Population and disease transitions in the Åland Islands, Finland

Childhood epidemics and the demographic landscape of the Aland Archipelago

“…During the 19th century, the population of the Åland Islands grew at an average rate of 0.5%, similar to Sweden but much less than the 1.0% average of Finland (Mielke et al 1987). While there was a general decline in crude death rates over the course of the 19 th century, epidemics and the 1808-09 War of Finland resulted in peaks of very high mortality (between 24 and 26 per 1,000 population) placing the archipelago in the first stage of Omran's (1971) epidemiological transition (Mielke, 2016). Mielke and colleagues (1987) concluded that the population decline, attributed to the crisis mortality of the 1808-09 War of Finland, and slow population recovery was likely due to subsequent declines in birth rates, higher than average mortality, and low infant survival.…”

“…In the classical model, the first demographic transition describes the shift from pre-industrial to post-industrial as characterized by declines in the frequency and magnitude of mortality crises leading up to the twentieth century. Declines in fertility follow more slowly, but ultimately both mortality and fertility eventually reach historically low levels; a pattern which was observed in Western Europe in the 18 th century, expanded to much of Europe and the United States by the nineteenth century, and followed by other developed countries across Europe by the 20 th century (Mielke, 2016). The second demographic transition characterizes current trends in Western Europe and the United States in which populations are aging and persistently low fertility and mortality often result in population declines.…”

“…tuberculosis). In addition, population density, without effective approaches to sanitation, led to water source contamination by human and animal waste, increasing the risk and prevalence of waterborne pathogens and persistent parasitic infection (Cockburn, 1971;Mielke, 2016). Infectious diseases became endemic as populations grew to sizes not observed in prehistory and spread through epidemics as trade routes and migration increased contact between new population centers.…”

“…As pandemics and crisis mortality recedes, fertility becomes the primary driver of population growth and as mortality reaches a stable low rate, life expectancy continues to rise (Omran, 1971). Studies from England, Wales, Chile, and Japan show that the greatest reductions in mortality were observed in infants, young children, and mothers (Mielke, 2016). Consequently, the age-distribution of mortality transferred toward the older segments of the population, increasing life expectancy, but also providing a larger portion of the population susceptible to chronic and degenerative diseases (Barrett et al, 1998;Mackenbach, 1994).…”