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Sat 27 March
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Thursday 25 March 2021 14.30 - 15.45
B-7 ECO30 Multiple Determinants of Health in History: New Quantitative Analyses of Interventions, Growth and the Environment in Europe and Japan during Industrialization
B
Network: Economic History Chair: Jarmo Peltola
Organizers: Joël Floris, Jarmo Peltola, Sakari Saaritsa Discussant: Eric Schneider
Joël Floris : Mortality Changes in Swiss Districts 1888-1930
Between 1850 and 1914, Switzerland developed from a relatively poor economy to a country at the top of the European GDP p. c. distribution. At the same time, life expectancy at birth increased significantly. Other indicators of living standards such as real wages or average adult height show the same ... (Show more)
Between 1850 and 1914, Switzerland developed from a relatively poor economy to a country at the top of the European GDP p. c. distribution. At the same time, life expectancy at birth increased significantly. Other indicators of living standards such as real wages or average adult height show the same upward trend. In contrast to the GDP p. c. ranking, however, Switzerland achieved only an average position in the European distribution of the other indicators before World War I.

The literature explains the comparatively average level of real wages with high inequality, regional differences and high living costs. The demographic literature also emphasizes regional differences: Around 1850, life expectancy is higher in rural and alpine regions than in urban areas and in the lowlands; before the First World War, the situation is reversed, life expectancy is higher in cities and in the lowlands. The fact that the hygienic-sanitarian measures in particular had their effect here is particularly suggested by the sharp decline in infant mortality. The lower decline in the Alpine and rural regions seems to confirm that hygiene practices and sanitation measures were implemented less quickly in those regions. For adults, progress in mortality is lower and regional differences smaller. The increasing economic differences between the regions do not seem to have an immediate impact on life expectancy and mortality risks in adulthood.

In this paper we analyse the development of life expectancy and mortality rates in the districts of Switzerland between 1888 and 1930. What influence did medical improvements and hygienic-sanitary reforms have on regional mortality rates? What was the role of better nutrition and economic modernisation in regional differences in mortality? And what influence did Switzerland's strongly federalist political system have on these developments? (Show less)

Daniel Gallardo Albarran : Cyclical Mortality and Sanitation in Germany, 1890-1913
A growing number of studies in the last two decades has analyzed the determinants of mortality during the late 19th and early 20th century. While there seems to be widespread agreement that water supply and sewerage systems improved the disease environment substantially, this literature has overlooked several aspects of sanitary ... (Show more)
A growing number of studies in the last two decades has analyzed the determinants of mortality during the late 19th and early 20th century. While there seems to be widespread agreement that water supply and sewerage systems improved the disease environment substantially, this literature has overlooked several aspects of sanitary investments that could shed new light on a variety of mechanisms of disease reduction. First, earlier studies have primarily focused on annual mortality without considering changing mortality patterns throughout the year across time and space. Second, the ‘traditional’ approach employing rough public health measures (e.g. availability, or lack thereof, of piped water) make identification difficult because they do not reflect the extent to which urban dwellers had access to public health infrastructures. And third, the estimation of average effects does not take into account that the effectiveness of water supply and sewerage systems may differ along socioeconomic, institutional and cultural dimensions. The present study contributes to fill these gaps by analyzing the German experience of large cities during the period 1890-1913. For this purpose, I am creating a new dataset with information on mortality by disease on a monthly basis, continuous variables of sanitary investments, and local characteristics that can interact with sanitation measures. (Show less)

Kota Ogasawara, Minami Yumitori : Pandemic In uenza and the Gender Imbalance: Evidence from Early Twentieth Century Japan
This study uses the 1918-1920 influenza pandemic in Japan with newly digitized
and complete census records on births, infant deaths, and sex ratios during childhood to analyze mortality selection in utero and its persistency in the gender imbalance.
We find that fetal exposure to pandemic influenza during the first trimester of the
pregnancy ... (Show more)
This study uses the 1918-1920 influenza pandemic in Japan with newly digitized
and complete census records on births, infant deaths, and sex ratios during childhood to analyze mortality selection in utero and its persistency in the gender imbalance.
We find that fetal exposure to pandemic influenza during the first trimester of the
pregnancy period decreased the proportion of males at birth in this period. We
then show that the decline in male births might have been associated with the
deterioration of fetal health due to pandemic influenza. Analyses using Population
Censuses provide evidence suggesting that postnatal influenza exposure had long-term
impacts on the sex ratio of children aged 5-12. (Show less)

Sakari Saaritsa, Eero Simanainen & Markus Ristola : It's the Nurses, Stupid! The Effectiveness of Early Health Professionals in Rural Finland, 1880-1938
This paper analyses the mortality effects of different types of early health professionals introduced in Finnish rural municipalities in 1880-1938 using a new panel data with c. 25 000 observations. Our results suggest that female ambulatory nurses had a more significant role in reducing overall mortality than doctors. The effectiveness ... (Show more)
This paper analyses the mortality effects of different types of early health professionals introduced in Finnish rural municipalities in 1880-1938 using a new panel data with c. 25 000 observations. Our results suggest that female ambulatory nurses had a more significant role in reducing overall mortality than doctors. The effectiveness of doctors depended on the proximity of the service involved, with resident municipal doctors showing an effect, but those shared between several municipalities or state hired regional doctors working in peripheral areas showing none. The value of working under the supervision of a doctor for a nurse likewise depended on the type of doctor. Controlling for local mortality trends removes all association of mortality decline with doctors, but not with nurses. Drawing on qualitative evidence, we explain this by the capacity of the nurses to influence behavior in communities, which mattered more than treatment or impersonal public information campaigns in the pre-biomedical context. (Show less)



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