Infant Mortality in Nine Industrial Parishes in Northern England, 1813–1836

Evidence about infant mortality in a number of industrial towns was derived from baptismal and burial registers of the Anglican Church. The level of infant mortality during the period 1813–1836, after correction for underregistration, was comparable to that of British towns during the second half of the century. Infant mortality increased during this period, perhaps as a reflection of rapid population growth. In each of the parishes a winter peak and a summer trough was found in the seasonal index of infant deaths during this period. This pattern is very different from the high summer mortality that prevailed in British towns during the late nineteenth century. However, mortality in the summer increased over time, thus reducing the depth of the summer trough in infant deaths, and perhaps represents a movement towards the summer peak so apparent later in the century.     

Urban-rural differentials in infant mortality in Victorian England

This paper examines the magnitude of urban-rural differentials in infant mortality in England during the nineteenth and early twentieth centuries and also compares the timing of decline for a selection of towns of varying size, and their immediate rural hinterlands. Most towns continued to experience short-term fluctuations in infant mortality until the very end of the nineteenth century; however, in some of the adjacent rural communities--where levels of infant mortality were much lower--conditions were sufficiently favourable to allow a continuous decline in infant mortality from at least the 1860s, if not before. The final part of the paper considers the causes of these patterns and their implications for explanations of infant mortality decline.     

Absolute Change in Cause-Specific Infant Mortality for Blacks and Whites in the US: 1983–2002

This paper examines absolute change in infant mortality from 5 leading causes of death for whites and blacks over a 20 year period. Change in infant mortality varies by cause, race, and birth weight. Absolute decline in mortality from respiratory distress syndrome (RDS) and sudden infant death syndrome (SIDS) in the overall study population has been more rapid for black infants during the period after specific technological innovations were approved and behavioral practices were recommended for these conditions. For low birth weight infants, blacks experienced greater decline in mortality from SIDS and whites experienced greater decline in RDS mortality. Despite remarkable declines in mortality from these causes, relative racial disparities have increased over this time period. For the overall study population, blacks and whites experienced similar rates of mortality decline from congenital anomalies. Mortality decline from this cause among low birth weight infants occurred at a faster pace for whites. Mortality from causes for which no specific innovations were developed increased for blacks but remained relatively constant for whites. An analysis of absolute change complements the relative disparities approach by revealing the dynamics of change, thus providing a more complete understanding of changing racial disparities in infant mortality.     

Risk Factors for Infant Mortality in Nineteenth-Century Sweden

This study examines risk factors for infant mortality using individual-level data from a sample of parishes in northern Sweden in the nineteenth century. Sweden is of particular interest because of its unusually regular pattern of infant mortality decline during the century. We follow a sample of women longitudinally through their successive pregnancies and observe the mortality experience of each child. Exploratory and multivariate logistic regression analyses reveal an important intra-familial dimension to infant mortality that appears from the early stages of a woman's reproductive career. In addition, multivariate analyses by birth-order group suggest that ignoring intra-familial correlations of infant mortality may result in incorrect inferences. Siblings' shared probabilities of dying as infants suggest that high-birth-order children were not necessarily disadvantaged in any systematic way.     

Beyond infant mortality: gender and stillbirth in reproductive mortality before the twentieth century

Though it has been the largest component of reproductive mortality since its statutory registration in 1928, stillbirth has received little attention from historical demographers, who have relied on the more orthodox indicator of early human survival changes - "infant mortality". The exclusion of stillbirth hampers demographic analysis, underestimates progress in newborn vitality, and over-privileges post-natal causes in theoretical explanation. A case is made for estimating stillbirth before 1928 as a ratio of early neonatal death, and for employing perinatal mortality as an historical indicator of female health status. The long-run trend of reproductive mortality (encompassing mature foetal and live born infant death during the first eleven months) reveals a substantial decline in perinatal causes in the first industrial century (1750-1850), implying a major concurrent improvement in the nutritional status of child bearers. Reproductive mortality is a more complete indicator of death in infancy. It offers demographers a means of fracturing the fertility versus mortality dualism and a potential purchase on gender as a demographic variable, while re-opening the case on mortality in the demographic dynamic of the world we have lost.     

Spatial Inequality in Mortality in France over the Past Two Centuries

This article analyzes the evolution of spatial inequalities in mortality across 90 French territorial units since 1806. Using a new database, we identify a period from 1881 to 1980 when inequalities rapidly shrank while life expectancy rose. This century of convergence across territories was mainly due to the fall in infant mortality. Since 1980, spatial inequalities have levelled out or occasionally widened, due mainly to differences in life expectancy among the elderly. The geography of mortality also changed radically during the century of convergence. Whereas in the 19th century high mortality occurred mainly in larger cities and along a line from North-west to South-east France, it is now concentrated in the North, and Paris and Lyon currently enjoy an urban advantage.     

