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.
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.
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.’” 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.
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. The influenza virus quickly overwhelmed lungs that months and years of exposure to open hearth smelting had already weakened.
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.
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.
 Mullen and Nelson, “’The Most Peculiar Disease,’” 55; U.S. Census Bureau, 1910 Census, Montana.
 Murphy, Mining Cultures, 12, 16.
 Toole, Twentieth-Century Montana, 147.
 Emmons, The Butte Irish, 72.
 Howard, High, Wide, and Handsome, 97.
 Murphy, Mining Cultures, 4.
 Emmons, The Butte Irish, 73-4, 152.
 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.