The role of a provincial hospital: The Norfolk and Norwich hospital, 1771–1880

Up to the mid-1950's most economic and social historians accepted that improved medical measures, notably the expansion of hospital facilities, made a significant contribution to population growth in the late eighteenth and early nineteenth centuries by helping to reduce mortality rates. In an article which first appeared in 1955, T. McKeown and R. G. Brown criticized what had become the ‘traditional’ view. Though the number of hospitals increased, and though there were advances in medical education and knowledge, such developments, McKeown and Brown suggested, were of little value to the population until reflected in improvements in the standards of treatment available. ‘In assessing the contribution of hospitals to the reduction of mortality’, they argued, ‘we are less concerned with the number of beds than with the results of treatment of the patients who occupied them’.     

Marital Fertility Control Among the Qing Nobility: Implications for Two Types of Preventive Check

Demographers, as early as Malthus, have assumed that the preventive checks, delayed marriage and celibacy, were absent in traditional China. In this paper on the Qing (1644–1911) imperial lineage, we demonstrate that, instead, there may have been a different, more ‘modern’ preventive check: fertility control within marriage. Marital fertility of lineage couples during the eighteenth and nineteenth centuries was low to moderate. Such low fertility was the product of three behavioural mechanisms: late starting, early stopping and, most significantly, long spacing. Couples apparently regulated their fertility according to their economic resources and the sex of their surviving children. Moreover, they did so, we suggest, by regulating their coital frequency. Deliberate fertility control, in other words, was already within the ‘calculus of conscious choice’ for some Chinese well before this century. The speed of contemporary sinitic fertility transitions may accordingly be attributed to the fact that they did not require a change in attitudes, only the diffusion of new incentives and effective technologies.     

The North Korean famine and its demographic impact

The North Korean famine began in 1995 and its ill effects, while peaking in the late 1990s,undoubtedly linger. Recent conjectures on excess deaths caused by the famine range widely from about 200,000 to 3 million or more. This article assesses the demographic impact of the famine with greater rigor than has previously been attempted and describes the unique setting in which the famine occurred. The analysis begins with a pair of population projections based on mortality statistics from two sources. Given their contradictory implications, the analysis turns to less direct evidence of famine‐related mortality. That evidence includes China's demographic experience during the Great Leap Forward and recent measurements of child malnutrition in North Korea. Crosscountry comparisons translate this malnutrition into corresponding levels of infant mortality. The article concludes that famine‐related deaths in North Korea from 1995 to 2000 most likely numbered between 600,000 and 1 million.     

Fertility and mortality in Finland since 1750

Summary In this paper the development of fertility and mortality in Finland, and their interrelations with each other and with economic factors is discussed. An analysis by individual years shows that rises and falls in mortality and fertility rates did not always coincide with poor and good harvests. Fertility in Finland decreased slightly at the turn of the eighteenth and nineteenth centuries, but fell sharply over the period 1876-1925. This fall corresponded closely to changes in the death rate, especially for infants, and appears to justify the conclusion that the changes were connected. These population shifts have been called the first and second demographic transitions, of which the latter was the more dramatic. Factors tending to reduce mortality among infants and in other age groups during the second demographic transition are obvious; those underlying the first demographic transition are less clear. In this connection, the importance of breast feeding and campaigns designed to favour the practice are stressed. These helped to reduce infant mortality and were one of the main reasons for the first demographic transition. Finnish material also suggests that some kind of family planning existed during the pre-industrial period; it is only by making this assumption that the various figures can be made compatible.     

Do fertility transitions influence infant mortality declines? Evidence from early modern Germany

The timing and sequencing of fertility transitions and early-life mortality declines in historical Western societies indicate that reductions in sibship (number of siblings) may have contributed to improvements in infant health. Surprisingly, however, this demographic relationship has received little attention in empirical research. We outline the difficulties associated with establishing the effect of sibship on infant mortality and discuss the inherent bias associated with conventional empirical approaches. We offer a solution that permits an empirical test of this relationship while accounting for reverse causality and potential omitted variable bias. Our approach is illustrated by evaluating the causal impact of family size on infant mortality using genealogical data from 13 German parishes spanning the sixteenth, seventeenth, eighteenth, and nineteenth centuries. Overall, our findings do not support the hypothesis that declining fertility led to increased infant survival probabilities in historical populations.     