An Evolutionary Interpretation of Fertility Decline: New Evidence

This article presents new evidence that partly reinforces and partly qualifies the results of a recent article on fertility decline published in this journal by Sanderson and Dubrow. Eight panel regression analyses were carried out, four for the period between 1960 and 1990 and four more for the period of the original demographic transition, that between 1880 and 1940. The analyses for the 1960–1990 period show that Sanderson and Dubrow's original conclusion that infant mortality decline was causing fertility decline (rather than the reverse) was correct. On the other hand, Sanderson and Dubrow's conclusion that enhanced female empowerment led to fertility decline proved incorrect. The new analyses reported here show that the reverse was in fact the case: women became more empowered as a result of declining fertility. The panel analyses carried out for the 1880–1940 period showed that infant mortality decline seemed to be an important cause of fertility decline between 1880 and 1910 but not between 1910 and 1940. However, the reverse hypothesis—that fertility decline caused infant mortality decline during this period—was falsified. I conclude that the causes of fertility decline in the modern world may be different, at least to some extent, from those in the original demographic transition. This is an unsatisfying (because unparsimonious) result that suggests the need for more research.     

Infant mortality decline in Malaysia, 1946–1975: The roles of changes in variables and changes in the structure of relationships

This analysis has identified several factors contributing to the dramatic decline in infant mortality since World War II in Malaysia, as well as one factor that prevented the infant mortality rate from declining even more rapidly. Our main findings are the following: On average, mothers' education more than doubled over the study period, contributing to the decline in their infants' mortality. In addition, the beneficial effect of mothers' education on infant survival appears to have become stronger over the study period. Hence, further advances in education should lead to further improvements in infants' survival prospects. Another analysis of these data (Peterson et al. 1985) found that education is somewhat more influential in affecting child mortality in low-mortality, high-income areas than in the opposite type of areas. Therefore, socioeconomic development may have complemented, instead of substituted for, the the beneficial effect of mothers' education in promoting infant and child survival in Malaysia. Improvements in water and sanitation also contributed to the infant mortality decline, especially for babies who did not breastfeed. However, unlike education, these influences have become less important over time, especially for babies who are not breastfed. Hence, further improvements in water and sanitation, a goal of Malaysia's Rural Environmental Sanitation Programme, may have smaller relative effects on infant mortality than did previous improvements. Targeting such improvements on areas where women breastfeed little or not at all, however, will increase their effectiveness in promoting infant survival. The substantial reductions in breastfeeding that have taken place since World War II have kept the infant mortality rate in Malaysia from declining as rapidly as it would have otherwise. We estimate that, in our sample, the detrimental effects on infant survival of the decline in breastfeeding have more than offset the beneficial effects of improvements in water and sanitation. Unlike some other researchers (e.g., Palloni 1981), we find that changes in fertility levels and in the timing and spacing of births have had negligible effect in explaining the decline in infant mortality within the samples we have considered. We have excluded births to older women from our analysis, however; this exclusion may have led to an understatement of the influence of changes in the age pattern of childbearing.(ABSTRACT TRUNCATED AT 400 WORDS)     

Trends,Age Patterns and Differentials in Childhood Mortality in Haiti (1960–1987)

This paper examines the trends, patterns and differentials in childhood mortality in Haiti between 1960 and 1987 with data from three surveys and one census. Data comparability is maximized by a series of adjustments, and both direct and indirect techniques are applied. The results indicate that a slow decline in childhood mortality has occurred since 1960 for the country as a whole. Neonatal survival has shown impressive gains, especially in rural Haiti. Post-neonatal mortality has not, however, declined at the same rate. Mortality between the ages of one and five years has declined at about the same pace as infant mortality, maintaining consistency with model patterns of mortality change. The overall national decline in child mortality appears to have consisted of two phases. The first occurred in rural Haiti during the late 1960s and early 1970s and was due largely to a fall in neonatal mortality. The second phase of the decline was concentrated in Port-au-Prince, and seems to have affected all ages of childhood.     

The role of public health improvements in health advances: The twentieth-century United States

Mortality rates in the United States fell more rapidly during the late nineteenth and early twentieth centuries than in any other period in American history. This decline coincided with an epidemiological transition and the disappearance of a mortality "penalty" associated with living in urban areas. There is little empirical evidence and much unresolved debate about what caused these improvements, however. In this article, we report the causal influence of clean water technologies--filtration and chlorination--on mortality in major cities during the early twentieth century. Plausibly exogenous variation in the timing and location of technology adoption was used to identify these effects, and the validity of this identifying assumption is examined in detail. We found that clean water was responsible for nearly half the total mortality reduction in major cities, three quarters of the infant mortality reduction, and nearly two thirds of the child mortality reduction. Rough calculations suggest that the social rate of return to these technologies was greater than 23 to 1, with a cost per person-year saved by clean water of about dollar 500 in 2003 dollars. Implications for developing countries are briefly considered.     

