What can we learn from the health outcomes of the 1918 pandemic?

Cheryl Widman

Cheryl Widman is a newly minted PhD in Special Education from the University of Illinois at Chicago. A former Chicago Public Schools math and Special Education teacher at Title 1 schools, Cheryl has a keen interest in public policy. As a LEND predoctoral training fellow, Cheryl was selected to attend the AUCD Disability Policy Seminar in Washington, DC where she presented a policy paper in support of the Autism Cares Act in 2014. Cheryl has presented at US and international Autism conferences since 2003, most recently at Autism-Europe in Nice, France in September 2019 where she presented the preliminary results from her doctoral dissertation, Understanding Parent Participation in the Postsecondary Education of Students with Autism Spectrum Disorder. The parent of an adult with ASD, Cheryl is a Board Member of The Arc of Illinois, a partner of the Illinois Autism Task Force, and a member of the Think College Affinity Credentials Committee.


When my child was growing up, I often reflected upon my own pregnancy as a way to understand what variables might have contributed to my son’s autism. I wondered if there was a catalyst that ensured the expression of my autism gene. I would guess many mothers of special needs children have done the same. At the time I was pregnant, I worked in Chicago’s financial district and had caught many of the infections that were circulating in the trading pits. I remember having been violently ill with the flu during my pregnancy, and with an abundance of caution, I refused to take any medication that would mitigate the symptoms.

Now a Special Educator and researcher, my questions during this pandemic focused on health outcomes of the Influenza Pandemic of 1918. I wanted to know if there were health outcomes data, and if there were, what could we learn from the last pandemic. My search led me to an article published by the St. Louis Federal Reserve Bank (Garrett, 2007). This article referenced Almond’s (2006) paper, “Is the 1918 Pandemic Over? Long-term Effect of In Utero Influenza Exposure in the Post-1940 US Population.” The answer is this: the 1918 flu pandemic had a permanent effect on the lives of those who were born to women who had been pregnant during the pandemic, one-third of whom had contracted the disease. The effect of the pandemic went beyond higher mortality rates, but the individuals who survived experienced lower educational attainment and were 15% less likely to graduate from high school, increasing the likelihood of poverty (Almond, 2006). By 1980, as a result of in utero exposure to influenza, these individuals had a 20% higher rate of disability relative to those who were not a part of the 1918 birth cohort.

In 2005, Almond and Mazumder identified schizophrenia, cancer, diabetes, heart problems, speech problems, hearing problems, hypertension, kidney problem, and stomach problems among the diseases and impairments experienced by the 1918 cohort. Since a significant number of these individuals failed to finish high school, as a Special Educator I wondered about how many experienced learning disabilities. Those reporting speech problems piqued my interest because I want to know more about their communication disorder.

What I have learned from reading some of the literature examining the 1918 flu health outcomes is that children born to mothers who are/were pregnant during this Coronavirus pandemic are at risk– and we need to keep in mind that some women may have been asymptomatic for COVID-19. Another question that I have relates to epigenetics, specifically the cohort of adolescents currently undergoing puberty and the potential for epigenetic changes that may impact future generations which Bygren and colleagues (2014) learned about through examining fluctuations in the Swedish food supply. In other words, the health outcomes of this pandemic could be felt for generations to come.

The lesson here is that we need to be closely screening this current cohort of children as they are born and continuing the screening process with every postnatal check-up so that we can begin early intervention as early as possible, if necessary. As Special Educators, in a couple of years, these children will be entering our pre-k classrooms. We need to be ready to accommodate them by training more Special Education teachers and early intervention specialists. Right now, we all need to be advocating for the improvement and reauthorization of IDEA rather than gutting it. This is not a partisan issue. It is a human issue. If we care about children’s outcomes, we need to go to work on improving IDEA for the current, next, and future generations of children.


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