Age at baptism in pre-industrial England

Abstract The adequacy of English parish registers as demographic sources has been a subject for much debate.(1) Most attention has been directed to the problem of how far the population at large continued to use the sacraments ofthe Established Church in the late eighteenth and early nineteenth centuries, especially in areas affected by urban growth or Nonconformity. But the more general problem of how far the ecclesiastical registers of ceremonies are acceptable substitutes for registers of vital events also deserves some attention.     

Age at baptism in pre-industrial England

The adequacy of English parish registers as demographic sources has been a subject for much debate.¹ Most attention has been directed to the problem of how far the population at large continued to use the sacraments ofthe Established Church in the late eighteenth and early nineteenth centuries, especially in areas affected by urban growth or Nonconformity. But the more general problem of how far the ecclesiastical registers of ceremonies are acceptable substitutes for registers of vital events also deserves some attention.     

Reproduction,Compositional Demography,and Economic Growth: Family Planning in England Long Before the Fertility Decline

This article offers a radical reinterpretation of the chronology of control over reproduction in England's history. It argues that, as a result of post–World War II policy preoccupations, there has been too narrow a focus in the literature on the significance of reductions in marital fertility. In England's case this is conventionally dated to have occurred from 1876, long after the industrial revolution. With a wider angle focus on “reproduction,” the historical evidence for England indicates that family planning began much earlier in the process of economic growth. Using a “compositional demography” approach, a novel social pattern of highly prudential, late marriage can be seen emerging among the bourgeoisie in the course of the eighteenth and early nineteenth centuries. There is also evidence for a more widespread resort to such prudential marriage throughout the population after 1816. When placed in this context, the reduction in national fertility indexes visible from 1876 can be seen as only a further phase, not a revolution, in the population's management of its reproduction.     

Famine,Maternal Nutrition and Infant Mortality: A Re-examination of the Dutch Hunger Winter

During the Dutch Hunger Winter (1945), a unique, documented example of mass famine in an industrialized population, total reproductive loss (fetal and infant mortality) among most exposed mothers remained relatively low. This is explained by highly favourable fetal mortality and unfavourable infant mortality. The author traces the pattern of low fetal mortality to the higher levels of ‘embodied health status’ of famine mothers. The high infant mortality of the famine area testifies to the severity of the food and fuel shortage, yet another factor held down the rate of stillbirth. This other factor, it is argued, has a socio-economic character, it is the intrinsic ‘embodied’ nutritional status of the regional population, arising from favourable opportunities for growth and development among successive generations of mothers. This explanation highlights the importance of maternal vitality, (a synthetic, historically variable and culturally determined phenomenon) as a neglected feature of historical demography.     

Urbanization as a Global Historical Process: Theory and Evidence from sub‐Saharan Africa

Urbanization has traditionally been understood as a byproduct of economic development, but this explanatory framework fails to account for the phenomenon of “urbanization without growth” observed in sub‐Saharan Africa throughout the 1980s and 1990s. In light of this apparent anomaly, I argue that urbanization is better understood as a global historical process driven by population dynamics associated with technological and institutional innovations that have substantially improved disease control and food security in urban settlements across the globe. These innovations first emerged in Europe in the eighteenth and nineteenth centuries and were subsequently diffused through colonialism, trade, and international development assistance. A range of qualitative and quantitative evidence is presented to demonstrate that this historically grounded theory of urbanization offers a more convincing explanation for the stylized facts of Africa's urban transition—and hence the process of world urbanization more broadly—than the traditional economic account.     

