza make its way throughout the country and instituted prevention measures and regulations at the first sign of the disease in Montana. The Board required local health officers to immediately report all cases and outbreaks, close schools and prohibit public gatherings when influenza was “in epidemic form in any community,” and isolate influenza patients until recovery. Infection control measures in hospitals included screening all incoming patients for influenza, separating influenza patients from others, and disinfecting “all discharges from the nose and mouth of patients.”

The Board knew that these measures did not prevent influenza from becoming epidemic in other states and regions and suspected the same for Montana; thus, their efforts focused on mitigation and relief. The Board foresaw the challenges ahead and wired the United States Public Health Service to request six doctors and 25 nurses for Montana. However, by mid-October, less than a month after the first suspected influenza death in the state, requests for assistance overwhelmed the Board. More petitions for providers arrived than the Board could fill, and there was “nothing…to indicate the board [would] be able to meet these appeals from influenza stricken communities.” Despite the efforts and attention of rural physicians, nurses, volunteers, and officials, life in rural Montana posed too many challenges to successfully combat the spread of influenza.

Economy, Environment, and Influenza in Butte

The relationship between economy, living conditions, and mortality rate is especially evident through an examination of Butte’s pandemic experience. Butte’s experience was thoroughly documented and well-preserved; only the State Board of Health kept a comparably comprehensive record of pandemic activity, and in some instances, Butte’s are more thorough. Unfortunately, all communities, Butte included, only documented the number of influenza and pneumonia deaths; there is no breakdown by occupation or ethnicity, only age and gender. However, these records still make a thorough examination of how the city’s economic activity influenced its demographics and environment and, consequently, its battle with influenza possible. This is especially important since the city accounted for such a great portion of the state’s pandemic deaths.

            Butte had one of the highest mortality rates of all American cities. Over one-third of all Montana’s pandemic deaths were in Butte, a ratio out of proportion with the population breakdown of the state, as only 10 percent of Montana’s residents lived in the city. Demographics alone do not account for the city’s high mortality rate. Butte’s demographic characteristics were comparable to the rest of the state; the city had a nearly equal ratio of populations susceptible to the 1918-1919 influenza virus as the rest of Montana. Butte was unique. The city was nearly three times as large as all other Montana communities, and urban living, combined with the effects of the primary economic activity, copper mining, created a terribly unhealthy environment. Mining and urban living created extremely unhealthy living and working conditions, making the city’s already susceptible population especially vulnerable to influenza and leading to its exceptionally high mortality rate.[1]

             Underground miners made up the largest portion of Butte’s workforce and faced the deadliest and unhealthiest conditions. Miners worked long shifts, often 12 hours, many of them underground. Accidental death and injury were common, and the underground environment invited disease. Sanitation underground was poor and encouraged illnesses. Toilet cars were not always available, and human waste mingled with animal excrement from mules used to pull ore cars. Before the installation of ventilation systems in the 1920s, the temperatures in Butte’s deepest underground mines often reached over 100°F with a humidity level of 100 percent. Men often rose to the surface wet with perspiration and condensation. A walk home in the cold turned clothing to ice, creating condensation and resulting in a situation that invited fever and weakened immune systems.[2]

            The thick, stagnant, and poorly ventilated air in underground caverns created lasting health conditions. Silicate dust in the underground mines left the lungs scarred and susceptible to respiratory illness, including influenza. A 1917-1918 USPHS report estimated that “’at least 20 per cent [sic] of the underground workers who had been employed five years or more in the Butte mines had miners’ consumption.’”[3] Tuberculosis was a common affliction in Butte. Between 1911 and 1916, the city’s death rate from tuberculosis was more than double the national average. Hundreds of people in Butte suffered from lung diseases and infections, conditions that presented serious complications for influenza patients. Butte’s population, due to demographic makeup, was already susceptible to the influenza virus of 1918-1919, but the conditions that many of the city’s residents worked in increased their vulnerability and made it exceedingly difficult for their immune systems to fend off the virus.[4] 

            Even if they did not work underground, almost all of Butte’s residents, including the carpenters, blacksmiths, and engineers that worked above ground, and the merchants, entertainers, and prostitutes that followed the boom, depended upon the mining industry. Mining affected disease susceptibility and quality of life for them as well. The mines and smelters created extremely unhealthy living conditions for all of the city’s residents. Mining companies used open hearth smelting to separate copper from the rock once it came out of the ground. Enormous wood and charcoal-fueled fires burned in and around the city. Butte’s residents held rags over their faces to walk through the city’s streets and carried lanterns in the middle of the day to help them see through the haze. Smelting not only killed all vegetation in the area, but the “sulphurous smoke” caused lung infections and other respiratory disorders.[5] The influenza virus quickly overwhelmed lungs that months and years of exposure to open hearth smelting had already weakened.[6]

