Infant and child mortality by socioeconomic status in early nineteenth century England

by Jaadla Hannaliis (University of Cambridge)

The full article from this blog (co-authored with E. Potter, S. Keibek,  and R.J.  Davenport) was published on The Economic History Review and is now available on Early View at this link

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Figure 1. Thomas George Webster ‘Sickness and health’ (1843). Source: Photo credit: The Wordsworth Trust, licenced under CC BY-NC-SA

Socioeconomic gradients in health and mortality are ubiquitous in modern populations. Today life expectancy is generally positively correlated with individual or ecological measures of income, educational attainment and status within national populations. However, in stark contrast to these modern patterns, there is little evidence for such pervasive advantages of wealth to survival in historical populations before the nineteenth century.

In this study, we tested whether a socioeconomic gradient in child survival was already present in early nineteenth-century England using individual-level data on infant and child mortality for eight parishes from the Cambridge Group family reconstitution dataset (Wrigley et al. 1997). We used the paternal occupational descriptors routinely recorded in the Anglican baptism registers for the period from 1813–1837 to compare infant (under 1) and early childhood (age 1–4) mortality by social status. To capture differences in survivorship we compared multiple measures of status: HISCAM, HISCLASS, and also a continuous measure of wealth which was estimated by ranking paternal occupations by the propensity for their movable wealth to be inventoried upon death (Keibek 2017).  The main analytical tool was event history analysis, where individuals were followed from baptism or birth through the first five years of life, or until their death, or leaving the sample for other reasons.

Were socioeconomic differentials in mortality present in the English population by the early nineteenth century, as suggested by theorists of historical social inequalities (Antonovsky 1967; Kunitz 1987)? Our results provide a qualified yes. We did detect differentials in child survival by paternal or household wealth in the first five years of life. However the effects of wealth were muted, and non-linear. Instead we found a U-shaped relationship between paternal social status and survival, with the children of poor labourers or wealthier fathers enjoying relatively high survival chances.  Socioeconomic differentials emerged only after the first year of life (when mortality rates were highest), and were strongest at age one. Summed over the first five years of life, however, the advantages of wealth were marginal. Furthermore, the advantages of wealth were only observed once the anomalously low mortality of labourers’ children was taken into account.

As might be expected, these results provide evidence for the contribution of both environment and household or familial factors. In infancy, mortality varied between parishes, however the environmental hazards associated with industrialising or urban settlements appear to have operated fairly equally on households of differing socioeconomic status. It is likely that most infants in our eight  reconstitution parishes were breastfed throughout the first year of life – which  probably conferred a ubiquitous advantage that overwhelmed other material differences in household conditions, for example, maternal nutrition.

To the extent that wealth conferred a survival advantage, did it operate through access to information, or to material resources? There was no evidence that literacy was important to child survival. However, our results suggest that cultural practices surrounding weaning may have been key. This was indicated by the peculiar age pattern of the socioeconomic gradient to survival, which was strongest in the second year of life, the year in which most children were weaned. We also found a marked survival advantage of longer birth intervals post-infancy, and this advantage accrued particularly to labourers’ children, because their mothers had longer than average birth intervals.

Our findings point to the importance of breastfeeding patterns in modulating the influence of socioeconomic status on infant and child survival. Breastfeeding practices varied enormously in historical populations, both geographically and by social status (Thorvaldsen 2008). These variations, together with the differential sorting of social groups into relatively healthy or unhealthy environments, probably explains the difficulty in pinpointing the emergence of socioeconomic gradients in survival, especially in infancy.

At ages 1–4 years we were able to demonstrate that the advantages of wealth and of a labouring father operated even at the level of individual parishes. That is, these advantages were not simply a function of the sorting of classes or occupations into different environments. These findings therefore implicate differences in household practices and conditions in the survival of children in our sample. This was clearest in the case of labourers. Labourers’ children enjoyed higher survival rates than predicted by household wealth, and this was associated with longer birth intervals (consistent with longer breastfeeding), as well as other factors that we could not identify, but which were probably not a function of rural isolation within parishes. Why labouring households should have differed in these ways remains unexplained.

To contact the author:  Hj309@cam.ac.uk

References

Antonovsky, A., ‘Social class, life expectancy and overall mortality’, Milbank Memorial Fund Quarterly, 45 (1967), pp. 31–73.

Keibek, S. A. J., ‘The male occupational structure of England and Wales, 1650–1850’, (unpub. Ph.D. thesis, Univ. of Cambridge, 2017).

Kunitz, S.J., ‘Making a long story short: a note on men’s height and mortality in England from the first through the nineteenth centuries’, Medical History, 31 (1987), pp. 269–80.

Thorvaldsen, G., ‘Was there a European breastfeeding pattern?’ History of the Family, 13 (2008), pp. 283–95.

Plague and long-term development

by Guido Alfani (Bocconi University, Dondena Centre and IGIER)

 

The full paper has been published in The Economic History Review and is available here.

A YouTube video accompanies this work and can be found here.

