The Man Who Predicted Pandemic Inequality a Century Ago

Edgar Sydenstricker dug into the pandemic of 1918 and found income level was a key factor in who lived and who died

Whet Moser
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The St Louis Red Cross Motor Corps on duty during the Influenza epidemic, 1918. Photo: Underwood Archives/Getty Images

Edgar Sydenstricker, the preeminent epidemiologist of his generation, showed how the 1918 flu pandemic was hardest on the poor, as were so many of the health conditions he studied. He had a plan to fix it. Today, we’re finding, and debating, the same things.

As the flu pandemic of 1918 circled the United States in wave after wave or two years, the poor died in droves. It was a predictable outcome. Researchers in the burgeoning field of epidemiology had just documented similar patterns with tuberculosis, and pointed to obvious causes — comorbidities resulting from hard physical labor, overwork, and poverty, and transmission within overcrowded, substandard housing.

But someone had to do the work to document it. Edgar Sydenstricker had an ideal education for the time, and a perfectly Dickensian name for such a figure. The young researcher began as a labor economist, switching to health economics at the dawn of the field in the U.S. He arrived at the U.S. Public Health Service (PHS) after studying income and working conditions during a particularly brutal period, just in time for the greatest health crisis in the…

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