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

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.