A Quiescent Phase in Human Mortality? Exploring the Ages of Least Vulnerability

Demographic studies of mortality often emphasize the two ends of the lifespan, focusing on the declining hazard after birth or the increasing risk of death at older ages. We call attention to the intervening phase, when humans are least vulnerable to the force of mortality, and consider its features in both evolutionary and historical perspectives. We define this quiescent phase (Q-phase) formally, estimate its bounds using life tables for Swedish cohorts born between 1800 and 1920, and describe changes in the morphology of the Q-phase. We show that for cohorts aging during Sweden’s demographic and epidemiological transitions, the Q-phase became longer and more pronounced, reflecting the retreat of infections and maternal mortality as key causes of death. These changes revealed an underlying hazard trajectory that remains relatively low and constant during the prime ages for reproduction and investment in both personal capital and relationships with others. Our characterization of the Q-phase highlights it as a unique, dynamic, and historically contingent cohort feature, whose increased visibility was made possible by the rapid pace of survival improvements in the nineteenth and twentieth centuries. This visibility may be reduced or sustained under subsequent demographic regimes.     

Infant and Child Mortality Among the Qing Nobility: Implications for Two Types of Positive Check

Demographers, as early as Malthus, have assumed that in traditional China the positive check, mortality, was largely beyond human control. This paper re-examines the role of the positive check in late imperial China through an analysis of an historical source of unprecedented demographic detail and accuracy: the genealogy of the Qing (1644–1911) imperial lineage. Basing ourselves on our calculations on the infant, child, and young adult mortality of 33,000 lineage members born in Beijing between 1700 and 1840, we conclude that during the late eighteenth century, many lineage couples regularly used infanticide to control the number and sex of their infants. At the same time, they also took advantage of innovations in paediatric care to protect the children they decided to keep. Although these results derive from an elite population, they, nevertheless, call into question our understanding of the operation of the positive check in late imperial China's demographic system, suggesting a much larger potential role for individual agency than was previously thought.     

Mortality and Metropolis: The Case of London 1675–1825

Recent work in population history emphasizes that demographic phenomena should be seen in a wider social and economic context. This perspective is, however, more easily achieved in the case of fertility than of mortality, which is widely treated as a variable ‘exogenous’ to economy and society. In the present paper it is argued that the inclusion of spatial structure and migration in accounts of historical demographic regimes can restore long-term variations in mortality to an ‘endogenous’ position. Within such a model a central role is played by large metropolitan populations, which act as endemic reservoirs of infection, with high but relatively stable levels of mortality. Data from the annual London Bills of Mortality allow empirical testing for the period 1675–1825, with results which generally conform to theoretical expectations, although a substantial reduction in mortality occurs during the latter part of the period.     

Demographic Changes in North Korea: 1993–2008

Given the scarcity of population data, few demographic analyses have been conducted on population trends in North Korea. Using the 1993 and 2008 population and housing census data, we prospectively reconstruct population change in the country during the 15 intercensal years. Reconstruction of the population trends of North Korea enables us to assess the consistency of the available demographic evidence and to assess the demographic impact of the famine in the 1990s. According to the results of the population reconstruction and our counterfactual population projections, the famine caused between 240,000 and 420,000 total excess deaths—lower than the previous estimate of 600,000–1 million; and the human costs of the deteriorating living conditions between 1993 and 2008 may be estimated as 600,000 to 850,000 total excess deaths attributable to economic decline in the post‐Cold war era. The reconstructed population trends mirror the continuing deterioration of the living conditions in North Korea since the early 1990s.     

Marital fertility control among the Qing nobility: implications for two types of preventive check

Demographers, as early as Malthus, have assumed that the preventive checks, delayed marriage and celibacy, were absent in traditional China. In this paper on the Qing (1644-1911) imperial lineage, we demonstrate that, instead, there may have been a different, more 'modern' preventive check: fertility control within marriage. Marital fertility of lineage couples during the eighteenth and nineteenth centuries was low to moderate. Such low fertility was the product of three behavioural mechanisms: late starting, early stopping and, most significantly, long spacing. Couples apparently regulated their fertility according to their economic resources and the sex of their surviving children. Moreover, they did so, we suggest, by regulating their coital frequency. Deliberate fertility control, in other words, was already within the 'calculus of conscious choice' for some Chinese well before this century. the speed of contemporary sinitic fertility transitions may accordingly be attributed to the fact that they did not require a change in attitudes, only the diffusion of new incentives and effective technologies.     