 

How did preindustrial economies react to extreme mortality crises caused by severe epidemics of plague? Were health shocks of this kind able to shape long-term development patterns? While past research focused on the Black Death that affected Europe during 1347-52 ( Álvarez Nogal and Prados de la Escosura 2013; Clark 2007; Voigtländer and Voth 2013), in a forthcoming article with Marco Percoco we analyse the long-term consequences of what was by far the worst mortality crisis affecting Italy during the Early Modern period: the 1629-30 plague which killed an estimated 30-35% of the northern Italian population — about two million victims.

 

Figure 1 Luigi Pellegrini Scaramuccia (1670), Federico Borromeo visits the plague ward during the 1630 plague,

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Source: Milan, Biblioteca Ambrosiana

 

This episode is significant in Italian history, and more generally, for our understanding of the Little Divergence between the North and South of Europe. It had recently been hypothesized that the 1630 plague was the source of Italy’s relative decline during the seventeenth century (Alfani 2013). However, this hypothesis lacked solid empirical evidence. To resolve this question, we take a different approach from previous studies, and  demonstrate that plague lowered the trajectory of development of Italian cities. We argue that this was mostly due to a productivity shock caused by the plague, but we also explore other contributing factors. Consequently,  we provide support for the view that the economic consequences of severe demographic shocks need to be understood and studied on a case-by-case basis, as the historical context in which they occurred can lead to very different outcomes (Alfani and Murphy 2017).

After assembling a new database of mortality rates in a sample of 56 cities, we estimate a model of population growth allowing for different regimes of growth. We build on the seminal papers by Davis and Weinstein (2002), and Brakman et al. (2004) who based their analysis on a new framework in economic geography framework in which a relative city size growth model is estimated to determine whether a shock has temporary or persistent effects. We find that cities affected by the 1629-30 plague experienced persistent, long-term effects (i.e., up to 1800) on their pattern of relative population growth.

 

Figure 2. Giacomo Borlone de Buschis (attributed), Triumph of Death (1485), fresco

Alfani 2

Source: Oratorio dei Disciplini, Clusone (Italy).

 

We complete our analysis by estimating the absolute impact of the epidemic. We find that in northern Italian regions the plague caused a lasting decline in both the size and rate of change  of urban populations. The lasting damage done to the urban population are shown in Figure 3. For urbanization rates it will suffice to notice that across the North of Italy, by 1700 (70 years after the 1630 plague), they were still more than 20 per cent lower than in the decades preceding the catastrophe (16.1 per cent in 1700 versus an estimated 20.4 per cent in 1600, for cities >5,000). Overall, these findings suggest that surges in plagues may contribute to the decline of economic regions or whole countries. Our conclusions are  strengthened by showing that while there is clear evidence of the negative consequences of the 1630 plague, there is hardly any evidence for a positive effect (Pamuk 2007). We hypothesize that the potential positive consequences of the 1630 plague were entirely eroded by a negative productivity shock.

 

Figure 3. Size of the urban population in Piedmont, Lombardy, and Veneto (1620-1700)

Alfani 3

Source: see original article

 

Demonstrating that the plague had a persistent negative effect on many key Italian urban economies, we provide support for the hypothesis that the origins of  relative economic decline in northern Italy are to be found in particularly unfavorable epidemiological conditions. It was the context in which an epidemic occurred that increased its ability to affect the economy, not the plague itself.  Indeed, the 1630 plague affected the main states of the Italian Peninsula at the worst possible moment when its manufacturing were dealing with increasing competition from northern European countries. This explanation, however, provides a different interpretation to the Little Divergence in recent literature.

 

To contact the author: guido.alfani@unibocconi.it

 

References

Alfani, G., ‘Plague in seventeenth century Europe and the decline of Italy: and epidemiological hypothesis’, European Review of Economic History, 17, 4 (2013), pp.  408-430

Alfani, G. and Murphy, T., ‘Plague and Lethal Epidemics in the Pre-Industrial World’, Journal of Economic History, 77, 1 (2017), pp. 314-343.

Alfani, G. and Percoco, M., ‘Plague and long-term development: the lasting effects of the 1629-30 epidemic on the Italian cities’, The Economic History Review, forthcoming, https://doi.org/10.1111/ehr.12652

Álvarez Nogal, C. and Prados de la Escosura,L., ‘The Rise and Fall of Spain (1270-1850)’, Economic History Review, 66, 1 (2013), pp. 1–37.

Brakman, S., Garretsen H., Schramm M. ‘The Strategic Bombing of German Cities during World War II and its Impact on City Growth’, Journal of Economic Geography, 4 (2004), pp. 201-218.

Clark, G., A Farewell to Alms (Princeton, 2007).

Davis, D.R. and Weinstein, D.E. ‘Bones, Bombs, and Break Points: The Geography of Economic Activity’, American Economic Review, 92, 5 (2002), pp. 1269-1289.

Pamuk, S., ‘The Black Death and the origins of the ‘Great Divergence’ across Europe, 1300-1600’, European Review of Economic History, 11 (2007), pp. 289-317.

Voigtländer, N. and H.J. Voth, ‘The Three Horsemen of Riches: Plague, War, and Urbanization in Early Modern Europe’, Review of Economic Studies 80, 2 (2013), pp. 774–811.