Mortality, migration and epidemiological change in English cities, 1600–1870

Abstract

Objective This study tests the argument that industrialisation was accompanied by a dramatic worsening of urban health in England. Materials Family reconstitutions derived from baptism, marriage and burial records for the period before 1837, and from civil registration of deaths and census populations between 1837 and 1900. Methods Age-specific mortality rates are used as indicators of population health. Results The available evidence indicates a decline in urban mortality in the period c.1750-1820, especially amongst infants and (probably) rural-urban migrants. Mortality at ages 1-4 years demonstrated a more complex pattern, falling between 1750 and 1830 before rising abruptly in the mid-nineteenth century. Conclusions These patterns are better explained by changes in breastfeeding practices and the prevalence or virulence of particular pathogens than by changes in sanitary conditions or poverty. Mortality patterns amongst young adult migrants were affected by a shift from acute to chronic infectious diseases over the period. Significance Pathogen evolution, infant care and migration exerted major influences on mortality trends and should be given greater attention in studies of the health impacts of British industrialisation. Limitations Evidence of urban mortality rates is very limited before 1837 and may not be fully representative of industrialising populations. Mortality also provides only a partial picture of the health of urban populations and may be distorted by migration patterns. Further research There is enormous scope for collaboration between archaeologists and historians to investigate the health of industrial populations, through the triangulation and contextualisation of diverse sources of evidence.

Survivorship and the second epidemiological transition in industrial‐era London

“…By the mid-18th century, smallpox was endemic in urban areas (Davenport et al, 2011). This is an important consideration, as shifts from epidemic to endemic infectious disease dynamics, as well as improvements in diet or nutrition, might have substantially benefited the health of pregnant individuals, as reflected by declining infant mortality (documented by Davenport, 2021) and increased survivorship, as suggested by the current study.…”

“…However, a sudden rise in smallpox infant mortality in rural areas in the mid‐18th century may have benefitted London in the succeeding decades, as it would have decreased smallpox susceptibility among adult survivors who subsequently moved to urban areas (Davenport et al, 2011). This is an important consideration, as shifts from epidemic to endemic infectious disease dynamics, as well as improvements in diet or nutrition, might have substantially benefited the health of pregnant individuals, as reflected by declining infant mortality (documented by Davenport, 2021) and increased survivorship, as suggested by the current study.…”

“…In London, infant mortality appears to have increased from the mid‐17th century to the mid‐18th century, but then fell after 1750, with the early infant period (i.e., the first month of life) experiencing the greatest improvements in mortality. Though childhood mortality (ages 1–4) also improved after 1750, there was “a partial reversal of these improvements” at these ages in the 1830s–1860s (Davenport, 2021, p. 46). The lower estimated infant mortality from 1750 onward could be an artifact of wet‐nursing practices during this period, specifically urban families sending infants to wetnurses in rural areas and thus the possibility that some infants from London would have died and been buried in rural context, thus leading to underestimates of urban infant mortality rates (Davenport, 2021; Newton, 2011).…”

“…Though childhood mortality (ages 1–4) also improved after 1750, there was “a partial reversal of these improvements” at these ages in the 1830s–1860s (Davenport, 2021, p. 46). The lower estimated infant mortality from 1750 onward could be an artifact of wet‐nursing practices during this period, specifically urban families sending infants to wetnurses in rural areas and thus the possibility that some infants from London would have died and been buried in rural context, thus leading to underestimates of urban infant mortality rates (Davenport, 2021; Newton, 2011). The possibility remains, however, that estimates of improved infant mortality in the 18th century reflect real improvements in risks of mortality in London during the 1700s.…”