Preliminary Programme

The long lasting, high incidence of infant deaths in Maastricht has puzzled scholars for many years. Whereas the majority of the Netherlands witnessed a vast decrease in infant mortality during the last decades of the nineteenth century, Limburg, and Maastricht in particular, had to endure continuing high rates or even a nominal increase during those decades. The common assumption by doctors and scholars in the past, was that the lack of breastfeeding was to blame. This made infants much more susceptible to gastro-intestinal infectious diseases, especially during hot summers. More recent theories relate the Roman Catholic denomination of the southern provinces to their mothers not breastfeeding their children.
Eventually infant mortality rates of the southern provinces did decrease, although this happened a few decades later than in the north-western part of the Netherlands. What caused the infant mortality to drop after all these years? In this paper, individual level cause of death data will be analysed in order to gain a deeper understanding of this process and its causes. This is a rather unique opportunity, since these type of data are truly scarce. The major advantages of the data are: 1) the causes of death are not yet classified into incomprehensible old disease categories, and 2) the available information on the individual is much richer. In addition to information on the cause of death, we know the age and gender of the deceased, but also the place of death, the exact death date, religion, and the occupation (if applicable, and otherwise the occupation of the parents). This creates the possibility to perform a wide range of analyses such as on the timing in the year (seasonal influences), on the influence of social economic status, or on spatial effects, which could be combined with other data on certain hygienic or public health measures.
In this paper the emphasis will be on explaining the eventual decrease in infant mortality in Maastricht by looking into smaller groups (divided by age in terms of weeks and months, gender, and social economic status) and how different trends for those groups contributed to the overall decline. Investigating how and why infant mortality in Maastricht eventually did decrease, may also shed new light on the issue of why this decline came so late. (Show less)

This paper examines mortality patterns in the city of Hermoupolis, on the Greek island of Syros from 1859 to 1940. It outlines the main reasons that contributed to mortality decline and removal of ‘urban penalty’ in Hermoupolis in the first decades of the twentieth century. This study draws on a unique database, containing individual-level death records (ca 45,000 individuals) for the entire population of the city.
In the mid-nineteenth century Hermoupolis was the most important Greek industrial centre and one of the biggest ports in the East Mediterranean. By the late-nineteenth century and due to the rise of other ports and industrial centres in the Greek mainland, the city experienced a serious decline in its economy and gradually transformed into a provincial and rather insignificant city.
Levels of mortality in Hermoupolis in the second half of the nineteenth century were high, with life expectancy at birth (e0) ranging from 28 years in 1870 to 35 years in 1907. Hermoupolis’ CDR of 32 per thousand in 1896 was higher than the national average (around 25 at the time) and the highest yet calculated rate in Greece in almost every census year from the mid-nineteenth century until 1940. Comparisons of Hermoupolis with other semi-urban and rural Greek populations suggest that an ‘urban penalty’ was clearly operating in the city even during the first decades of the twentieth century, most likely as a result of insufficient sanitary infrastructures, low living standards, unhealthy working conditions and in-migration.The high prevalence of infectious diseases in combination with the relatively low e0 (43 for both sexes in 1928) suggests that the second stage of Omran’s epidemiologic transition ‘age of receding pandemics’ was still ongoing, although in its final phase. A combination of factors was found to be responsible for the mortality decline in Hermoupolis, including mass immunisations, decline in fertility and wider access to water, which may have enabled improvements in personal hygiene among the residents of the city.
Finally, this paper produces important new insights into Mediterranean urban historical demography and is the first comprehensive study of urban mortality in Greece utilizing the largest and one of the longest time-series yet calculated from civil registration and census data. (Show less)

As the current corona crisis shows, the history of infectious diseases in western societies is far from over. However, we had somehow forgotten about that heavy burden of infectious diseases in the past, how heavy it was, and what it looked and felt like for people living with it. By the 1950s we seemed to have escaped from that burden, which caused life expectancy to rise significantly, even before mass vaccination programs were introduced. The international academic debate on how we succeeded in lifting that deadly burden is raging with full force, mainly focusing on nutrition, economic factors, and public and private hygiene. A fundamental drawback of current research, however, is the use of highly-aggregated data, making it impossible to move beyond general outlines and explanations open to ecological fallacy. Recently, truly unique data have become available for Amsterdam (1856-1940) enabling us to contextualize death and disease at the individual level and to move beyond high aggregations and limited disease classifications set up by nineteenth-century health practitioners. In this paper some possibilities for future research will be discussed, by focusing on some first results of the development of causes-specific infant mortality in the period 1856-1895, and the smallpox epidemic in 1871. (Show less)