            The health threats were not just in the air, and unhealthy living conditions plagued most of the city’s residents, regardless of employment. Overcrowding and poor sanitation were common in all but the most economically prosperous sections of Butte. Cabins crowded onto the city’s rocky slopes and ridges, and entire families lived in one or two rooms. Butte’s Board of Health found that in one neighborhood, residents had only 335 cubic feet of indoor air. No lawns or parks grew outdoors, and horses, cattle, chickens, and other animals roamed the streets. Waste disposal was especially problematic in these areas; refuge and stagnant water filled the dirt areas around homes. Many young single workers lived in crowded boarding houses, often two or three to a single room. The boarding houses had the same waste disposal problems that single-family homes did. Toilets were located outdoors and rarely tended. Neighborhoods were not divided along occupational lines, so these conditions affected many of Butte’s citizens, regardless of employment. These unhealthy surroundings caused not only respiratory infections, but bred a number of other diseases; constant battle with infectious disease slowly wears down the immune system, opening up the body to secondary infections like influenza or tuberculosis.[7]

            The high rates of disease, especially “miners’ consumption” and other lung diseases, in Butte help explain the city’s exceptionally high mortality rate. The Silver Bow County Coroner’s records list a number of deaths from tuberculosis, lobar pneumonia, and vascular heart disease in individuals younger than 40. Influenza exacerbated these pre-existing conditions, making many of these deaths at least partly attributable to the disease. Respiratory disorders like lung infections and, especially, tuberculosis caused serious problems for influenza patients. Any disorder that weakened the lungs made it easier for the virus to invade and more difficult for the body to fight it. Tuberculosis, in particular, was a substantial risk factor for influenza. Like the 1918-1919 influenza virus, tuberculosis primarily affected young adults and was more common in males, meaning many of Butte’s residents were already at risk for tuberculosis. Employment in underground mines and life in the heavily polluted city increased the chances of tuberculosis, which weakened the lungs and immune system and made the body more susceptible to influenza. Influenza readily killed the healthiest of Butte’s adults, so those suffering with co-occurring tuberculosis and influenza infections had dramatically increased odds of mortality.[8]


[1] Mullen and Nelson, “’The Most Peculiar Disease,’” 55; U.S. Census Bureau, 1910 Census, Montana.

[2] Murphy, Mining Cultures, 12, 16.

[3] Toole, Twentieth-Century Montana, 147.

[4] Emmons, The Butte Irish, 72.

[5] Howard, High, Wide, and Handsome, 97.

[6] Murphy, Mining Cultures, 4.

[7] Emmons, The Butte Irish, 73-4, 152.

[8] Silver Bow County Coroners’ Register, August 1918-October 1920, GR.COR.SB001, Butte-Silver Bow Public Archives (hereafter BSBPA), Butte, MT; Andrew Noymer and Michel Garenne, “The 1918 Influenza Epidemic’s Effects on Sex Differentials in Mortality in the United States.” Population Development and Review 26, no. 3 (September 2000), 573-4.

Physical Environment and the Spread and Virulence of Influenza in Rural MT

      Geographic circumstances led to the development of the state’s mining and agricultural industries, but the living and working conditions these activities created an environment that allowed influenza to thrive. Rural Montanans often lived in extremely isolated areas without a number of necessities, including heat and clean water. Rich mineral deposits in the Rocky Mountain foothills created a booming mining industry in Montana, but the residents of urban mining centers often lived in poverty in overcrowded tenements and worked in dirty and poorly ventilated underground caverns. Living and working conditions were not only risk factors for influenza but other diseases as well. During the pandemic, the number of deaths due to things other than influenza was higher than average; influenza and pneumonia complicated the preexisting conditions that living conditions often created. The relationship between Montana’s economy and physical environment played a significant role in the state’s high mortality rate.[1]

            Following the Expanded Homestead Act, thousands made their way to Montana to set up homesteads and farms, and many of these people lived in poor conditions where illness thrived. Rural families struggled to keep warm in Montana’s bitter winters. As the autumn and winter of 1918-1919 set in, families battling influenza also fought freezing temperatures. Rural families often resorted to burning their fence posts and outbuildings to keep warm, and influenza infection made the labor required to heat homestead shacks increasingly difficult, speeding the course of the illness and creating other issues as well. Clean water was also a constant problem. Many rural Montanans hauled their water from railroad stations or wells and cisterns miles away from their homes. This task was impossible for an individual fighting influenza, and during the pandemic rural families went without water or used water from sources closer to home. Even before the pandemic, outbreaks of waterborne illnesses such as cholera, typhoid fever, and giardia were common. The constant battles with such diseases weakened immune systems, leaving rural residents vulnerable to influenza when it arrived.[2] 


[1] Crosby, America’s Forgotten Pandemic, 86.