Revising Infant Mortality Rates for the Early Twentieth Century United States

Accurate vital statistics are required to understand the evolution of racial disparities in infant health and the causes of rapid secular decline in infant mortality during the early twentieth century. Unfortunately, U.S. infant mortality rates prior to 1950 suffer from an upward bias stemming from a severe underregistration of births. At one extreme, African American births in southern states went unregistered at the rate of 15 % to 25 %. In this study, we construct improved estimates of births and infant mortality in the United States for 1915–1940 using recently released complete count decennial census microdata combined with the counts of infant deaths from published sources. We check the veracity of our estimates with a major birth registration study completed in conjunction with the 1940 decennial census and find that the largest adjustments occur in states with less-complete birth registration systems. An additional advantage of our census-based estimation method is the extension backward of the birth and infant mortality series for years prior to published estimates of registered births, enabling previously impossible comparisons and estimations. Finally, we show that underregistration can bias effect estimates even in a panel setting with specifications that include location fixed effects and place-specific linear time trends.     

The estimation of mortality at the London Foundling Hospital, 1741-99

The high mortality of foundlings across Europe has long been established by historical demographers but methods of quantification have not permitted comparison with rates in the populations beyond the foundling hospitals. This study investigates mortality rates at the London Foundling Hospital in the eighteenth century in a way that addresses the issue. The study finds that although foundling mortality was extremely high at certain periods in the hospital's history, there is evidence for a decline towards the end of the century, in common with national and local rates. This suggests that the causes of the mortality fall were common even to infants born in disadvantaged circumstances, and brought up away from their mothers. Several possible reasons for the fall in mortality are considered, including improved nutrition among mothers, a shift in the disease environment, and changes in such habits as gin drinking.     

Infant mortality by Father’s occupation from the 1911 Census of England and Wales

Infant mortality in England and Wales only began its secular decline at the beginning of this century, although mortality among those aged 1-4 began to decline earlier. The 1911 Census of Fertility provides the basis for estimates of infant mortality among occupational groups. A diagrammatic model of decline is elaborated, using fertility decline, social class, income, and urban/rural distribution as explanatory variables. Results of the analysis suggest that infant mortality decline, whose average value was 35 percent from a peak of 132 per 1,000, was increased by improvements in the urban environment and advanced by high or regular income, whereas fertility decline had only a small effect.     

The effects of infant mortality on fertility revisited: new evidence from latin america

In this paper, we examine empirical evidence for a relation between infant and child mortality and fertility in Latin American countries from 1920 to 1990. We investigate the relation at several levels of aggregation and evaluate the extent to which evidence at one level is consistent with evidence at other levels. We first examine aggregate cross-country information over several decades, a type of data typically used in past research on the topic. We also examine yearly series of births, deaths, infant deaths, and socioeconomic indicators for selected countries to track the association between short-term fluctuations in fertility and infant mortality. Finally, we use micro-level data from the Demographic and Health Surveys (DHS) to assess the relation between fertility and child mortality from individual reproductive histories. The evidence we assemble from these different data sets is remarkably consistent and suggests small positive effects of infant mortality on fertility. These effects, however, may be too small to support the hypothesis that changes in child mortality are of more than modest importance in the process of fertility decline in Latin America in the late twentieth century.     

Two and a half centuries of demographic history in a Bavarian village

Abstract A village genealogy containing family histories of couples married between 1692 and 1939 serves as the basis for a study of the demographic history of a Bavarian village. The past patterns of marriage, re-marriage, widowhood, illegitimacy, bridal pregnancy, marital fertility, family size, and birth intervals are examined. Both the age at marriage and illegitimacy increased and then declined during the nineteenth century, apparently in response to changes in restrictive marriage legislation. Differences in fertility for occupational groups were insignificant. Marital fertility remained extremely high before 1900 suggesting the absence of any substantial family limitation within marriage. A rise in marital fertility that occurred during the last half of the nineteenth century appears to result from a change in breast-feeding customs. The actual number of children surviving to maturity for most couples was kept quite low, however, through late marriage and high infant mortality. Only during the twentieth century are substantial declines in infant mortality and fertility evident.     

