Penn Student and Woodbridge Native Uncovers Hidden Toll of 1918 Flu on Philly's Vulnerable Communities

Matthew Breier, a rising third-year student at the University of Pennsylvania, is spending his summer immersed in primary sources like death certificates and Philadelphia’s 1918 city directory to learn about the impact of the 1918 influenza pandemic on Black and immigrant neighborhoods.  As he researches each person who died of influenza, he works to catalog information about their demographics and neighborhoods.  “If you see two people with the same last name listed right next to each other and they died a day or two apart, or even on the same day, you can imagine that they were a mother and her child or a husband and wife,” says Breier, who is double majoring in health and societies and in anthropology with minors in classical studies and history.  It brings this research to life for me.”

He has pored through the thick directory to help public health historian David Barnes, associate professor in the Department of History and Sociology of Science, with research on the impact of the pandemic on Philadelphia’s Black and immigrant neighborhoods.

Breier has conducted this work through the Penn Undergraduate Research Mentoring Program (PURM), a 10-week opportunity from the Center for Undergraduate Research and Fellowships.  The program provides rising second- and third-year students with a $5,000 award to work alongside Penn faculty.

Barnes says the 1918 flu pandemic was one of the worst in history and an anomaly compared to other outbreaks in that there was no flight from big cities, no blame or scapegoating, no heroes or villains, no clear beginning or end, and no major medical discoveries.  “If there’s one constant in the history of epidemic diseases or infectious disease in general, it’s that they’re never equal-opportunity killers.  The poor, disenfranchised, and marginalized always suffer more and die in greater numbers,” Barnes says.  “Now, was that true of the 1918 flu?” he asks.  “The answer is we don’t know.  It’s mind-boggling how little we know about this thing that happened during the age of scientific medicine, during the age of mass media.”

He explains that there are two components of the summer research project:  mapping where people who died from influenza lived, and learning more about the characteristics of neighborhoods with high and low mortality rates.

New Insights, New Skills:  Breier says his research has mainly involved going through death certificates and Ancestry Library to find names he checks in the city directory.  He has also taken trips to the Historical Society of Pennsylvania and Van Pelt-Dietrich Library Center to explore the housing, family structure, and community organization of Black and immigrant neighborhoods in Philadelphia in 1918.  “We are gathering these addresses in order to plot them on a map to understand the distribution and spread of influenza throughout the various neighborhoods and wards of the city,” he says.  Breier has observed that deaths in African American communities seemed to be less commonly reported than deaths of European immigrants, particularly those of immigrants from England, Russia, Germany, Belgium, Italy, and Ireland.

Pages from Philadelphia’s 1918 city directory:  At the Historical Society, he found a detailed account from the Red Cross of the distribution of supplies to hospitals and the volunteers who made masks, pneumonia jackets, and food.  Breier also read personal accounts of the nurses and volunteers who cared for the ill in their homes and Emergency Hospitals around Philadelphia at their own peril, as some volunteers also died of influenza.

The research with Barnes has also taught Breier new skills.  He has learned how to use Ancestry Library and how to do research in the Special Collections Library of the Historical Society of Pennsylvania.  He has also learned how to read microfilm, since many of the Philadelphia city directories are only available in that medium.  He says he sent his parents a picture of the machine to see if they knew what it was.  They did.

Also involved in this research are Nicholas Bonneau, adjunct assistant professor of public health at Franklin & Marshall College and a former fellow at Penn’s McNeil Center for Early American Studies, and Katya Korendiy, a rising third-year student supported in this work by Barnes’ research fund.

Looking to the future, Barnes says he is trying to see what researchers find at each stage before deciding what to do next.  One possibility is to undertake the same project for another city. Barnes envisions a website to document findings and a series of maps, a scholarly article, and maybe a book down the line.

A Present Pandemic Drives Interest In The Past:  Barnes has spent his career specializing in the 19th century, he says, because “there’s just no end of 19^th century problems and 19^th century transformations that need our understanding and our attention.”

As COVID hit, he was finishing his 2023 book, “Lazaretto,”—to which four previous PURM students contributed significant research—about quarantine in Philadelphia in the 19th century.  He was getting interviewed about the history of quarantine and epidemics, and he talked about how the 1918 pandemic was the best analogy to COVID when talking about disease transmission.  Barnes says COVID became an important part of his teaching.  “There’s many different lessons we could learn from COVID, but to me the glaring lesson of COVID was differential vulnerability, that certain populations were much more likely to have severe cases and die from COVID than others,” he says, “and I felt like we weren’t learning that lesson.”

Barnes began to pay more attention to recent work in social epidemiology, looking at research on how chronic stress weakens immune responses and makes people more vulnerable to health threats.  A statistic he shares with his students is that in 2024, a Black woman with an advanced degree is more likely to die in childbirth than a white woman who did not finish high school.  He says the disparity is not related to genetics or behavior, rather “the most plausible explanation is this idea of chronic stress, that the experience of dealing with racial discrimination every single day of their lives builds up in the body and creates this biochemical vulnerability.”

Barnes says he became interested in whether people in the past experienced chronic stress, and he decided to study whether certain populations were more vulnerable to dying from the flu in 1918.  While Barnes was landing on this area of research, Breier was a high school student living in Woodbridge, Connecticut.  “COVID affected the majority of my high school years, and it really opened my eyes to how devastating a disease could be on an individual level and also to society,” he says.  That affected his decision to become a health and societies major, and when he took Barnes’ course The People’s Health this spring, Breier did a project looking at the parallels between COVID and the 1918 flu.

Breier says his favorite part of PURM is how it enabled him to receive one-on-one mentorship from Barnes for research in a department he cares about deeply and that it has introduced him to how research in the humanities works.  “In order to understand the full picture of the period and event we are examining, we must interact with and examine both quantitative and qualitative data and documents,” Breier says.  “I love being part of PURM and feel that it is an incredibly valuable experience.