Smallpox and Epidemiological-Demographic Change in Europe: The Role of Vaccination

The relationship between smallpox epidemics, overall mortality and population growth, as reflected in an excess of births over deaths, has been examined with regard to the main sources of evidence from different parts of Europe. Epidemiological-demographic changes concomitant with different phases in the introduction of immunisation against the disease have been assessed in the light of evidence from records showing some causes of death as well as numbers of burials. By the eighteenth century; smallpox epidemics appear to have become predominant as an influence on fluctuations in overall mortality in much of Europe. Evidence is reviewed which suggests that although inoculation had probably protected many from smallpox after the mid-eighteenth century, to an extent that could have reduced overall mortality, vaccination enthusiastically promoted after 1800 had a dramatic epidemiological-demographic impact. Data from many sources have been summarised and indicate that the disease was virtually brought under control in North Western Europe during the course of the nineteenth century. Smallpox had probably caused between 8 and 20 per cent of all deaths directly in eighteenth-century Europe as well as unquantifiable secondary and associated morbidity and mortality. The removal of such a deleterious disease from a chain of infections affecting the population at this time, accounted for much of the increasingly more important role of mortality decline as the significant factor in demographic change. The evidence is circumstantial, but suggests that the unprecedented population growth of the early decades of the nineteenth century could in large part have been due to the control of smallpox through vaccination measures. The virtual elimination of the disease as a killer in Europe by the end of the century, following legislation and revaccination programmes was a unique achievement with further consequences for sustained population growth and improvements in health which for many were the only source of improvements in the standard of life.     

‘Walking out’: the mobilities of love

ABSTRACT

In this article, I propose that mobility performs a crucial role in the production and sustenance of intimate relationships and focus, in particular, on courtship practices and their modern-day equivalents. I pursue this discussion through close readings of literary and autobiographical texts from the nineteenth century through to the millennium, and by means of a framework that triangulates the work of Tim Ingold, David Seamon and Henri Bergson. My focus here is on how the mobilities we practice during the everyday routines of courtship – i.e. the paths we make, the routes we take, the roads we travel, the journeys we repeat, the transport we use – come to characterise the relationship concerned and impact upon its progress. Both Ingold’s work on ‘lines’ and Seamon’s on ‘place-ballet’ are conceptually suggestive in this regard and speak to recent work in mobilities/cultural geography on the significance of patterns of movement in the praxis of relationships.     

Child mortality and reproductive behaviour in German village populations in the past: A micro-level analysis of the replacement effect

Abstract Reproductive histories of couples married during the eighteenth and nineteenth centuries in a sample of 14 German villages are analysed in order to answer several questions regarding the relationship between child mortality and reproductive behaviour. An effort is made through selection of cases and use of multiple classification analysis to eliminate or control non-volitional or otherwise confounding influences on the relationship between a couple's experience with child mortality and their fertility. The results do not provide a decisive answer to the question of whether, under a regime of otherwise presumed natural fertility, previous experience of child mortality affected subsequent reproductive behaviour. The evidence was much clearer in indicating that behaviour consistent with replacement efforts emerged or strengthened as family limitation spread. Finally, the results indicated that though it was not necessary for overall child mortality to decline before family limitation practices were adopted, couples with the most favourable child mortality experience were most likely to practise family limitation and to reduce their fertility. Child mortality appeared at least to impede, if not totally prevent, efforts to reduce the number of children ever born or to cease childbearing at an earlier age or at a given parity.     

Demographic Trends in Ukraine: Past,Present, and Future

Ukraine, during the first half of the twentieth century, underwent a series of man‐made demographic catastrophes—World War I, the Bolshevik Revolution, the 1932/33 famine linked to land collectivization, the massive deportations and executions of Stalin's Great Terror, and World War II. This article assembles estimates of the demographic impact of these deadly events. In their absence, it is estimated that Ukraine's hypothetical population would have been 87 million on the eve of independence in 1991, instead of its actual 52 million. Pre‐independence demographic losses were episodic and driven by external forces. By contrast, since independence in 1991, Ukraine has experienced a sustained demographic crisis of its own making. Ukraine's population declined from 52 million in 1990 to 45 million by 2013. Fertility, while it has recovered from its lowest point, remains at a TFR of about 1.5—far below replacement. Emigration, although the greatest hemorrhage of young people in the 1990s is over, is still of concern. The loss of Crimea and the unsettled state of affairs in Southeastern Ukraine give further cause for concern.