Nineteenth‐century mortality trends: a reply to Szreter and Mooney†

Romola J Davenport

doi:10.1111/ehr.13109

Abstract

AbstractIn a recent article in this journal I challenged Szreter and Mooney's account of a mortality crisis in English industrial and manufacturing cities in the period c. 1830–1850. I argued, first, that there was no robust evidence for a major fall in urban life expectancies in this period; second, that there was evidence for a rise in mortality in early childhood, but that this rise occurred in rural as well as urban populations, and persisted until the 1860s; and third, that an increase in virulence of scarlet fever made a major contribution to this rise. Szreter and Mooney contested these conclusions on two main grounds: that my methodology for estimating urban life expectancies differed from theirs; and that the geography and chronology of scarlet fever patterns did not fit those of early childhood mortality. Here I demonstrate that these criticisms are invalid. Using their methodology I still find no evidence for a dramatic drop in urban life expectancies in the 1830s–40s. I also present new evidence that scarlet fever was a major cause of childhood mortality by the late 1830s and 1840s, in rural as well as urban populations, and could therefore account for the observed rise in early childhood mortality in this period.

Highlights

In a recent article in this journal I challenged Szreter and Mooney’s account of a mortality crisis in English industrial and manufacturing cities in the period c. 1830–1850
My recent article in this journal reviewed the empirical evidence and argued, first, that there was no robust evidence for a major fall in urban life expectancies in the 1830s and 1840s; second, that there was evidence for a rise in mortality in early childhood, but that this rise occurred in rural as well as urban populations, and persisted until the 1860s; and third, that an increase in the virulence of scarlet fever made a major contribution to this rise.[4]
registration districts (RDs) for the years 1838–42.27 Table 3 shows reported scarlet fever deaths as a percentage of deaths from all causes in the period 1838–42, for the districts considered in my original article

Summary

Scarlet fever death rate

Notes: Values in parentheses are 95% confidence intervals for mean values. Mean population densities (col. 2) are geometric mean values. RDs for the years 1838–42.27 Table 3 shows reported scarlet fever deaths as a percentage of deaths from all causes in the period 1838–42, for the districts considered in my original article (that is, RDs associated with the parishes used by the Cambridge Group for family reconstitution, and the central districts of the largest towns). The Registrar-General did not break down his counts of scarlet fever deaths by age, but we can assume from the age patterns of scarlet fever in later decades that most deaths occurred in this age range (the estimates in table 3 are calculated on the assumption that 90 per cent of scarlet fever deaths occurred at ages one to nine years).[29] On this assumption, scarlet fever accounted for 14.2 per cent of all deaths among children aged one to nine years in England and Wales in the period 1838–42. Corresponding figures for 1861–70 are 14.8 and 17.3%, suggesting that the use of the age range 1–9 to estimate the impact of scarlet fever at ages 1–4 would produce an overestimation of perhaps 16–17% of the true value at ages 1–4 years

Registration districts

Kent Nottinghamshire Staffordshire

OFFICIAL PUBLICATIONS

Findings

England and Wales