The spatial distribution of pertussis, but not measles or smallpox, in pre-health care Finland matches dialect groups

Infections spreading from host-to-host are a burden of social lifestyle mostly documented at the local scale (within groups). The influence of social structure at a broader scale (e.g., between groups or regions) on infectious disease dynamics is less understood partly due to the difficulty to identify the relevant social groups at this scale. Dialect groups encompass long-held human contacts and could indicate social groups relevant to infections. Using nationwide individual-level mortality records from pre-industrial Finland (1800–1850), we investigated which social grouping best predicted spatial variation in smallpox, pertussis and measles mortality by comparing models with no regional information, administrative regions and dialect groups. Dialect groups explained spatial variation of pertussis, adminsitrative regions for smallpox, while measles showed no broader scale spatial variation. These results highlight the complex spatial structuring of infectious diseases and stress the need for studies to identify the relevant social structure.