Socioeconomic Inequalities in Infant Mortality in Egypt: Analyzing Trends Between 1995 and 2014

This paper analyses the trend of the socioeconomic inequalities in infant mortality rates in Egypt over the period 1995–2014, using repeated cross-sectional data from the National Demographic and Health Survey. A multivariate logistic regression and concentration indices are used to examine the demographic and socioeconomic correlates of infant mortality, and how the degree of socioeconomic disparities in child mortality rates has evolved over time. We find a significant drop in infant mortality rates from 63 deaths per 1000 live births in 1995 to 22 deaths per 1000 live births in 2014. However, analyzing trends over the study period reveals no corresponding progress in narrowing the socioeconomic disparities in childhood mortality. Infant mortality rates remain higher in rural areas and among low-income families than the national average. Results show an inverse association between infant mortality rates and living standard measures, with the poor bearing the largest burden of early child mortality. Though the estimated concentration indices show a decline in the degree of socioeconomic inequality in child mortality rates over time, infant mortality rate among the poor remains twice the rate of the richest wealth quintile. Nonetheless, this decline in the degree of socioeconomic inequality in child mortality is not supported by the results of the multivariate logistic regression model. Results of the logistic model show higher odds of infant mortality among rural households, children who are twins, households with risky birth intervals. We find no statistically significant association between infant mortality and child’s sex, access to safe water, mothers’ work, and mothers’ nutritional status. Infant mortality is negatively associated with household wealth and regular health care during pregnancy. Concerted effort and targeting intervention measures are still needed to reduce the degree of socioeconomic and regional inequalities in child health, including infant mortality, in Egypt.     

Factors Associated with the Finnish Fertility Decline Since 1776

The analysis of annual age-specific fertility rates in Finland over more than 200 years reveals the existence of a significant early fertility decline at the end of the eighteenth century preceding the secular decline that started around 1910. A reconstruction of age-specific proportions married by a simulation model based on Coale's marriage model indicates that the mean age at marriage increased and the proportion ever-marrying decreased substantially during the period of the early fertility decline. A modification of the index of family limitation applied under certain assumptions to overall fertility rates also indicates that fertility was essentially natural until 1910. Cross-lagged correlation analysis shows that infant mortality does not influence subsequent fertility in the pre-modern period. Finally, a number of socio-economic indicators are related to fertility, and conclusions are drawn from the Finnish case about several hypotheses in the field of demographic transition.     

Population Variation in Cause of Death: Level,Gender, and Period Effects

The trends in 13 cause of death categories are examined with respect to expectation of life, sex differences, and period effects while misclassification of cause of death is controlled. The results suggest that as mortality declines, 1) the increasingly U-shaped age pattern of mortality is a period effect associated with the infectious diseases, 2) the risks of both overall infectious and degenerative causes of death decline, and 3) infectious disease mortality declines more in males, while degenerative disease mortality declines more in females. Finally, the model shows that some contemporary populations are approaching the .limits of reduction in mortality during infancy, childhood, and young adulthood. Past declines in the degenerative diseases, however, suggest that mortality may continue to decline.     

Estimates of vital rates for the Canadian Indians, 1960–1970

The present paper is an attempt to evaluate the registered data on Canadian Indians collected by the Department of Indian Affairs and Northern Development and to prepare vital rates for 1960–1970 using the adjusted data. A cursory examination of registered data for the purpose of developing various demographic indices and for making future estimates of population indicates certain anomalies that call for a careful appraisal of the data. The main problem is the inconsistency in the reporting of births, due largely to the late registration of births. One plausible reason for late registration may be the increased outward movement of Indians from their reserves. Indirect methods are used to adjust the number of births and infant deaths reported annually since 1960. On the basis of the adjusted data, vital rates for the Canadian Indians are calculated for the period 1960–1970. The crude death rate decreased from 10.9 in 1960 to 7.5 in 1970. The infant mortality rate registered a drastic decline, from 81.5 deaths per 1,000 births in 1960 to 34.9 in 1970. During this same time period the birth rate also declined, from 46.5 to 37.2.     

The decline in mortality in British Guiana, 1911-1960

In this paper an attempt is made to describe the pattern of declining mortality in British Guiana between 1911 and 1960. Specifically we identify the disease-specific mortality rates whose declines contributed most to the overall improvement, we consider the possibility that changing economic circumstances may have contributed to the decline in mortality, and we survey the improvements in public health facilities which occurred during the period. Broadly our conclusion is that improvements in public health facilities and not economic advances were responsible for the dramatic decline in mortality which was experienced. Before 1940 these advances took the form of improvements in the quality of the country’s water supplies, in methods of disposing of waste, and in medical facilities especially on the colony’s sugar estates. In addition, there was an advance in the dissemination of information with respect to pre- and post-natal care. In the postwar period British Guiana’s famous D.D.T. experiment was the most important reason death rates continued to fall.