Preliminary Programme

This paper is part of a research project on urban mortality before the health transition. We argue that the widespread diffusion of syndemics characterized urban morbidity in the past, where different diseases act synergistically, causing a mortality overload in the population. Syndemics are typical of areas with unfavourable environmental and socioeconomic conditions. We focus on Venice as a case study for our hypothesis. Around mid-19th century, Venice was one of the largest Italian cities, with 140,000 inhabitants. Mortality rates were among the highest in Europe. There were however huge differences, both from the social and the spatial points of view. In this paper, we explore the hypothesis the port activity of the city influenced its mortality patterns. Although the maritime commerce had dramatically shrunk since the golden age of the past, Venice was still the most important port in the Adriatic Sea and a large part of the population was employed in the maritime sector. Sailors concentrated in a few neighbourhoods close to the waterfront. We collected cause-specific, geo-located death records in 1854 (a year characterized by a mortality crisis) and 1869 (when mortality was “normal”). We compare the spatial and epidemiologic patterns in these two years, and test whether the port areas displayed any particular feature in both cases. (Show less)

Hermoupolis was created during the Greek Revolution against the Ottoman Empire (1821-1828) when Greek refugees from the city of Smyrna, Asia Minor, as well as from the islands of Chios, Psara, Kasos found refuge on the island of Syros. The population of Syros at the time was mainly Roman Catholic and for this reason the island was protected by French and Austrian warships. Within few years the settlement at Hermoupolis grew rapidly from having merely 150 people in 1821 to 13,805 in 1828.

Hermoupolis became one of the most important demographic, economic, social and cultural centers of Greece in the 19th century mainly due to demographic and economic factors, while in the same time its population rose to 20,000 in the following decades, thus making it the second largest city in the newly founded Greek kingdom. This attraction was diminished after 1870, when the city suffered an economic crisis and decline. The last quarter of the 19th century is the time when a converge of factors leads to the decline of the city. However, Hermoupolis sustained the functions of a large city until the 1930s, despite the fact that it wasn’t the most important port of the country.

The Municipal Hospital was established in 1826 and the Lazaretto, which was the biggest in the Greek kingdom, was established in 1841. It seems that the cholera epidemic that struck Hermoupolis from June to September 1854 revised the perceptions of the usefulness of the Lazaretto and totally influenced the ideas about public health care.

The aim of this paper is to highlight the main public health problems that had to be faced by a new port city and how the local authorities tried to resolve them. The paper focuses on the period from the establishment of the city (1821-1826) to the cholera epidemic (1854).

The main sources are the archive of the Council of Elders (Demogerontia) for the period 1828-1835, the Minutes of the City Council of Hermoupolis for the period 1840-1914, the patients’ log and record books for the period 1834-1858, the draft registers of death certificates of the Municipality of Hermoupolis of the years 1848-1853, 1876-1879, 1892-1898, 1902-1904 and 1912-1913, the official registers of death certificates of the Municipality of Hermoupolis of the years 1859-1914 and the local Press from 1834 to 1914. (Show less)

Port cities in the European past acted as ‘gateways of disease’ in the same way that airports today function as hubs for the transmission of infectious diseases such as the Ebola and the ZIKA viruses. Major port cities in the past represent unique laboratories to study the spread of major diseases and how to combat them. This paper introduces for the first time an analysis of major groups of infectious diseases in the port city of Amsterdam, and how public authorities tried to cope with the continuous threat of invading diseases. We make use of community level cause of death statistics for the period 1875-1899, as well as qualitative source material of city authorities involved in public health interventions. (Show less)

This paper presents and discusses the mortality pattern of Hermoupolis, utilizing the longest time-series yet calculated for a Greek urban centre from the unpublished civil registration sources. Hermoupolis was the first urban centre and by far the most important port of modern Greece in the 1860s and 1870s. As a port, its principal function was distributive, since it was the largest centre of the transit trade in the Eastern Mediterranean, and also an effective commercial and maritime crossroads of the Mediterranean and the Black Sea (Delis, 2015). In the late 1880s it was relegated to a provincial, rather insignificant port.
Hermoupolis experienced very high mortality levels in the second half of the nineteenth and early twentieth century. CDR (32 per thousand in 1896) seems to be among the highest in Greece (around 25 at the time) and can only be compared with some of the unhealthiest port-cities in contemporary Europe such as mid-nineteenth-century Liverpool. Life expectancy was as low as 29 years in 1870. It gradually improved in the early twentieth century reaching 46 years in 1928. Age-specific mortality analysis based on individual level sources and record linkage shows that declines in childhood and infant mortality were responsible for much of the mortality decline in Hermoupolis in the early twentieth century. Cause specific mortality analysis shows the typical pattern of infectious, respiratory and digestive diseases as the main causes of death from 1916 to 1940.
Hermoupolis had a hospital since 1827, the largest quarantine area in Greece by 1842 and a strong association of physicians by the 1870s. Levels of public health were rather poor in Hermoupolis even until the 1930s. However when an outbreak occurred in Greek or Mediterranean and Black Sea ports protective measures were taken against the diseases.
Hermoupolis, therefore was chosen for this study not only because it was one of the most important nineteenth-century port-cities experiencing unusually high mortality but also because of the unique data sources that possesses and which this study has utilised (civil registration continuously available from 1859 and a wealth of qualitative sources). This paper, finally, explores the epidemiological profile of the port-city and also the measures adopted by the local authorities aiming to improve public health and what effect did these actions have, if any. (Show less)