Why So Little H1N1 in AR, WV and VT?

The Natural State

While looking at some of the H1N1 flu data on the CDC website, I was struck by the fact that West Virginia had been completely spared, and that out of the 6,754 cases reported nationwide, Arkansas and Vermont had only 6 confirmed cases combined.

So what do the three states have in common that might account for this clean bill of health?  Not much on the surface.  I was thinking that both Vermont and Arkansas were given their names by Frenchmen.   But what about West Virginia?  No, no French connection there.   Vermont is named after a mountain.  Arkansas has the Ozark and the Ouachita mountain ranges; West Virgina the Appalachians.   Could it be the rarefied mountain air?  Or that the states are landlocked?

I have a theory, not entirely my own, that is a product of a little research and common sense.   First, what do the states with the most cases – Illinois, New York, Texas and California have in common?  They are densely populated. Mexico City fits this description too.  The virus can spread quickly when people are confined in close quarters on buses, subways, at school and work and in busy supermarkets and shopping centers.   Arkansas, West Virgina and Vermont are three of the least densely populated states in the country and there are simply fewer opportunities for exposure.  Makes sense?   Before you say duh, consider this:  these three states have something else in common – they have an aging population.  The median age of an Arkansas resident is 37, 40 for West Virgina and Vermont.   What does this have to do with anything?  The median age of the H1N1 victim is 15.   The theory here is that younger people do not yet have a fully functional immune system and will not have had the developmental benefit of exposure to many types of virus threats as have adults and the elderly.  California, Texas and Illinois, with the lion share of H1N1 victims, are three of the youngest states.  The median age of a Texas resident is 33.  Simply put, in these heavily and densely populated states, there are more high risk youth who will have much greater exposure rates to the virus than their counterparts in smaller, more sparsely populated states.

And there is another intangible that just came to mind.  The ArkBenJerry-UnitedSquare (Small)ansas mascot is the Razorback.   Arkansas hogs are treated with the utmost respect.  Go hogs! And in Vermont, they feed their pigs Ben and Jerry’s ice-cream.  It’s true.  Vermont pigs are a little bit spoiled and apparently don’t like mint chocolate.  They don’t!