[2] Toole, Twentieth-Century Montana, 64.

Influenza in Montana: The State’s Economy and Demographics

No state or region had the same pandemic experience. The four hardest hit areas in the United States – Pennsylvania, Maryland, Colorado, and Montana – shared few commonalities as far as geography, culture, economy, or demographics. These factors all played a role in Montana’s high mortality rate, but each stemmed from the state’s economic system. Mining and agriculture dominated early twentieth-century Montana’s economy. The Homestead Acts of 1862 and 1909 encouraged settlement of Montana’s eastern plains, and copper and silver mines in the west and southwest portion of the state drew large numbers of young, able-bodied adults to Montana. The state’s demographic, social, and cultural diversity, encouraged by these economic opportunities, created a population and environment perfect for influenza’s survival.[1]

            Montana’s economic opportunity drew the population most susceptible to influenza to the state. Most of Montana’s newcomers during the early years of the twentieth century were young adults, and a great many of those were either male, foreign-born, or both, the demographic groups most likely to die of the disease. The 1910 census reported that sixty percent of the state’s 376,053 residents were male, and nearly a quarter of the population was foreign-born. In Butte, Montana’s largest urban area and the community the pandemic hit hardest, the male to female ratio was more unbalanced than any other city in the United States. Butte had twenty-five percent more males than females, and over thirty percent of all the city’s residents were foreign-born. Montana’s population was not only predominantly male and foreign-born, but young as well. Over fifty percent of Butte’s population was between the ages of twenty and forty-four, and thirty-three percent of the state’s overall population were males between the ages of eighteen and forty-four. Continued immigration certainly increased these numbers in the years immediately preceding the pandemic, especially in Butte, where copper production reached a peak in 1916.[2]


[1] Crosby, America’s Forgotten Pandemic, 66;

[2] United States Census Bureau, 1910 United States Census, Silver Bow County, MT; Howard, High, Wide, and Handsome, 94; Murphy, Mining Cultures, 23.

Vulnerable Populations

All young adults were at highest risk of dying of influenza, but of these, two groups had especially high mortality rates: males and immigrants. The male mortality rate was fifty percent higher than the female rate, and the chances of death increased in foreign-born individuals. Some researchers have suggested that this is due to social and cultural behaviors. Young men were less likely to stay at home and rest when ill, allowing the disease to progress beyond the point of treatment. Usually, they also spent more time out of the home than women did, and daily contact with new microbes gave them stronger immune systems than females, increasing their chances of developing fatal cases of influenza or pneumonia. Immigrants were unfamiliar with American public health and healthcare systems and practices and did not seek care due to differing ethnic beliefs and language barriers.[1]

These cultural factors certainly played a role in male and immigrant susceptibility, but the biggest risk factors, especially for immigrants, were biological. Researchers surmise that previous influenza epidemics granted many individuals some immunity to the 1918-1919 virus. However, these epidemics primarily affected urban areas. The immigrant rush of the early twentieth century brought thousands of men and women between the ages of 20 and 40 to the United States, most from rural areas of Eastern and Southern Europe. Their lack of exposure to disease, especially compared to their American neighbors in crowded workplaces and urban tenements, made them especially susceptible to influenza in 1918.[2]

Influenza killed with no regard for physical strength, gender, race, or ethnicity, and indigenous peoples around the world, however isolated, suffered exceptionally high morbidity and mortality rates during the pandemic. The relative isolation of many indigenous peoples meant they had little or no natural immunity to pathogens of any kind and little or no access to public health and healthcare resources. The lethal virus of 1918-1919 killed entire villages in the remote corners of Alaska and decimated populations in the Pacific islands. In the United States, the Native American mortality rate was four times that of urban whites. Influenza infected twenty-four percent of those on reservations and the virus killed two percent of the entire Native population between October 1918 and March 1919. The experience of Native populations is an extremely important part of the pandemic narrative, especially for Montana, a state with seven reservations. High mortality rates on reservations may mean that Montana’s overall mortality rate is much higher than originally believed. However, much more study is necessary to understand the impact of influenza on Montana’s reservations and tribal populations.[3]


[1] Thomas A. Garret, “War and Pestilence as Labor Market Shocks: U.S. Manufacturing Wage Growth, 1914-1919.” Economic Inquiry 47 no. 4 (October 2009), 713; Howard Phillips and David Killingray, introduction to The Spanish Influenza Pandemic of 1918-1919: New Perspectives (London: Routledge, 2003), 8; Crosby, America’s Forgotten Pandemic, 67.

[2] Walters, “The Contemporary Perspective,” 857; Katz, “A Study in Mortality,” 422; Katz, “Further Study in Mortality,” 619.

[3] Crosy, America’s Forgotten Pandemic, 231-2; Steele, “Montana Frontier,” 83.