Early childhood mortality in late nineteenth century Philadelphia, determinants of trends and variation
Western nations experienced dramatic declines in mortality levels during the course of industrialization. Attempts to identify the specific processes influencing the nature of these declines have put forward a range of possible factors, which are both numerous and complex. One means of attempting to disentangle these relationships is to focus analysis on selected populations in a single area. Locally-specific studies can provide important detail on the determinants of changes in mortality. Such detail, in conjunction with broader theories based on a national or regional scope, provides an important balance in understanding the mortality transition. This study examines the determinants of early childhood mortality in Philadelphia during the late nineteenth century. Information available for this city provides the opportunity to create a fairly detailed picture of the hazards and advantages of urban life for young children during this period. More specifically these data support a variety of methods for examining the general determinants of early childhood mortality patterns in the city, including both cross-sectional and temporal variations in mortality. During the period of study, many causes of death were ill-defined and a large portion of the decline cannot be attributed to causes that were diagnosed with great specificity. Among older children, significant portions of the decline could be linked to infectious diseases with specific diagnoses. For younger children, the data point toward the importance of diarrheal disease, which exhibited a highly seasonal pattern dominated by summer mortality. This analysis focuses on summer diarrheal mortality. A striking pattern of summer mortality was quite pronounced in the late nineteenth century for infants and one year olds, disappearing in the second decade of the twentieth century. For the period 1860 to 1880, one year olds displayed a decline in summer mortality, while the indices for infants actually increased. Following a period of no decline for either age group between 1880 and 1895, summer mortality began its final stage of decline for infants and one year olds. The relative contributions of breastfeeding, weaning, supplemental foods, water and milk supplies, sanitation and urban infrastructure and public health activities to these observed declines are examined.
Cheney, Rose Ann, "Early childhood mortality in late nineteenth century Philadelphia, determinants of trends and variation" (1993). Dissertations available from ProQuest. AAI9321370.